Hi, Thanks for asking. Based on your query, my opinion is as follows. 1. Possible syndrome or genetic cause. 2. Test details necessary for full opinion. You are at present having pancytopenia, due to marrow depression. 3. Bone marrow biopsy is necessary to evaluate the cause. Feltys syndrome is one of the common causes of neutropenia with rheumatoid arthirits manifestations. More details necessary. Hope it helps. Any further queries, happy to help again.