Learn About Felty Syndrome
Felty syndrome is a disorder that includes rheumatoid arthritis (RA), a swollen spleen, decreased white blood cell count, and repeated infections. It is rare.
Seropositive rheumatoid arthritis (RA); Felty's syndrome
The cause of Felty syndrome is unknown. It is more common in people who have had rheumatoid arthritis (RA) for a long time. People with this syndrome are at risk for infection because they have a low white blood cell count.
Symptoms include:
- General feeling of discomfort (malaise)
- Fatigue
- Weakness in leg or arm
- Loss of appetite
- Unintentional weight loss
- Ulcers in the skin
- Joint swelling, stiffness, pain, and deformity
- Recurrent infections
- Red eye with burning or discharge
In most cases, people who have this syndrome are not getting recommended treatment for RA. They may need other medicines to suppress their immune system and reduce the activity of their RA.
Methotrexate may improve the low neutrophil count. The drug rituximab has been successful in people who do not respond to methotrexate.
Granulocyte-colony stimulating factor (G-CSF) may raise the neutrophil count.
Some people benefit from removal of their spleen (splenectomy).
Vadim Gorodetskiy practices in Moscow, Russian Federation. Mr. Gorodetskiy is rated as an Elite expert by MediFind in the treatment of Felty Syndrome. His top areas of expertise are Felty Syndrome, Splenomegaly, Schnitzler Syndrome, and Adult T-Cell Leukemia.
University Of Virginia Physicians Group
Thomas Loughran is a Hematologist Oncology specialist and an Oncologist in Charlottesville, Virginia. Dr. Loughran is rated as a Distinguished provider by MediFind in the treatment of Felty Syndrome. His top areas of expertise are Adult T-Cell Leukemia, Leukemia, Felty Syndrome, and Acute Myeloid Leukemia (AML). Dr. Loughran is currently accepting new patients.
Wellstar Medical Group LLC
Mohammad Kamran is a Rheumatologist in Marietta, Georgia. Dr. Kamran is rated as an Advanced provider by MediFind in the treatment of Felty Syndrome. His top areas of expertise are Rheumatoid Arthritis (RA), Psoriatic Arthritis, Dermatomyositis, and Gout. Dr. Kamran is currently accepting new patients.
Treating the RA, however, should improve Felty syndrome.
You may have infections that keep coming back.
Some people with Felty syndrome have increased numbers of large granular lymphocytes, also called LGL leukemia. This will be treated with methotrexate in many cases.
Contact your health care provider if you develop symptoms of this disorder.
Prompt treatment of RA with currently recommended medicines markedly decreases the risk of developing Felty syndrome.
Published Date: April 01, 2025
Published By: Diane M. Horowitz, MD, Rheumatology and Internal Medicine, Northwell Health, Great Neck, NY. Review provided by VeriMed Healthcare Network. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
Johnson TM, Mikuls TR, England BR. Clinical features of rheumatoid arthritis. In: Firestein GS, McInnes IB, Koretzky GA, Mikuls TR, Tuhina N, O'Dell JR, eds. Firestein & Kelley's Textbook of Rheumatology. 12th ed. Philadelphia, PA: Elsevier; 2025:chap 72.
McInnes IB. Rheumatoid arthritis. In: Goldman L, Cooney KA, eds. Goldman-Cecil Medicine. 27th ed. Philadelphia, PA: Elsevier; 2024:chap 243.
Savola P, Bhattacharya D, Huuhtanen J. The spectrum of somatic mutations in large granular lymphocyte leukemia, rheumatoid arthritis, and Felty's syndrome. Semin Hematol. 2022;59(3):123-130. PMID: 36115688 pubmed.ncbi.nlm.nih.gov/36115688/.