Felty’s Syndrome: Causes, Symptoms, Treatment- Azathioprine, Methotrexate, Surgery

Felty’s syndrome is a rare disease which is usually associated with reduced white blood cell count, recurring infections, rheumatoid arthritis and a swollen spleen. Felty’s syndrome is a result of combination of neutropenia, leukopenia, splenomegaly and rheumatoid arthritis.

Felty's Syndrome

Felty’s syndrome is a condition which often occurs in individuals who suffer with rheumatoid arthritis for prolonged period, which not only results in joint erosion, but may also cause rheumatoid nodules.

In some cases just having an enlarged spleen does not mean that the patient is suffering with the condition of Felty’s syndrome. Many individuals suffering with Felty’s syndrome may have high levels of rheumatoid factor, which usually result in severe kind of the disease.

A physical examination indicating an enlarged spleen, swollen lymph nodes and enlarged liver may implicate toward Felty’s syndrome. An ultrasound of the abdomen helps in verifying the swollen spleen. Blood tests may show a reduced number of white blood cells or neutrophils.

Felty's syndrome

Epidemiology of Felty’s Syndrome

More than one percent of individuals with rheumatoid arthritis suffer with Felty’s syndrome. Felty’s syndrome is more frequent in individuals suffering with rheumatoid arthritis for about 10 years of duration. In the course of rheumatoid arthritis, men get affected with Felty’s syndrome earlier when compared to women. Women are three times more prone to Felty’s syndrome when compared to men. Whites more commonly get affected with Felty’s syndrome than blacks.

Presently, a decline is seen in the incidence of Felty’s syndrome with evolution of better and more effective treatment for rheumatoid arthritis.

Causes and Risk Factors of Felty’s Syndrome

Felty's Syndrome

The exact cause of Felty’s syndrome is unknown. However, patients suffering with rheumatoid arthritis may develop this condition, but this could not be taken as the definite cause in all of the cases. The production of white blood cells is carried out in the bone marrow. Decreased circulation of white blood cells may result in Felty’s syndrome, but this does not affect the active functioning of the bone marrow. In Felty’s syndrome, excess white blood cells get stored up in the spleen. This is especially seen in patients who have antibodies developed in their body against a specific type of white blood cells.

Signs and Symptoms of Felty’s Syndrome

Treatment for Felty’s Syndrome

Felty’s syndrome treatment is not always necessarily required. The underlying cause for Felty’s syndrome that is rheumatoid arthritis needs to be managed in the best possible way. Rheumatoid disease modifying drugs like azathioprine and methotrexate help in treating the patients suffering with active arthritis, ulcer in the legs and recurrent infections. Weekly injections with granulocyte stimulating factor are used in severe infectious diseases. These injections often help in increasing white blood cells count.

Surgery for removal of the spleen may be done in some of the cases.

Investigations for Felty’s Syndrome

A complete subjective and physical examination is performed to diagnose Felty’s syndrome. Joints exhibiting rheumatoid arthritis, probably swollen liver and lymph nodes and swollen spleen may indicate toward Felty’s syndrome.

Tests For Diagnosing Felty’s Syndrome May Include:

Pramod Kerkar, M.D., FFARCSI, DA
Pramod Kerkar, M.D., FFARCSI, DA
Written, Edited or Reviewed By: Pramod Kerkar, M.D., FFARCSI, DA Pain Assist Inc. This article does not provide medical advice. See disclaimer
Last Modified On:July 2, 2021

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