When viewing this topic in a different language, you may notice some differences in the way the content is structured, but it still reflects the latest evidence-based guidance.

Felty syndrome

Last reviewed: 10 Nov 2024
Last updated: 02 Nov 2023

Summary

Definition

History and exam

Key diagnostic factors

  • splenomegaly
  • joint deformities
Full details

Other diagnostic factors

  • rheumatoid nodules
  • hepatomegaly
  • history of vasculitis
  • frequent skin and respiratory tract infections
Full details

Risk factors

  • rheumatoid arthritis (RA) >10 years
  • family history of RA
  • age >50 years
  • white ethnicity
Full details

Diagnostic tests

1st tests to order

  • CBC
  • peripheral blood smear
  • serum erythrocyte sedimentation rate
  • serum CRP
  • LFTs
  • serum rheumatoid factor
Full details

Tests to consider

  • serum antinuclear antibodies
  • serum anticyclic citrullinated peptide (anti-CCP) antibodies
  • ultrasound of abdomen
  • CT scan of abdomen
  • chest x-ray
  • bone marrow biopsy
  • virologic tests
Full details

Treatment algorithm

ACUTE

all patients

Contributors

Authors

Dobrina N. Hull, MA, MRCP, PhD
Dobrina N. Hull

Consultant Rheumatologist

Kingston Hospital

Kingston upon Thames

UK

Disclosures

DH declares that she has no competing interests.

Acknowledgements

Dr Dobrina N. Hull would like to gratefully acknowledge Dr Gerald Coakley, a previous contributor to this topic. GC is the author of one reference cited in this topic and has been reimbursed by Novartis to attend an educational conference in the UK.

Peer reviewers

Simon Bowman, PhD, FRCP

Consultant Rheumatologist and Honorary Senior Clinical Lecturer in Rheumatology

Selly Oak Hospital

Birmingham

UK

Disclosures

SB declares that he has no competing interests.

Alice Klinkhoff, MD, FRCPC

Medical Director

Mary Pack Arthritis Program

Clinical Associate Professor

University of British Columbia

Vancouver

BC

Canada

Disclosures

AK is the author of a study referenced in this topic.

Alan Bridges, MD

Professor and Vice Chair

Department of Medicine

University of Wisconsin Hospital

Madison

WI

Disclosures

AB declares that he has no competing interests.

  • Differentials

    • Large granular lymphocyte (LGL) syndrome
    • Lymphoproliferative disorders
    • Myeloproliferative disorders
    More Differentials
  • Guidelines

    • Guideline for vaccinations in patients with rheumatic and musculoskeletal diseases
    More Guidelines
  • Patient information

    Rheumatoid arthritis

    More Patient information
  • padlock-lockedLog in or subscribe to access all of BMJ Best Practice

Use of this content is subject to our disclaimer