Abstract
A 52-year-old woman was admitted to our hospital in December 1989 because of polyarthritis which involved her bilateral wrists, finger joints, shoulders, right knee and ankle. In 1982, she developed myasthenia gravis and hyperthyroidism. She received thymectomy and partial thyroidectomy in 1985, which made her free of symptoms without any medication. She began to suffer from polyarthralgia with morning stiffness in May 1989. Her rheumatoid factor was positive and X rays of the joints showed bony erosion. Furthermore, leukocytepenia (1, 200-2, 200/mm3) and splenomegaly was also noted, therefore, she was diagnosed as Felty's syndrome. Although titer of the anti-acetylcholine receptor antibody was high, she showed no symptoms of myasthenia gravis. Oral methotrexate (7.5 mg/week) and prednisolone (10mg/day) improved her polyarthritis, but the leukocyte count still remained under 3, 000/mm3. A combination of these diseases was rare and this case seemed to be of interest in considering the variety of the overlap of autoimmune diseases.
