Severe pancytopenia and splenomegaly associated with felty's syndrome, both fully responsive solely to corticosteroids

Key Clinical Message In severe cases of pancytopenia with subsequent infections due to long‐term untreated Felty's syndrome, the initiation of immunosuppressive treatment with sole prednisone (1 mg/kg iv) should be considered, despite that, the low neutrocytes count would make one physician hesitant. A full resolution of whole blood count within 3 weeks and a 30% reduction in spleens sized was noted.