My wife 33 was dignosed with RA 5 years ago, for almost 2 years she was treated methotretate, prednisone, plaquenil, but the joint pains were not going away, She quit these meds and started to treat her thyroid as she had many symptoms of hypothyrodism.Her joint pains greatly improved and she is still on the thyroid meds today, but still has a very high rheumothoid factor count. During this time whole her white blood count was droping, 2 years ago it was as low as 2.0 and enlarged spleen was diagnosed. Bone marrow biopsy was preformed but no abnormalities were found. Today she is neutropenic with wbc as low as 1.5 and neuthrophil level around 500, but does not catch infections. During the last couple of years her blood levels normalized during pregnancy but droped very low in the last weeks of pregnancy. Also in the past she received neupogen shots which brought the levels higher for periods of time before they droped again. She was checked for hiv, verious infections and bacterias and doctors did not find anything. Today her spleen is much larger than in the past 19 cm,low wbc 1.5,high rheumothoid factor, doctors suspect feltys syndrome as a result of the auto immune disease, my question is if any of the doctors ever had this kind of case and what is her best options at this point??? She does not catch infections, has a sligthly elevated temp last couple of weeks but again docs think its from the autoimmune, thank you for any help.