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Felty's Syndrome

What Is Felty’s Syndrome?

Felty’s syndrome is a rare disorder that involves three conditions. These conditions are rheumatoid arthritis (RA), a low white blood cell count, and an enlarged spleen. The Arthritis Society of Canada reports that less than 1 percent of people with RA have Felty’s syndrome.

Not much is known about the condition, but doctors consider it a serious disorder. Some people don’t have any noticeable symptoms beyond those associated with RA. Other people may display a number of symptoms, including:

  • fatigue
  • serious infections
  • a fever
  • weight loss
  • discolored patches of skin

What Are the Symptoms of Felty’s Syndrome?

Sometimes, people who have Felty’s syndrome may not have any symptoms. Other times, they may have specific symptoms that occur with the syndrome, such as:

  • eye discharge
  • a burning feeling in the eyes
  • fatigue
  • weight loss
  • joint pain, swelling, stiffness, and deformities
  • a loss of appetite
  • general discomfort
  • infections
  • pale coloring to skin

Additional symptoms may include ulcers, discolored areas on the skin, and an enlarged liver. These symptoms vary from case to case.

What Causes Felty’s Syndrome?

The cause of Felty’s syndrome is unknown, but doctors believe it’s a genetic condition. It’s possible that the affected individuals need only one abnormal gene to develop the disease. The National Organization for Rare Diseases (NORD) notes that Felty’s syndrome may be an autoimmune disorder.

Although people who’ve had RA for a long time are at greater risk for Felty’s syndrome, RA isn’t always the cause of the disorder.

Who Is at Risk for Felty’s Syndrome?

Felty’s syndrome may be more common in people with long-term RA. Other possible risk factors may include:

  • having a positive test result for the HLA-DR4 gene
  • having inflammation of tissues lining the joints
  • testing positive for rheumatoid factor, which is an antibody used to diagnose RA
  • having RA symptoms outside of the joints
  • being Caucasian
  • being older than age 50

According to the Arthritis Society of Canada, women are three times more likely than men to develop Felty’s syndrome.

How Is Felty’s Syndrome Diagnosed?

Your doctor will begin with a physical examination. The physical exam may reveal whether you have a swollen liver, spleen, or lymph nodes. Your joints may show signs of RA, such as swelling, redness, and warmth. Your doctor may also order an abdominal ultrasound and blood work, including a complete blood count (CBC).

A CBC may reveal that your white blood cell count is low. The abdominal ultrasound may reveal the presence of a swollen spleen. Having a low white blood cell count, swollen spleen, and RA usually indicates that you have Felty’s syndrome.

What Are the Treatment Options for Felty’s Syndrome?

Most people diagnosed with Felty’s syndrome are already receiving treatment for RA. Having Felty’s syndrome may require additional medications. Your doctor may prescribe methotrexate, which is the most effective form of treatment for many of the symptoms. Some people may also benefit from having their spleen surgically removed.

If you experience recurring infections, following these tips can help reduce the amount of infections you experience:

  • Try to avoid injuries.
  • Get a yearly flu shot.
  • Avoid crowded places during flu season.
  • Wash your hands thoroughly.

What Is the Long-Term Outlook?

While there’s no cure for Felty’s syndrome, treating your RA can only help. Individuals who have their spleen removed may experience fewer symptoms, though the long-time benefit of this surgery is unknown, according to the NORD. However, people who have Felty’s syndrome are prone to recurring infections ranging from mild to severe.

Being vigilant about your health by following your doctor’s course of treatment and maintaining a healthy lifestyle can decrease your symptoms. Taking care of your immune system by avoiding those with the flu and getting a yearly flu shot can also reduce the amount of infections you experience. 

Content licensed from:

Written by: Elly Dock and Winnie Yu
Medically reviewed on: Mar 23, 2016: University of Illinois-Chicago, College of Medicine

This feature is for informational purposes only and should not be used to replace the care and information received from your health care provider. Please consult a health care professional with any health concerns you may have.
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