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Anti-tumour necrosis factor (TNF) α treatment has had a tremendous effect on the managment of rheumatoid arthritis, but it needs to be monitored closely. Guidelines state that haematological complications are rare, so regular full blood counts are not recommended.1,2 We noticed that a minority of our patients with rheumatoid arthritis receiving anti-TNF treatment developed neutropenia (<2×109/l). Table 1 summarises the demographics of 133 patients with rheumatoid arthritis. Of these, 14.3% of patients had at least one episode of neutropenia, with no obvious cause other than the anti-TNF treatment. The lowest neutropenic episodes had counts that ranged from 1.02 to 1.94 (8/19 patients had an episode with counts <1.5). The time period …
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