Felty's syndrome complicated with marked thrombocytopenia

Abstract

A 32-year-old woman with 16 years duration of rheumatoid arthritis was admitted to the Juntendo University hospital in December 1985, and was diagnosed as Felty's syndrome be-cause of the simultaneous occurence of rheumatoid arthritis, splenomegaly, and the marked leukopenia. In this case, anti-DNA antibody and anti nuclear antibody have shown positive, and erythema, thrombocytopenia, and polyarthritis were recognized. These incidence are of definite SLE (Systemic Lupus Erythematosus). This indicates Felty's syndrome may be a connecting link lying somewhere between rheumatoid arthritis and SLE.
Felty's syndrome is very rare in Japan: only 30 cases have been reported since 1972. This case is characterized by the marked thrombocytopenia, which can be found in 55% of the above 30 cases. Thrombocytopenia was hypothesized by Thorne to be the fourth criteria of Felty's syndrome in 1982. Thrombocytopenia is not essential criterion, but, as a relatively frequent occurrence, it is valuable to illuminate its mechanism.