Felty syndrome is a rare hematological syndrome in rheumatoid arthritis.
It is thought to occur in ~ 1% of patients with rheumatoid arthritis 2.
Felty syndrome comprises of the triad of:
- typically with severe articular and extra-articular disease
Additionally, patients may have bicytopaenia or pancytopaenia, recurrent bacterial infections, and non-cirrhotic portal hypertension.
- rheumatoid factor (RF): >95% of patients are positive 5
- antinuclear antibody (ANA): 47-100% are positive 5
- HLA-DR4*0401 antigen: 78% of patients have the antigen 5
- large granular lymphocyte (LGL) expansion: ~ 30% of patients may have it 5
Treatment and prognosis
Treatment is through immunosuppression to treat Felty syndrome and rheumatoid arthritis, such as use of methotrexate and rituximab 6. If frequent severe bacterial infections, G-CSF may be administered 6.
History and etymology
It is named after Augustus Roi Felty (1895 -1964), an American physician 1.
- 1. Felty AR. Chronic arthritis in the adult, associated with splenomegaly and leucopenia. A report of 5 cases of an unusual clinical syndrome. Bulletin of the Johns Hopkins Hospital, Baltimore, 1924, 35: 16.
- 2. Shih WJ, Domstad PA, Li CY, DeLand FH, Maruyama Y. Radiocolloid scintigraphy in Felty's syndrome. (1986) AJR. American journal of roentgenology. 147 (1): 181-3. doi:10.2214/ajr.147.1.181 - Pubmed
- 3 Jain T, Mittal C, Sengupta R, Rubin B. Non-articular Felty's syndrome: An uncommon diagnosis. The Netherlands journal of medicine. 73 (9): 435-6. Pubmed
- 4. Rozin A, Hoffman R, Hayek T, Balbir-Gurman A. Felty's syndrome without rheumatoid arthritis?. Clinical rheumatology. 32 (5): 701-4. doi:10.1007/s10067-012-2157-3 - Pubmed
- 5. Balint GP, Balint PV. Felty's syndrome. Best practice & research. Clinical rheumatology. 18 (5): 631-45. doi:10.1016/j.berh.2004.05.002 - Pubmed
- 6. Liu X, Loughran TP. The spectrum of large granular lymphocyte leukemia and Felty's syndrome. (2011) Current opinion in hematology. 18 (4): 254-9. doi:10.1097/MOH.0b013e32834760fb - Pubmed