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- Felty's syndrome facts
- What is Felty's syndrome?
- What causes Felty's syndrome?
- What are risk factors for Felty's syndrome?
- What are the signs and symptoms of Felty's syndrome?
- How do doctors diagnose Felty's syndrome?
- What specialists treat Felty's syndrome?
- What is the treatment for Felty's syndrome? What are complications of Felty's syndrome?
- Are there home remedies for Felty's syndrome?
- What is the prognosis of Felty's syndrome?
- Is it possible to prevent Felty's syndrome?
Felty's syndrome facts
- Felty's syndrome is a complication of long-standing rheumatoid arthritis.
- Patients with Felty's syndrome can have more infections than the average person and can develop leg ulcers.
- The cause of Felty's syndrome is not known.
- Felty's syndrome is diagnosed by the presence of three conditions: rheumatoid arthritis, an enlarged spleen, and an abnormally low white blood count.
- Treatment of Felty's syndrome is not always required, but medications are used for serious manifestations.
What is Felty's syndrome?
Felty's syndrome is a complication of long-standing rheumatoid arthritis. Felty's syndrome is defined by the presence of three conditions: rheumatoid arthritis, an enlarged spleen (splenomegaly), and an abnormally low white blood cell count. Felty's syndrome is uncommon. It affects less than 1% of patients with rheumatoid arthritis.
What causes Felty's syndrome?
The cause of Felty's syndrome is not known. Some patients with rheumatoid arthritis develop Felty's syndrome, but most do not. White blood cells are produced in the bone marrow. There seems to be an active bone marrow function in patients with Felty's syndrome, producing white cells, despite the low numbers of circulating white blood cells (neutropenia). White cells may be stored excessively in the spleen of a patient with Felty's syndrome. This is especially true in patients with Felty's syndrome that have antibodies against the particular type of white blood cells usually affected (cells called granulocytes or neutrophils).
What are risk factors for Felty's syndrome?
The risk factor for Felty's syndrome is having rheumatoid arthritis.
What are the signs and symptoms of Felty's syndrome?
Some patients with Felty's syndrome have more infections, such as pneumonia or skin infections, than the average person. This increased susceptibility to infections is attributed to the low white blood counts that are characteristic of Felty's syndrome. Ulcers in the skin over the legs can complicate Felty's syndrome.
How do doctors diagnose Felty's syndrome?
There is no single test for Felty's syndrome. Physicians diagnose Felty's syndrome based on the presence of rheumatoid arthritis, an enlarged spleen (splenomegaly), and an abnormally low white blood cell count. Most patients do have rheumatoid arthritis antibodies (rheumatoid factor) in the blood and are referred to as having seropositive rheumatoid arthritis.
What specialists treat Felty's syndrome?
Felty's syndrome is treated by internists, rheumatologists, and hematologists.
What is the treatment for Felty's syndrome? What are complications of Felty's syndrome?
Treatment of Felty's syndrome is not always required. The underlying rheumatoid arthritis is managed in the standard fashion. Treatments used for patients with recurring infections, active arthritis, or ulcer in the legs include rheumatoid disease modifying drugs, such as methotrexate (Rheumatrex, Trexall) and azathioprine (Imuran). Patients with severe infectious diseases may benefit by weekly injections with a stimulating factor (granulocyte stimulating factor/GSF) that acts to increase the amount of white blood cells. Surgical removal of the spleen has been performed for the same reasons but has not been evaluated by long-term research studies.
What is the prognosis of Felty's syndrome?
The prognosis of Felty's syndrome is generally very good. The best outcomes are a result of consistent monitoring and doctor-patient interaction.
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Firestein, Gary S., et al. Kelley's Textbook of Rheumatology, 9th Edition. Philadelphia, PA: Saunders, 2013.
Top Felty's Syndrome Related Articles
auranofinAuranofin (Ridaura) is a gold-containing chemical (salt) prescribed for the treatment of rheumatoid arthritis, juvenile rheumatoid arthritis, psoriatic arthritis, and Felty's syndrome. Review side effects, dosage, warnings and precautions, drug interactions, and pregnancy safety information prior to taking any medication.
aurothioglucoseAurothioglucose (Solganal) is a medications prescribed for the treatment of rheumatoid arthritis, juvenile rheumatoid arthritis, and Felty's syndrome. Side effects, drug interactions, warnings and precautions, and patient information should be reviewed prior to taking any medication.
aurothiomalateGold sodium thiomalate; aurothiomalate (Myochrysine) is a drug prescribed for the treatment of adult and juvenile rheumatoid arthritis, psoriatic arthritis, and Felty's syndrome. Review side effects, drug interactions, warnings and precautions, and patient information prior to taking any medication.
azathioprineAzathioprine (Imuran, Azasan) is a drug prescribed for prevention of organ rejection in kidney transplants. Off label uses for azathioprine (Imuran, Azasan) include rheumatoid arthritis, multiple sclerosis, Crohn's disease, myasthenia gravis, ulcerative colitis, and autoimmune hepatitis. Side effects, drug interactions, and safety during pregnancy information should be reviewed prior to taking this drug.
CAT ScanA CT scan is an X-ray procedure that combines many X-ray images with the aid of a computer to generate cross-sectional and three-dimensional images of internal organs and structures of the body. A CT scan is a low-risk procedure. Contrast material may be injected into a vein or the spinal fluid to enhance the scan.
Enlarged SpleenAn enlarged spleen or splenomegaly, is generally caused by other diseases or conditions such as infections, cancers, blood disorders, or decreased blood flow. Symptoms of an enlarged spleen are often unnoticed. A feeling of fullness after eating a small amount of food and not being able to eat large meals may be a symptom of an enlarged spleen. Treatment for an enlarged spleen depends upon the cause.
Liver BiopsyLiver biopsy is a procedure used to remove a small piece of liver tissue for examination for signs of disease or damage to the liver. Preparation for liver biopsy includes discontinuing certain medications. The techniques used to perform liver biopsy include percutaneous liver biopsy, transvenous liver biopsy, and laparoscopic liver biopsy. Recovery from liver biopsy are generally one to two days. Certain risks are associated with liver biopsy.
Methotrexate (Rheumatrex, Trexall) is a drug prescribed to treat cancer, psoriasis, inflammatory diseases of the skin, arthritis (rheumatoid arthritis in adults and children), psoriatic arthritis, polymyositis, lupus, and to induce miscarriage in women with ectopic pregnancies. Side effects drug interactions, dosage, and pregnancy safety information should be reviewed prior to taking this drug.
Neutropenia is a marked decrease in the number of neutrophils, neutrophils being a type of white blood cell (specifically a form of granulocyte) filled with neutrally-staining granules, tiny sacs of enzymes that help the cell to kill and digest microorganisms it has engulfed by phagocytosis.
Signs and symptoms of neutropenia include gum pain and swelling, skin abscesses, recurrent ear and sinus infections, sore mouth, low-grad fever, pneumonia-like symptoms, and pain and irritation around the rectal area.
Neutropenia has numerous causes, for example, infections (HIV, TB, mono); medications (chemotherapy); vitamin deficiencies (anemia); bone marrow diseases (leukemias), radiation therapy, autoimmune destruction of neutrophils, and hypersplenism.
Treatment of neutropenia depends upon the cause and the health of the patient.
penicillaminePenicillamine (Cuprimine, Depen) is an antirheumatic drug prescribed for the treatment of:
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Rheumatoid ArthritisRheumatoid arthritis (RA) is an autoimmune disease that causes chronic inflammation of the joints, the tissue around the joints, as well as other organs in the body. Because it can affect multiple other organs of the body, rheumatoid arthritis is referred to as a systemic illness and is sometimes called rheumatoid disease. The 16 characteristic early RA signs and symptoms include the following.
- Both sides of the body affected (symmetric)
- Joint deformity
- Joint pain
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- Joint stiffness
- Joint swelling
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- Loss of joint function
- Loss of joint range of motion
- Many joints affected (polyarthritis)
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Rheumatoid FactorRheumatoid factor is often measured in blood tests for the diagnosis of rheumatoid arthritis. However, rheumatoid factor can also be present in individuals with other conditions such as lupus, infectious hepatitis, syphilis, mononucleosis, tuberculosis, liver disease, and sarcoidosis.
UltrasoundUltrasound (and ultrasonography) is imaging of the body used in the medical diagnosis and screening of diseases and conditions such as:
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- heart disease,
- kidney stones,
- liver disease,
- diseases of the female reproductive, and
- diseases of the male reproductive organs.