A 24-year-old woman with rheumatoid arthritis involving the sacroiliac joint and fingers is noted to have splenomegaly and neutropenia (Felty's syndrome). She is advised to have splenectomy, but she should be informed that

Felty's syndrome is characterized by splenomegaly, neutropenia, and rheumatoid arthritis. Steroids are used initially, but their effect usually is transient. Splenectomy favorably alters the leukocyte count; it does not alter the clinical course of rheumatoid arthritis. As with all patients undergoing elective splenectomy, this patient must be given pneumovax, as well as Hemophilus and meningococcal vaccines before surgery.