FELTY’S SYNDROME

Felty’s Syndrome is a rare disease that is associated with complications in patients

suffering from long-term rheumatoid arthritis. Although it is thought to affect less than

1% of sufferers of rheumatoid arthritis, medical professions fear that this number may be

greater because many who have the disease exhibit no symptoms at all. Typically,

women are three times as likely to develop Felty’s Syndrome as their male counterparts.

However, the reason for this has not clearly been determined.

There is no known cause of Felty’s Syndrome although a number of theories have

been proposed. One theory is that the immune system is destroying the body’s white

blood cells. Another possibility is that the low white blood cell count is due to the white

blood cells being stored in the spleen. Other researchers feel that it is caused by the bone

marrow producing abnormal white blood cells. People with Felty’s Syndrome may

experience fatigue, weight loss and recurrent infections. Still others may develop ulcers

in the skin on their lower legs. These symptoms are usually accompanied by the stiffness

and swelling of joints.

Although there is little known about the disease, the condition is most commonly

found in people over 50 years of age who exhibit the following symptoms 1) severe

longstanding rheumatoid arthritis; 2) enlarged spleen; 3) low white cell count. Each of

these conditions will be explored in further detail.

Long Standing Rheumatoid Arthritis

Rheumatoid arthritis is an autoimmune disease. The immune system

begins to designate healthy tissue as foreign and begins to attack the membrane around

the joints. The cause of rheumatoid arthritis is unknown. The majority of people living
with rheumatoid arthritis are women. It can occur in individuals between the ages of

twenty-five and fifty-five (25-55).

The symptoms of rheumatoid arthritis begin gradually with fatigue, stiffness in

the joints, and muscle aches. Increasing joint pain and swelling of the joints usually

follow these symptoms. Both sides of the body are equally affected. If the right wrist is

affected, the left wrist is most likely affected also.

Enlarged Spleen

The spleen is part of the immune system and helps the body fight off infection.

An enlarged spleen (spleenomegaly) is usually a sign of infection. When the spleen is

enlarged, it traps and stores blood cells. People with Felty’s Syndrome usually have an

active bone marrow function. The body is producing white blood cells but they are being

trapped in the spleen. The spleen grows larger with the more blood cells it stores. This

may explain the low white blood cell count in the bloodstream of people with Felty’s

Syndrome.

Low White Blood Cell Count

One of the most threatening effects of the disease is due to the low white blood

cell count. The white blood cell is one of the body’s main fighting forces against disease.

Whenever a germ or infection enters the body, it is the white blood cells that defend the

body. In healthy individuals, white blood cells continually look out for signs of disease.

When a germ does appear, the white blood cells attack by producing protective antibodies

that will overpower the germ or at other times it surrounds and eventually devours the

bacteria. Patients suffering from low white blood cell count are prone to contracting

infections because their bodies do not function in this manner.

The treatment of Felty’s Syndrome is often unnecessary if the underlying

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condition of rheumatoid arthritis is controlled. These lifelong treatments include

medications such as methotrexate and anti-inflammatory agents, physical therapy and

exercise. Weekly injections of a granulocyte-stimulating factor may be necessary for

people with severe infections. This increases the amount of white blood cells in the

bloodstream. Removal of the spleen may be considered for people who have severe,

recurring infections.

The severity of the symptoms of Felty’s Syndrome varies with each person.

There is no cure for this disease and it gets progressively worse as the immune system

continues to attack the joints. People who suffer from this disease will have increasing

problems with pain and swelling of their joints and infections.

The destruction of joints that occurs with Felty’s Syndrome can be delayed with

early treatment. Lifestyle changes can also help with the complications of Felty’s

Syndrome. People with Felty’s Syndrome need to be very health conscious and adhere to

a nutritious diet. Because the low white blood count makes sufferers of Felty’s

Syndrome more prone to infection, yearly flu shots are recommended. Crowded areas

should be avoided during flu outbreaks. Friends and family should be avoided if they

have a cold or the flu. Thorough hand washing also helps prevent infection. Exercise is

also helpful in maintaining mobility of joints. People with Felty’s Syndrome should also

get the proper amount of rest.

Although Felty’s Syndrome is a disease that causes long-term problems, people

can continue to have a good quality of life. The key is to take an active part in the

treatment of the disease. With the proper treatment plan and appropriate lifestyle

changes, people can minimize the symptoms of Felty’s Syndrome and live a relatively

normal, full life.

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 REFERENCES:

Shiel Jr., William MD, FACP, FACR (2007). Felty’s Syndrome

http://www.medicinenet.com/feltys_syndrome/article.htm

The Arthritis Society (2005). Felty’s Syndrome

http://www.arthritis.ca/types%20of%20arthritis/feltys/default.asp?s=1

Keating, Richard MD,FACR, FACP (2006). Felty Syndrome

http://www.emedicine.com/med/topic782.htm

Peng, Stanford MD, PhD (2005) Rheumatoid Arthritis

http://www.healthline.com/adamcontent/rheumatoid-arthritis?
utm_medium=ask&utm_source=smart&utm_campaign=article&utm_term=Rheumatoid+
Arthritis&ask_return=Rheumatoid+arthritis

http://www.wrongdiagnosis.com/r/rheumatoid_arthritis/treatments.htm