[Treatment of Felty's syndrome accompanied by agranulocytosis using high-dose corticoids. 3 cases].

Three cases of severe Felty's syndrome (neutrophils 80/mm3 in 2 cases and 800/mm3 in one) with enlarged spleen (1 case) and leg ulcer (2 cases) were treated with high doses of corticosteroids (methylprednisolone 1 g by intravenous infusion over 3 hours, on 3 consecutive days). In all 3 patients a dramatic result was obtained, the granulocytes returning to normal values in 24 to 48 hours. In 2 cases, an early relapse (1 month) required a second course in high dosage; after a follow-up of 36 and 8 months respectively, the number of granulocytes remains stable under prednisone 5 to 10 mg/day. The third patient was improved by one single course of infusions and remains stable after 18 months. It must be noted that one patient had previously been treated with plasma exchange and another with corticosteroids without any significant result.