Felty syndrome

Definition

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

Causes, incidence, and risk factors

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

Signs and tests

A physical examination shows an swollen spleen and possibly a swollen liver and lymph nodes. Joints may show signs of rheumatoid arthritis.

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

An ultrasound of the belly area (abdomen) may confirm a swollen spleen.

Treatment

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

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

Expectations (prognosis)

Progression of rheumatoid arthritis is likely.

Complications

Recurrent infections may develop.

Calling your health care provider

Call for an appointment with your health care provider if symptoms of this disorder develop.

Prevention

There is no known prevention.

References

Harris ED, Budd RC, Genovese MC, Firestein GS, Sargent JS, Sledge CB. Kelley's Textbook of Rheumatology. 7th ed. St. Louis, Mo: WB Saunders; 2005:1101-1103.

Feldman M, Friedman LS, Sleisenger MH, eds. Sleisenger & Fordtran’s Gastrointestinal and Liver Disease. 7th Ed. Philadelphia, PA: WB Saunders; 2002:1615-1616.