Ministry Health Care

Felty syndrome is a disorder that involves rheumatoid arthritis, a swollen spleen, decreased white blood cell count, and repeated infections. It is rare.

The cause of Felty syndrome is unknown. It is more common in people who have had rheumatoid arthritis for a long time. People with this syndrome are at risk of infection because they have a low white blood cell count.

• 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

A physical exam will show:

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

A complete blood count ( CBC) may show a lower number of white blood cells called neutrophils.

An abdominal ultrasound may confirm a swollen spleen.

Persons with this syndrome are usually already receiving treatment for rheumatoid arthritis. They may need other medicines to suppress their immune system.

Methotrexate may improve the low white blood cell count.

Some people benefit from removal of the spleen (splenectomy).

Infections may continue to occur.

Rheumatoid arthritis is likely to get worse.

You may have infections that keep coming back.

Call your health care provider if you develop symptoms of this disorder.

Prompt treatment of rheumatoid arthritis may decrease the risk of developing Felty syndrome.

Sweeney SE, Harris ED, Firestein GS. Clinical features of rheumatoid arthritis. In: Firestein GS, Budd RC, Gabriel SE, et al, eds. Kelley's Textbook of Rheumatology. 9th ed. Philadelphia, Pa: Saunders Elsevier; 2012:chap 70.