Felty's syndrome is manifested by enlargement of the spleen, often also lymph nodes and liver, and leukopenia - a decrease in the number of leukocytes in the peripheral blood, in particular granulocytopenia (i.e. a decrease in the number of granulocytes in the peripheral blood below normal).
Most patients withFelty's syndromehave rheumatoid nodules, discoloration of the skin, vasculitis symptoms (ulceration on the shins and around the nail folds, including peripheral neuropathy). In the serum of patients, apart from the constantly present rheumatoid factor, one can also find immune complexes, antinuclear and anti-leukocyte antibodies.
The cause ofgranulocytopeniais more complex. Anti-leukocyte antibodies and circulating immune complexes are believed to damage granulocytes. Circulating immune complexes can vary in size and biochemical properties. Some of them damage phagocytic cells (phagocytosis consists in absorbing the intruder by the appropriate cell, and then - digesting it inside it). Both the granulocytes charged with these complexes and damaged by the anti-leukocyte antibodies are eliminated in the spleen and in the lymphatic system. The marrow usually shows a viable renewal capacity, but the number of mature granulocytes is reduced.
Treating Felty's syndrome
glucocorticoids are used. Nevertheless, this therapy has a side effect - it increases the already high susceptibility of patients to infections. Treatment with gold s alts can have a positive effect on both joint symptoms and counteract granulocytopenia. It is also believed that gold s alts inhibit phagocytosis. If such treatment does not help, and granulocytosis persists, spleen resection is performed. However, this treatment does not affect the course of rheumatoid arthritis, nor does it improve impaired immunity - it only prevents granulocytopenia. The obtained result is often temporary. In some cases, an increase in peripheral blood granulocytes has been observed after treatment with lithium compounds.