Felty’s syndrome
Felty’s syndrome is potentially serious condition characterized by triad of rheumatoid arthritis, splenomegaly and abnormally low white blood count.
The cause to felty’s syndrome is still unknown .But believed that, some patients with rheumatoid arthritis for a long time developed this condition. Some research show that splenomegaly and low white cell count is due to splenic sequestration and autoimmune coated granulocyte destruction.
What are symptoms of Felty’s syndrome?
Although many patients with Felty’s syndrome are asymptomatic, some develop serious and life-threatening infections secondary to granulocytopenia. Common symptoms are:
- Painful, stiff, and swollen joints, most commonly in the joints of the hands, feet, and arms
- mild involvement to severe with deformity and erosion of the joints
- firm, non-tender spleen
- Massive splenomegaly
- splenic rupture, portal hypertension with esophageal varices(few patients)
- mild hepatomegaly is common
- Recurrent serious infections likes skin infection, respiratory tract infections and urinary tract infections
- some get oral ulcers, sinusitis, otitis media, osteomyelitis, and septic arthritis
- rheumatoid nodules
- Sjogren’s Syndrome
- Weight loss
- Skin pigmentation
- Leg ulcer mostly occur over the tibias and ankles
- Pericarditis
How is Felty’s syndrome diagnosed?
Felty’s syndrome is diagnosed by patient’s history, physical examination and lab tests.
Lab tests shows:
- Low neutrophil
- Present of anemia with increased reticulocyte count.
- low palates count
- High titers of RF.
- Present of antinuclear antibodies(ANAs)
- increased erythrocyte sedimentary rate (ESR)
How is Felty’s syndrome treated?
Treatment of Felty’s syndrome is not always required. Immunosuppressive therapy for RA often improves granulocytopenia and splenomegaly. The management of rheumatoid arthritis is managed in the standard fashion like NSAIDs and steroids. If 1st line treatment failed than Second-line” or “slow-acting” drugs by disease-modified anti-rheumatic drugs like Hydroxychloroquine, Methotrexate, Gold salt is required. Patients with infection required antibacterial, antiviral or antifungal drugs. Splenectomy is recommended only in patients with severe intractable disease who exhibit no improvement with medical therapy and experience recurrent or serious infection.
Related posts:
