A complication of long-standing rheumatoid arthritis characterized
by the presence of 3 conditions -- rheumatoid arthritis, an enlarged spleen (splenomegaly),
and an abnormally low white blood cell count. The white blood cells that are low
are called granulocytes (or neutrophils).
F elty syndrome predisposes to infections such as pneumonia or skin infections,
because of the low white counts. Ulcers in the skin over the legs can also complicate
Felty's syndrome. The cause of the syndrome is not known. White cells may be stored
excessively in the spleen. especially in patients with Felty's syndrome who have
antibodies against granulocytes.
In Felty syndrome, the underlying rheumatoid arthritis is managed in the standard
manner. Patients with severe infectious disease may benefit from weekly injections
of granulocyte colony stimulating factor (G-CSF) to stimulate the production of
granulocytes.
The syndrome was named for the American physician Augustus Roi Felty (1895-1964)
who first described it in 1924 at Johns Hopkins Hospital.
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