Diagnosis of Felty's syndrome, distinguished from hematological neoplasm: A case report
- Authors:
- Ruo‑Zhi Xiao
- Mu‑Jun Xiong
- Zi‑Jie Long
- Rui‑Fang Fan
- Dong‑Jun Lin
View Affiliations
Affiliations: Department of Hematology, Third Affiliated Hospital, Sun Yat‑Sen University, Guangzhou, Guangdong 510630, P.R. China
- Published online on: December 27, 2013 https://doi.org/10.3892/ol.2013.1779
-
Pages:
713-716
Metrics: Total
Views: 0 (Spandidos Publications: | PMC Statistics: )
Metrics: Total PDF Downloads: 0 (Spandidos Publications: | PMC Statistics: )
This article is mentioned in:
Abstract
Felty's syndrome (FS) is characterized by the three conditions of rheumatoid arthritis (RA), neutropenia and splenomegaly, and occurs in few cases of longstanding erosive RA. Discriminating between rare occurrences of autoimmune diseases and malignancies is crucial. The present study describes the case of a 17‑year‑old female with a two‑year history of RA, presenting with an irregular fever, hepatosplenomegaly and enlarged lymph nodes. The antinuclear antibody titer was 1:320, while antibody results for anti‑dsDNA, anti‑Sm and rheumatoid factor were negative. The clinical presentation was similar to that of lymphoma. However, the fluorodeoxyglucose‑positron emission tomography and biopsy examinations of the liver and cervical lymph node did not support the diagnosis of lymphoma. According to the laboratory results and clinical symptoms, the differential diagnosis indicated FS, and immunosuppressive agents were administered. Two weeks later, the patient no longer had a fever, and the transaminase levels were normal, associated with shrinkage of the liver and spleen.
View References
1
|
Felty AR: Chronic arthritis in the adult
associated with splenomegaly and leucopenia. Bull Johns Hopkins
Hosp. 35:16–20. 1924.
|
2
|
Balint GP and Balint PV: Felty’s syndrome.
Best Pract Res Clin Rheumatol. 18:631–645. 2004.
|
3
|
Nassif PS and Feldon SE: Orbital lymphoma
in a patient with Felty’s syndrome. Br J Ophthalmol. 76:173–174.
1992.PubMed/NCBI
|
4
|
Lamy T and Loughran TP Jr: How I treat LGL
leukemia. Blood. 117:2764–2774. 2011. View Article : Google Scholar : PubMed/NCBI
|
5
|
Lois Iglesias A, Sifuentes Giraldo WA,
Bachiller Corral J, et al: Large granular lymphocyte leukemia as a
complication of rheumatoid arthritis. Reumatol Clin. 8:365–367.
2012.PubMed/NCBI
|
6
|
Liu X and Loughran TP Jr: The spectrum of
large granular lymphocyte leukemia and Felty’s syndrome. Curr Opin
Hematol. 18:254–259. 2011.
|
7
|
Breedveld FC, Lafeber GJ, de Vries E, et
al: Immune complexes and the pathogenesis of neutropenia in Felty’s
syndrome. Ann Rheum Dis. 45:696–702. 1986.
|
8
|
Dwivedi N, Upadhyay J, Neeli I, et al:
Felty’s syndrome autoantibodies bind to deiminated histones and
neutrophil extracellular chromatin traps. Arthritis Rheum.
64:982–992. 2012.
|
9
|
Dwivedi N and Radic M: Neutrophil
activation and B-cell stimulation in the pathogenesis of Felty’s
syndrome. Pol Arch Med Wewn. 122:374–379. 2012.PubMed/NCBI
|
10
|
Mahévas M, Audia S, De Lastours V, et al:
Neutropenia in Felty’s syndrome successfully treated with
hydroxychloroquine. Haematologica. 92:e78–e79. 2007.
|
11
|
Narváez J, Domingo-Domenech E,
Gómez-Vaquero C, et al: Biological agents in the management of
Felty’s syndrome: a systematic review. Semin Arthritis Rheum.
41:658–668. 2012.
|
12
|
Shipley E, Héraud A, Hennette A and
Vernhes JP: Efficacy of rituximab in Felty’s syndrome. Joint Bone
Spine. 5:621–622. 2008.
|