Table 12.1 Open in new tab Features of...

Table 12.1

Features of Felty’s syndrome

Triad of chronic arthritis, splenomegaly, and granulocytopenia	Associated with HLA-DR4
33% have clonal expansion of large granular lymphocytes	CD3+CD8+CD16+CD57+
Complications	Rheumatoid nodules, weight loss, Sjogren’s syndrome, lymphadenopathy, Leg ulcers, pleuritis, neurpathy, skin pigmentation, episcleritis Increased risk of lymphoma (NHL) Increased risk of bacterial infections
Immunological abnormalities	98% RF+
	60–80% ANA+ 77% ANCA+ (mostly anti-lactoferrin) Reduced complement Increased immunoglobulins
Treatment	As for RA Splenectomy may be required C-CSF for severe neutropenia

Triad of chronic arthritis, splenomegaly, and granulocytopenia	Associated with HLA-DR4
33% have clonal expansion of large granular lymphocytes	CD3+CD8+CD16+CD57+
Complications	Rheumatoid nodules, weight loss, Sjogren’s syndrome, lymphadenopathy, Leg ulcers, pleuritis, neurpathy, skin pigmentation, episcleritis Increased risk of lymphoma (NHL) Increased risk of bacterial infections
Immunological abnormalities	98% RF+
	60–80% ANA+ 77% ANCA+ (mostly anti-lactoferrin) Reduced complement Increased immunoglobulins
Treatment	As for RA Splenectomy may be required C-CSF for severe neutropenia