Felty's Syndrome



What is Felty’s Syndrome?

Felty’s syndrome is a complication of long-standing rheumatoid arthritis. Felty’s syndrome is defined by the presence of three conditions: rheumatoid arthritis, an enlarged spleen (splenomegaly), and an abnormally low white blood cell count.

How common is Felty’s Syndrome?

Felty’s syndrome is uncommon. It affects less than 1% of patients with rheumatoid arthritis. Please discuss with your doctor for further information.


What are the symptoms of Felty’s Syndrome?

The common symptoms of Felty’s Syndrome are:

  • General feeling of discomfort (malaise)
  • Fatigue
  • Loss of appetite
  • Unintentional weight loss
  • Pale-looking skin
  • Joint swelling, stiffness, pain, and deformity
  • Recurrent infections
  • Eye burning or discharge

There may be some symptoms not listed above. If you have any concerns about a symptom, please consult your doctor.

When should I see my doctor?

If you have any signs or symptoms listed above or have any questions, please consult with your doctor. Everyone’s body acts differently. It is always best to discuss with your doctor what is best for your situation.


What causes Felty’s Syndrome?

The cause of Felty’s syndrome is not known. Some patients with rheumatoid arthritis develop Felty’s syndrome, but most do not. White blood cells are produced in the bone marrow. There seems to be an active bone marrow function in patients with Felty’s syndrome, producing white cells, despite the low numbers of circulating white blood cells (neutropenia). White cells may be stored excessively in the spleen of a patient with Felty’s syndrome. This is especially true in patients with Felty’s syndrome that have antibodies against the particular type of white blood cells usually affected (cells called granulocytes or neutrophils).

Risk factors

What increases my risk for Felty’s Syndrome?

There are many risk factors for Felty’s Syndrome, such as:

  • Rheumatoid arthritis

Diagnosis & treatment

The information provided is not a substitute for any medical advice. ALWAYS consult with your doctor for more information.

How is Felty’s Syndrome diagnosed?

A physical exam will show:

  • Swollen spleen
  • Joints that show signs of RA
  • Possibly swollen liver and lymph nodes

A complete blood count (CBC) with differential may show a low number of white blood cells called neutrophils. Nearly all people with Felty syndrome have a positive test for rheumatoid factor.

An abdominal ultrasound may confirm a swollen spleen.

How is Felty’s Syndrome treated?

If your RA is under control, you may not need treatment for FS. If you do need help with your symptoms, there are ways to manage them:

  • Drugs that slow down the disease: Low-dose methotrexate (MTX) is often used to stop your FS from getting worse. It can cause some side effects, such as nausea and mouth ulcers. You’ll also need regular tests to make sure MTX isn’t hurting your liver. Other drugs your doctor might advise you to take include disease-modifying antirheumatic drugs (DMARDs) that are used to treat RA, such as glucocorticoids, hydroxychloroquine, auranofin, and penicillamine.
  • Drugs that affect your immune system: Newer medicines like rituximab (Rituxan and MabThera) can shut off the part of your immune system that isn’t working as it should. They’re given by IV but may take up to a few weeks to work.
  • Home care: Your doctor will tell you how much physical activity and rest you need. A heating pad may help with mild aches and pains. A nonsteroidal anti-inflammatory drug (NSAID) such as ibuprofen can also help.
  • Gold: Taken by mouth or put into a muscle with a shot, gold compounds have long been used to treat RA symptoms. They may help mild cases of FS as well.
  • Surgery: If your FS is severe and other treatments don’t work, your doctor may recommend that your spleen be taken out. This could return your red and white blood cells to normal levels and may lower your risk of infection. But doctors aren’t sure how long these last.

Lifestyle changes & home remedies

What are some lifestyle changes or home remedies that can help me manage Felty’s Syndrome?

If you have any questions, please consult with your doctor to better understand the best solution for you.

Hello Health Group does not provide medical advice, diagnosis or treatment.


Review Date: May 22, 2018 | Last Modified: May 22, 2018

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