The variable features of Felty's syndrome: Review of the literature, and report of a case with massive splenomegaly

Abstract A patient with advanced rheumatoid arthritis, massive splenic enlargement and recurrent infections is described. Initially it was thought that the patient had a hematologic malignancy because of the unusually large size of the spleen. However, careful evaluation revealed hypersplenism of the neutropenic type. The patient underwent splenectomy with a favorable hematologic and clinical response. The size of the spleen proved to be the largest recorded in an uncomplicated case of Felty's syndrome. The literature is reviewed with emphasis on the variable features and the response to splenectomy in this syndrome.