Felty's Syndrome : Symptoms and Treatment

Felty Syndrome - variant of the rheumatoid arthritis with a significant suppression of immunity.

Features of development and manifestation of Felty's syndrome.

Felty syndrome is more common in patients older than 40 years, usually in women.It is believed that the basis of Felty's syndrome is an autoimmune process that occurs in a process involving lymphoid tissue (lymph nodes and spleen), with the formation of immune complexes, antibodies and inhibition funktsiikostnogo marrow leukocytes.This is manifested in the form of neutropenia with decreased resistance to infections, and when they occur - in their heavy course.Therefore, in some cases, splenectomy is the only effective method of treatment.

The disease is characterized by great diversity, often atypical.At the same time the emergence of Felty syndrome is often preceded by several years of disease rheumatoid arthritis, mainly affecting interphalangeal joints of varying degrees of severity.

At the same time the majority of patients with Felt

y's syndrome are common (systemic) manifestations of connective tissue: it can be subcutaneous nodules, and fever, and muscle atrophy, and myocarditis, and poliserozita and polyneuropathy, widespread lymphadenopathy, weight loss.

The most common manifestations of Felty's syndrome.

  • articular syndrome - a polyarthritis of small peripheral joints,
  • progressive enlargement of the spleen (more than four times) - its lower pole can reach the level of the navel and determined by palpation, but in some cases, enlargement of the spleen is a late sign,
  • generalized lymphadenopathyIt found 50%.
  • enlargement of the liver, rarely - portal hypertension,
  • dark pigmentation of the exposed parts of the body, ulcers on the legs,
  • rheumatoid nodules, Sjogren's syndrome,
  • polyneuropathy,
  • diffuse pulmonary fibrosis and other vistseropatii.

Complications are rare and may occur as a ruptured spleen, heavily occurring secondary infections, the formation of portal hypertension, gastrointestinal bleeding, development of non-Hodgkin's lymphoma.

Felty syndrome Diagnostics

  • Blood: decrease in the number of white blood cells, hypochromic anemia, thrombocytopenia, eosinophilia.
  • bone marrow puncture: a decrease in the number of mature forms of neutrophils, the increase in the number of plasma cells.
  • Blood serum: the presence of rheumatoid factor, elevated gamma globulin, transaminases and alkaline phosphatase,
  • ultrasound of the abdomen - enlarged liver and spleen (hepatosplenomegaly), portal hypertension, ascites.

Basic principles of treatment of Felty syndrome

  • glucocorticoids and cytostatics
  • For the treatment of rheumatoid arthritis in some cases, drugs are shown gold
  • Splenectomy - removal of the spleen after failure of conservative therapy.
  • Symptomatic therapy and prevention of complications.

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