In addition, affected individuals may have abnormally low levels of circulating red blood cells (anemia), a decrease in circulating blood platelets that assist in blood clotting functions (thrombocytopenia), abnormal liver function tests and/or inflammation of the blood vessels (vasculitis). Complications
Recurrent infection
Enlargement of the spleen causing too few red blood cells and platelets in the bloodstream
Enlarged lymph nodes
Skin hyperpigmentation
Cutaneous ulceration

Causes
The cause of Feltys syndrome is unknown, but it has been found to be more common in those with chronic rheumatoid arthritis. Some patients share the HLA-DR4 serotype. This syndrome is mostly present in people having extra articular manifestations of rheumatoid arthritis. People with this syndrome are at risk of infection because they have a low white blood cell count. Mechanism
The underlying pathogenesis of Feltys syndrome is not clear. Rheumatoid Arthritis
Rheumatoid arthritis is an autoimmune disease that is characterized by inflammation of the synovial joints due to attack by the bodys own immune system. In this condition, the white blood cells travel through the bloodstream to the synovial joints and release pro-inflammatory cytokines upon arrival. The result of this chemical release causes the synovial cells to release harmful chemicals in response as well as begin the growth of new blood vessels, forming a pannus. The pannus receives blood supply from the newly formed vessels and grows inward, invading the articular cartilage and bone within the joint. The damage to the once healthy tissue causes inflammation and ultimately fluid build-up in the joint.
No well-conducted, randomized, controlled trials support the use of any single agent. Most reports on treatment regimens involve small numbers of patients.Splenectomy may improve neutropenia in severe disease. Use of rituximab and leflunomide have been proposed. Use of gold therapy has also been described. Prognosis
Prognosis is dependent on the severity of symptoms and the patients overall health. History
The condition was named after its discoverer, the American physician Augustus Roi Felty (1895–1964), who in 1924 saw a patient with a rare combination of conditions: chronic arthritis, splenomegaly, and leucopenia. His investigation of the medical literature revealed descriptions of four other cases. His findings prompted him to publish a description of the syndrome, which was subsequently named after him. See also
Caplans syndrome
Stills disease or Still-Chauffard-Felty syndrome, the juvenile form

References


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