Felty's syndrome
Keywords:
Felty's syndrome, rheumatoid arthritis, treatment.Abstract
Introduction: Felty's syndrome is a rare extra-articular complication of rheumatoid arthritis, first described in 1924. Felty described 5 patients who were characterized by the presence of a clinical triad of rheumatoid arthritis, splenomegaly, and neutropenia that appears fundamentally in patients with long years of evolution of their disease. It is a clinical entity with a high degree of mortality, given that it is a poorly diagnosed disease and therefore not treated.Objective: Present a clinical case of Felty´s syndrome, its clinical characteristics and the therapeutic procedure used.
Clinical case: 64-year-old female patient with a history of rheumatoid arthritis and hypothyroidism; both diseases without regular treatment. She attended to emergency with fever and the presence of ulcerative lesions on the left lower limb with a necrotic background. Due to leukopenia accompanied by splenomegaly, she was diagnosed with febrile neutropenia (sepsis) secondary to Felty's syndrome. Treatment was established and healing of the ulcerative lesions was gradually achieved, the eradication of the infection with recovery of normal neutrophil values and the subsequent recovery of the patient.
Conclusions: When diagnosing Felty's syndrome, the essential thing is to achieve immediate control of the underlying disease and the comorbidities; and through treatment obtain an increase in patient survival.
Downloads
References
2. Wu P, Sun W, Li J. Rheumatoid arthritis patients with peripheral blood cell reduction should be evaluated for latent Felty syndrome: A case report. Medicine. 2020 [acceso: 29/10/2021]; 99(51): 23608. Disponible en: http://dx.doi.org/10.1097/MD.0000000000023608
3. Ocampo JJ, Fregoso YA, Llorente L. Pancytopenia as Manifestation of Nonarticular Felty Syndrome. JCR. 2018 [acceso: 29/10/2021]; 27(8S): S613-14. Disponible en: https://dx.doi.org/10.1097/RHU.0000000000000906
4. Holbrook WP, Turner EP, Maciver JE. Felty's Syndrome. British Journal of Oral Surgery. 1980 [acceso: 31/10/2021]; 17(2): 157 - 160. Disponible en: https://doi.org/10.1016/S0007-117X(79)80043-8
5. Aluja Jaramillo F, Mahecha J. Manifestaciones torácicas y dermatológicas de las enfermedades sistémicas: claves para el radiólogo general. Rev. Colomb. Radiol. 2020 [acceso: 31/10/2021]; 31(4): 5435 - 5446. Disponible en: http://contenido.acronline.org/Publicaciones/RCR/RCR31-4/RCR-31-4-03_Manifestaciones.pdf
6. Yazıcı A, Uçar A, Mehtap Ö, Gönüllü EÖ, Tamer A. Presentation of three cases followed up with a diagnosis of Felty síndrome. Eur J Rheumatol. 2014 [acceso: 02/11/2021]; 1: 120 - 122. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5042221/pdf/ejr-1-3-120.pdf
7. Abdelkader HA, Abdel Galeil Y, Elbendary A, El Mofty M, Abdel Halim MRE. Multiple Skin Ulcers in a Rheumatoid Arthritis Patient: Answer. Am J Dermatopathol. 2020 [acceso: 02/11/2021]; 42(2): 146 - 147. Disponible en: https://dx.doi.org/10.1097/DAD.0000000000001326
8. Dubon P, Lim F, Bhandari S, Chauhan S, Solanki P, et al. Felty's Syndrome: Triad Not Always Evident. Florida: Florida Chapter of American College of Physicians Annual Meeting; 2019. [acceso: 02/11/2021]. Disponible en: https://scholarlycommons.hcahealthcare.com/cgi/viewcontent.cgi?article=1-023&context=internal-medicine
9. Burks EJ, Loughran TP. Pathogenesis of neutropenia in large granular lymphocyte leukemia and Felty síndrome. Blood Reviews. 2006 [acceso: 02/11/2021]; 20: 245 - 266. Disponible en: https://doi.org/10.1016/j.blre.2006.01.003
10. Revenga Martínez M, Morán-Álvarez P, Arroyo Palomo J, Valero Expósito M, Vázquez Díaz M. Artritis reumatoide. Medicine. 2021 [acceso: 02/11/2021]; 13(30): 1669 - 1680. Disponible en: https://doi.org/10.1016/j.med.2021.03.027
11. Gallardo Perez DE. Manifestaciones extraarticulares de Artritis Reumatoide. [Tesis de culminación de estudios médico]. Cuenca, Ecuador: Universidad Católica de Cuenca, Unidad Académica Salud y Bienestar, Carrera de Medicina; 2020. [acceso: 02/11/2021]. Disponible en: https://dspace.ucacue.edu.ec/bitstream/ucacue/8500/1/9BT2020-MTI081-DENISSE%20ESTEFANIA%20GALLARDO%20P%c3%89REZ.pdf
12. Fuertes Fuertes R. Impacto del estado nutricional en el pronóstico del paciente séptico. [Trabajo de Fin De Grado]. Valladolid, España: Universidad de Valladolid, Facultad de Medicina; 2020. [acceso: 06/11/2021]. Disponible en: https://uvadoc.uva.es/bitstream/handle/10324/41593/TFG-M-M1759%20%282%29.pdf?sequence=1&isAllowed=y
13. Carrillo Esper R, Rivera Buendía S, Carrillo Córdova JR, Carrillo Córdova LD. Estatinas, ¿alternativa terapéutica en sepsis? Gac Méd Méx. 2007 [acceso: 06/11/2021]; 143 (6): 499 - 503. Disponible en: https://www.medigraphic.com/pdfs/gaceta/gm-2007/gm076g.pdf
14. Porta Díaz M, Salvato Dueñas A, Alvaré Alvaré L, Melo Victores M, Lobato Pastrana D, González Concepción I. Estrategias de tromboprofilaxis y anticoagulación en pacientes pediátricos con COVID-19. Invest. Medicoquir. 2021 [acceso: 06/11/2021]; 13 (2): [aprox. 14 pant.]. Disponible en: http://revcimeq.sld.cu/index.php/imq/article/view/714/746
Published
How to Cite
Issue
Section
License
Authors who have publications with this Journal accept the following terms:
- The authors will retain their copyright and guarantee the Journal the right of first publication of their work, which will simultaneously be subject to the Creative Commons Attribution License. The content presented here can be shared, copied and redistributed in any medium or format; Can be adapted, remixed, transformed or created from the material, using the following terms: Attribution (giving appropriate credit to the work, providing a link to the license, and indicating if changes have been made); non-commercial (you cannot use the material for commercial purposes) and share-alike (if you remix, transform or create new material from this work, you can distribute your contribution as long as you use the same license as the original work).
- The authors may adopt other non-exclusive license agreements for the distribution of the published version of the work (for example: depositing it in an institutional electronic archive or publishing it in a monographic volume) as long as the initial publication in this Journal is indicated.
- Authors are allowed and recommended to disseminate their work through the Internet (e.g., in institutional electronic archives or on their website) before and during the submission process, which can produce interesting exchanges and increase citations. of the published work.