Felty's syndrome: response to low dose oral methotrexate.
We describe a case of Felty's syndrome with persistent severe neutropenia below 200 granulocytes/mm3, splenomegaly and repeated infections. The patient did not respond to treatment with intramuscular gold salts and lithium carbonate. After 2 months of oral methotrexate administration, 7.5 mg weekly, clinical improvement was notable: she remained afebrile, neutropenia disappeared and splenomegaly regressed. This clinical and laboratory improvement persisted 5 months later. Moreover, accidental discontinuance of the drug and later readministration supported the evidence that the improvement was due to methotrexate.
Isasi
C
C
Servicio de Reumatología, Clínica Puerta de Hierro, Madrid, Spain.
López-Martín
J A
JA
Angeles Trujillo
M
M
Andreu
J L
JL
Palacio
S
S
Mulero
J
J
D000284:Administration, Oral; D001172:Arthritis, Rheumatoid / Q000150:complications; D004351:Drug Resistance; D005258:Felty Syndrome / Q000150:complications / Q000188:drug therapy*; D005260:Female; D006046:Gold / Q000627:therapeutic use; D006801:Humans; D008094:Lithium / Q000627:therapeutic use; D016651:Lithium Carbonate; D008727:Methotrexate / Q000627:therapeutic use*; D008875:Middle Aged
D016651:Lithium Carbonate; D006046:Gold; D008094:Lithium; D008727:Methotrexate