FS and splenomegaly

 Q: 38 years old female with a known history of Felty syndrome (FS) is admitted to ICU with bacteremia. Physical examination followed by an ultrasound of abdomen showed massive splenomegaly. The size of splenomegaly correlates well with the severity of FS. 

A) True 

B) False

Answer: B

FS is consist of a triad 

• Rheumatoid arthritis (RA)
• Splenomegaly
• Neutropenia

Splenomegaly is usually massive in FS with a mean weight four times the normal. Despite that spleen size has no correlation with the other two components of triad i.e., degree of neutropenia and/or severity of RA. Patient with minimal or no splenomegaly can have severe FS.

#rheumatology

References:

1. Ruderman M, Miller LM, Pinals RS. Clinical and serologic observations on 27 patients with Felty's syndrome. Arthritis Rheum 1968; 11:377. 

2. Sienknecht CW, Urowitz MB, Pruzanski W, Stein HB. Felty's syndrome. Clinical and serological analysis of 34 cases. Ann Rheum Dis 1977; 36:500.

3. Campion G, Maddison PJ, Goulding N, et al. The Felty syndrome: a case-matched study of clinical manifestations and outcome, serologic features, and immunogenetic associations. Medicine (Baltimore) 1990; 69:69. 

4. Laszlo J, Jones R, Silberman HR, Banks PM. Splenectomy for Felty's syndrome. Clinicopathological study of 27 patients. Arch Intern Med 1978; 138:597.