Severe HSV1 pneumonia and EBV enteritidis in a patient with Felty syndrome and ulcerative colitis

Abstract

Background: Felty syndrome (FS), as a rare syndrome, primarily presents as splenomegaly and neutropenia in the context of rheumatoid arthritis (RA).although Inflammatory bowel disease and rheumatoid arthritis are both autoimmune diseases, they only appear together in rare cases.Herpesviruses can be activated in this pathological process, thereby precipitating associated infections, including severe herpes simplex virus type 1(HSV1) pneumonia, and Epstein-Barr virus (EBV) enteritidis in our case. Case presentation: Here, we report a case illustrating the rapid deterioration of FS following the discontinuation of prednisone andmethotrexate. During the course, this patient exhibited fever, diarrhea, cold sores, and finally be dignosed severe HSV1 pneumonia, cheilitis, EBV enteritidis and ulcerative colitis. Conclusions: In patients with rheumatoid arthritis, sudden cessation of anti rheumatic drugs may induce Felty syndrome, which in turn can induce the activation of herpesvirus in the body, leading to a series of herpesvirus related infections, such as ,cheilitis, pneumonia and enteritis. Early intravenous use of sufficient antiviral drugs and timely initiation of antirheumatic drugs may be a more appropriate solution.