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Felty’s syndrome (FS) is an uncommon extra-articular manifestation of rheumatoid arthritis (RA). It is more prevalent among women around 60 with a long history of severe articular disease, positive rheumatoid factor, and who carry the HLA-DR4 allele.1 Felty’s syndrome has a poor prognosis, with an increased mortality due to a higher incidence of severe infection.2 We describe a patient with seropositive, erosive RA and history of extra-articular manifestations, including vasculitis and FS. Treatment with etanercept gradually decreased the neutrophil count over 20 months. Discontinuation of etanercept and initiation of methotrexate was followed by a dramatic and sustained improvement of neutrophil count.
CASE REPORT
A 75 year old white woman with a 19 year history of seropositive RA with extra-articular manifestations including mononeuritis multiplex (1998) and at least a 4 year history of …