120 Felty’s syndrome
Diagnosis
This patient has moderate splenomegaly with rheumatoid arthritis (lesions) caused by Felty syndrome.
Advanced-level questions
What is Felty syndrome?
It is a rare complication of rheumatoid arthritis in which there is leucopenia with selective neutropenia and splenomegaly. The bone marrow is typically hyperplastic. The disease typically manifests late in the course of ‘burnt-out’ joint disease. The prognosis is poor because of recurrent Gram-positive infections. The ‘large granular lymphocyte syndrome’ (Fig. 120.1), a premalignant disorder of the T lymphocyte, occurs in one-third of the patients with Felty syndrome in rheumatoid arthritis.
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