Splenectomy in Felty's syndrome

Abstract The syndrome of rheumatoid arthritis, splenomegaly, leukopenia, and neutropenia is rare. When it occurs, it could become complicated by infection that does not respond to antibiotics and steroid therapy. We feel that splenectomy should be carried out once the diagnosis of Felty's syndrome is made. In the presence of infection, prompt splenectomy should be done, even if the patient shows signs of systemic toxicity. Splenectomy is the most beneficial treatment and may prevent a fatal outcome in these cases. Splenectomy is usually followed by immediate hematologic response. Steroid therapy may alter the arthritic symptoms but has no effect in altering or controlling the infection in these cases, even if accompanied by antibiotic therapy. Radiation of the spleen may reduce its size, but does not prevent or control the infections in patients with Felty's syndrome.