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Rituximab is Useful in the Treatment of Felty's Syndrome

Chandra, Preeti A MD1*; Margulis, Yevgeniya MD2; Schiff, Carl MD2

American Journal of Therapeutics: July/August 2008 - Volume 15 - Issue 4 - pp 321-322
doi: 10.1097/MJT.0b013e318164bf32
Case Report

Felty's syndrome is regarded as a severe variant of rheumatoid arthritis (RA) that develops in less than 1% of patients with RA. It consists of a triad of RA, splenomegaly, and leukopenia, which tends to develop after a long course of RA. Treatment of neutropenia is mainly comprised of disease-modifying antirheumatic drugs including methotrexate, hydroxychloroquine, auronofin, penicillamine, glucocorticoids, and granulocyte monocyte colony stimulating factor. Recently, there has been a growing interest in the biologic agent rituximab in the treatment of Felty's syndrome. To our knowledge, only one previous case of rituximab being beneficial in the treatment of Felty's syndrome has been reported. We report the case of a 60-year-old man with Felty's syndrome in whom treatment with rituximab led to a sustained neutrophil response and marked symptomatic improvement in the form of decrease in the size of rheumatoid nodules and better pain control.

Departments of 1Internal Medicine and 2Rheumatology, Maimonides Medical Center, Brooklyn, NY.

*Address for correspondence: Maimonides Medical Center, Department of Medicine, 4802 Tenth Avenue, Brooklyn, NY 11219. E-mail:

© 2008 Lippincott Williams & Wilkins, Inc.