THOUGH Felty's original description of the syndrome consisting of rheumatoid arthritis, splenomegaly, and leucopenia was published in 1924,1 it was not until 1932 that hematologic remission following splenectomy was first reported by Hanrahan.2 Since then, 46 cases subjected to splenectomy have appeared in the literature. In 37 of these the leucopenia was relieved.3 The rheumatic manifestations, however, have been alleviated inconstantly by the procedure.
The use of the steroid hormones in this disease had been reported only three times prior to the time of this case.* In all of these hematologic and rheumatic remissions were obtained. Normal white cell and differential counts were obtained together with regression of the splenomegaly in each case. However, after cessation of hormone therapy leucopenia, splenomegaly, and arthritic manifestations recurred.
The case herein reported is unusual because of the failure of hematologic response to cortisone with subsequent success following splenectomy.