The Diagnosis Felt(y) Right: A Case Report of Felty Syndrome With Limited Articular Involvement

We present a case of a 56-year-old female patient who presented to the emergency department with a one-day history of fever and confusion. She was found to have splenomegaly, multiple swan neck deformities, and pancytopenia. Chart review revealed that she had a three-year history of pancytopenia with two prior non-diagnostic bone marrow biopsies. Rheumatoid factor and cyclic citrullinated peptide antibody levels were elevated. The patient was ultimately diagnosed with Felty’s syndrome (FS). Felty’s syndrome is characterized by neutropenia, splenomegaly, and rheumatoid arthritis. This disease usually presents years after a diagnosis of rheumatoid arthritis is made. The neutropenia associated with Felty's syndrome can lead to life-threatening infections and therefore must be recognized so that the underlying cause of immunosuppression can be addressed.