This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: Immune system, Subject name: Medicine
Which of the following is true about felty&;s syndrome? 
Select and explain. 
A. More common in males, B. Occurs in early phase of disease, C. RA, lymphopenia, splenomegaly, D. Associated with high titres of RF
D: Associated with high titres of RF
Answer: D: Associated with high titres of RF 
Explanation: Felty's syndrome defined by the clinical triad of neutropenia, splenomegaly, and nodular RA and is seen in less than 1% of patients. It typically occurs in the late stages of severe RA and is more common in whites than other racial groups. T cell large granular lymphocyte leukemia (T-LGL) may have a similar clinical presentation and often occurs in association with RA. Ref: Harrison&;s Principles of Internal Medicine; 20th edition; Chapter 380 Rheumatoid Ahritis; Page no: 2138