Summary
Definition
Anamnesis y examen
Principales factores de diagnóstico
- presença de fatores de risco
- esplenomegalia
- deformidades articulares
Otros factores de diagnóstico
- nódulos reumatoides
- hepatomegalia
- história de vasculite
- infecções cutâneas e do trato respiratório frequentes
Factores de riesgo
- artrite reumatoide (AR) >10 anos
- história familiar de AR
- idade >50 anos
- etnia branca
Pruebas diagnósticas
Primeras pruebas diagnósticas para solicitar
- Hemograma completo
- esfregaço de sangue periférico
- velocidade de hemossedimentação sérica
- proteína C-reativa sérica
- TFHs
- fator reumatoide sérico
Pruebas diagnósticas que deben considerarse
- fatores antinucleares séricos
- níveis de anticorpos séricos antipeptídeos citrulinados cíclicos (anti-CCP)
- ultrassonografia do abdome
- tomografia computadorizada (TC) do abdome
- radiografia torácica
- biópsia da medula óssea
- exames virológicos
Algoritmo de tratamiento
todos os pacientes
Colaboradores
Autores
Dobrina N. Hull, MA, MRCP, PhD
Consultant Rheumatologist
Kingston Hospital
Kingston upon Thames
UK
Divulgaciones
DH declares that she has no competing interests.
Agradecimientos
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.
Revisores por pares
Simon Bowman, PhD, FRCP
Consultant Rheumatologist and Honorary Senior Clinical Lecturer in Rheumatology
Selly Oak Hospital
Birmingham
UK
Divulgaciones
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
Divulgaciones
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
Divulgaciones
AB declares that he has no competing interests.
Peer reviewer acknowledgements
BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.
Disclosures
Peer reviewer affiliations and disclosures pertain to the time of the review.
Referencias
Artículos principales
Felty AR. Chronic arthritis in the adult associated with splenomegaly and leucopenia. Bull Johns Hopkins Hosp. 1924;35:16-20.
Campion G, Maddison PJ, Goulding N, et al. The Felty syndrome: a case-matched study of clinical manifestations and outcome, serologic features, and immunogenetic associations. Medicine (Baltimore). 1990;69:69-80. Resumen
Balint GP, Balint PV. Felty's syndrome. Best Pract Res Clin Rheumatol. 2004 Oct;18(5):631-45. Resumen
Rashba EJ, Rowe JM, Packman CH. Treatment of the neutropenia of Felty syndrome. Blood Rev. 1996 Sep;10(3):177-84.Texto completo Resumen
Artículos de referencia
Una lista completa de las fuentes a las que se hace referencia en este tema está disponible para los usuarios con acceso a todo BMJ Best Practice.
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