Felty's Syndrome

Written by Elly Dock and Winnie Yu | Published on July 25, 2012
Medically Reviewed by George Krucik, MD


Felty’s syndrome is a rare disorder that involves three conditions: rheumatoid arthritis (RA), low white blood cell count, and an enlarged spleen.

Not much is known about the condition, but it is considered a serious disorder. Some people do not have any noticeable symptoms beyond those associated with rheumatoid arthritis. Others however, may develop serious infections.

What Causes Felty’s Syndrome?

The cause of Felty’s syndrome is not known, but it is believed to be a genetic condition. It is possible that the affected individuals need only one abnormal gene to develop the disease. It is also believed that Felty’s syndrome is an autoimmune disorder.

Although people with RA are at greater risk for Felty’s syndrome, RA is not the cause of the disorder.

Who Is at Risk for Felty’s Syndrome?

Felty’s syndrome may be more common in individuals with long-term rheumatoid arthritis. Other possible risk factors may include:

  • a positive test for the HLA-DR4 gene
  • inflammation of tissues lining the joints
  • rheumatoid factor (RF) positivity. RF is an antibody used to diagnose RA.
  • RA symptoms outside of the joints

Someone who is experiencing all of these symptoms may be at higher risk for Felty’s syndrome.

What Are the Symptoms of Felty’s Syndrome?

Sometimes people who have Felty’s syndrome may not have any symptoms. Other times, they may have specific symptoms that are associated with the syndrome such as:

  • eye discharge
  • burning feeling in eyes
  • fatigue
  • weight loss
  • joint pain, swelling, stiffness, and deformities
  • loss of appetite
  • general discomfort
  • infections
  • pale coloring to skin

Additional symptoms may include ulcers, discolored areas on the skin, and an enlarged liver. These symptoms vary from case to case.

How Is Felty’s Syndrome Diagnosed?

Your doctor will begin with a physical examination. The physical exam may reveal whether you have a swollen liver, spleen, or lymph nodes. Your joints may show signs of rheumatoid arthritis such as swelling, redness and warmth. Your doctor may also do an abdominal ultrasound and blood work, including a complete blood count (CBC).

A CBC may reveal that you your white blood cells are low. The abdominal ultrasound may reveal the presence of a swollen spleen. Having a low white blood cell count, swollen spleen, and RA usually means you have Felty’s syndrome.

How Is Felty’s Syndrome Treated?

Most people diagnosed with Felty’s syndrome are already receiving treatment for RA. Having Felty’s syndrome may require additional medications. Methotrexate may be prescribed and is considered to be the most effective form of treatment for many of the symptoms. Some people may also benefit from having their spleen surgically removed.

What Is the Long-Term Outlook for Felty’s Syndrome?

There is no cure for Felty’s syndrome. Doctors believe that the RA will likely worsen. Individuals who have had their spleen removed may have fewer symptoms. However, people who have Felty’s syndrome are prone to recurring infections. These infections may range from very common to severe. If serious infections continue to occur, there may be a possible risk of death.

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