Treatment of Felty's syndrome with leflunomide

Felty's syndrome (FS) is a rare manifestation of severe rheumatoid arthriti s (RA). It is an immune mediated inflammatory process, usually treated with standard disease modifying antirheumatic drugs. We describe a case of seve re FS that developed in a patient receiving methotrexate therapy for RA. Tr eatment with etanercept resulted in severe allergic cutaneous reactions. Th e patient subsequently responded to treatment with leflunomide. The respons e included dramatic improvement of leukopenia and neutropenia as well as ex cellent control of his arthritis, Leflunomide has recently been used effect ively for the treatment of RA and may be useful for the management of patie nts with FS.