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ISSN 1561-3046 (Electronic)

2022, Number 2

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Rev Cub Med Mil 2022; 51 (2)

Felty's syndrome

Fong PL, Domínguez SL, Lora PJA

Language: Spanish
References: 14
Page:
PDF size: 301.34 Kb.


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.


REFERENCES

  1. Nimri D, Abdallah MA, Waqas QA, Abdalla A, Tantoush H. Severe Neutropenia Complicated with Necrotizing Fasciitis Unveils a Diagnosis of Rheumatoid Arthritis: A Case Report. Cureus. 2019 [acceso: 29/10/2021]; 11(2): 4079. Disponible en: https://dx.doi.org/10.7759/cureus.40791.

  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.00000000000236082.

  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.00000000000009063.

  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)80043-84.

  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: Disponible en: http://contenido.acronline.org/Publicaciones/RCR/RCR31-4/RCR-31-4-03_Manifestaciones.pdf 5.

  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: Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5042221/pdf/ejr-1-3-120.pdf 6.

  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.00000000000013267.

  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: Disponible en: https://scholarlycommons.hcahealthcare.com/cgi/viewcontent.cgi?article=1023&context=internal-medicine 8.

  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.2006.01.0039.

  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.2021.03.02710.

  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: Disponible en: https://dspace.ucacue.edu.ec/bitstream/ucacue/8500/1/9BT2020-MTI081-DENISSE%20ESTEFANIA%20GALLARDO%20P%c3%89REZ.pdf 11.

  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: Disponible en: https://uvadoc.uva.es/bitstream/handle/10324/41593/TFG-M-M1759%20%282%29.pdf?sequence=1&isAllowed=y 12.

  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: Disponible en: https://www.medigraphic.com/pdfs/gaceta/gm-2007/gm076g.pdf 13.

  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: Disponible en: http://revcimeq.sld.cu/index.php/imq/article/view/714/746 14.




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