In a newly diagnosed RA patient, which finding would be most suggestive of Felty's Syndrome?

• A. Hepatomegaly
• B. Splenomegaly
• C. Cardiomegaly
• D. Anemia

Answer: (B)

Felty syndrome is rheumatoid arthritis with neutropenia and splenomegaly; the enlarged spleen traps neutrophils, leading to low neutrophil counts and a higher risk of infections. In a patient newly diagnosed with RA, splenomegaly most strongly points to Felty's because splenic enlargement is a defining feature of the syndrome. Hepatomegaly can occur in various conditions and is not as specific, anemia can be present due to hypersplenism or chronic disease but is less characteristic on its own, and cardiomegaly is not associated with Felty's. So the finding of splenomegaly best signals Felty's syndrome.