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Felty syndrome

Felty syndrome is a disorder that involves rheumatoid arthritis, a swollen spleen, decreased white blood cell count, and repeated infections. It is rare.

Causes

The cause of Felty syndrome is unknown. It is more common in people who have had rheumatoid arthritis for a long time. People with this syndrome are at risk of infection because they have a low white blood cell count.

Symptoms

  • General feeling of discomfort (malaise)
  • Fatigue
  • Loss of appetite
  • Unintentional weight loss
  • Pale-looking skin
  • Joint swelling, stiffness, pain, and deformity
  • Recurrent infections
  • Eye burning or discharge

Exams and Tests

A physical exam will show:

  • Swollen spleen
  • Joints that show signs of rheumatoid arthritis
  • Possibly swollen liver and lymph nodes

A complete blood count ( CBC) may show a lower number of white blood cells called neutrophils.

An abdominal ultrasound may confirm a swollen spleen.

Treatment

Persons with this syndrome are usually already receiving treatment for rheumatoid arthritis. They may need other medicines to suppress their immune system.

Methotrexate may improve the low white blood cell count.

Some people benefit from removal of the spleen (splenectomy).

Outlook (Prognosis)

Infections may continue to occur.

Rheumatoid arthritis is likely to get worse.

Possible Complications

You may have infections that keep coming back.

When to Contact a Medical Professional

Call your health care provider if you develop symptoms of this disorder.

Prevention

Prompt treatment of rheumatoid arthritis may decrease the risk of developing Felty syndrome.

References

Sweeney SE, Harris ED, Firestein GS. Clinical features of rheumatoid arthritis. In: Firestein GS, Budd RC, Gabriel SE, et al, eds. Kelley's Textbook of Rheumatology. 9th ed. Philadelphia, Pa: Saunders Elsevier; 2012:chap 70.

Update Date: 4/20/2013

Updated by: Gordon A. Starkebaum, MD, Professor of Medicine, Division of Rheumatology, University of Washington School of Medicine. Also reviewed by A.D.A.M. Health Solutions, Ebix, Inc., Editorial Team: David Zieve, MD, MHA, Bethanne Black, Stephanie Slon, and Nissi Wang.

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