Reactivation of rheumatoid arthritis and development of leukocytoclastic vasculitis in a patient receiving granulocyte colony-stimulating factor for Felty's syndrome

Abstract

Patients with Felty’s syndrome, the combination of rheumatoid arthritis, splenomegaly, and neutropenia, have increased susceptibility to bacterial infections. The patients are usually b-elated with steroids or splenectomy. Granulocyte-macrophage colony-stimulating factor (GM-CSF)1-6 and granulocyte colony-stimulating factor (G-CSF)5g have been reported to correct the neutropenia of Felty’s syndrome. Both drugs have also been reported to exacerbate inflammatory diseases such as vasculitis,loJ1 but to our knowledge, only GM-CSF has been reported to cause arthritis flare-up in palzients with Felty’s syndrome. 1,12 This report describes reactivation of previously inactive arthritis and development of leukocytoclastic vasculitis in a patient with Felty’s syndrome treated with G-CSF.