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FELTY'S SYNDROME: Response to Splenectomy After Cortisone Failure

FELTY'S SYNDROME: Response to Splenectomy After Cortisone Failure Abstract THOUGH Felty's original description of the syndrome consisting of rheumatoid arthritis, splenomegaly, and leucopenia was published in 1924,1 it was not until 1932 that hematologic remission following splenectomy was first reported by Hanrahan.2 Since then, 46 cases subjected to splenectomy have appeared in the literature. In 37 of these the leucopenia was relieved.3 The rheumatic manifestations, however, have been alleviated inconstantly by the procedure. The use of the steroid hormones in this disease had been reported only three times prior to the time of this case.* In all of these hematologic and rheumatic remissions were obtained. Normal white cell and differential counts were obtained together with regression of the splenomegaly in each case. However, after cessation of hormone therapy leucopenia, splenomegaly, and arthritic manifestations recurred. The case herein reported is unusual because of the failure of hematologic response to cortisone with subsequent success following splenectomy. REPORT OF References 1. References 4-6. 2. Felty, A. R.: Chronic Arthritis in the Adult, Associated with Splenomegaly and Leukopenia , Bull. Johns Hopkins Hosp. 35:16, 1924. 3. Hanrahan, E. M., and Miller, S. R.: Effect of Splenectomy in Felty's Syndrome , J. A. M. A. 99:1947, 1932. 4. Steinberg, C. L.: Splenectomy in Rheumatoid Arthritis , Ann. Int. Med. 38:787, 1953.Crossref 5. Bichel, J., and Kissmeyer-Nielsen, F.: Felty Syndrome Treated with ACTH (Adrenocorticotrophic Hormone) , Acta haemat. 6:65-70, 1951.Crossref 6. Freund, H. A.: Study of Immediate Effects of ACTH (Adrenocorticotrophic Hormone) on Histopathology of Felty Syndrome , J. Michigan M. Soc. 49:1065-1067, 1950. 7. Hammer, E.: Über die Bieninflussung des Felty Syndrome durch Cortison , Klin. Wchnschr. 30:90, 1952.Crossref 8. Goodman, L., and Gilman, A.: The Pharmacological Basis of Therapeutics: A Textbook of Pharmacology, Toxicology and Therapeutics for Physicians and Medical Students , New York, The Macmillan Company, 1941. 9. Wiseman, B. K., and Doan, C. A.: A Newly Recognized Granulopenic Syndrome Caused by Excessive Splenic Leukolysis and Successfully Treated by Splenectomy , J. Clin. Invest. 19:473, 1939. 10. Salassa, R. M.; Bennett, W. A.; Keating, F. R., Jr., and Sprague, R. F.: Postoperative Adrenal Cortical Insufficiency: Occurrence in Patients Previously Treated with Cortisone , J. A. M. A. 152:1509, 1953.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png A.M.A. Archives of Internal Medicine American Medical Association

FELTY'S SYNDROME: Response to Splenectomy After Cortisone Failure

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Publisher
American Medical Association
Copyright
Copyright © 1955 American Medical Association. All Rights Reserved.
ISSN
0888-2479
DOI
10.1001/archinte.1955.00250080155015
Publisher site
See Article on Publisher Site

Abstract

Abstract THOUGH Felty's original description of the syndrome consisting of rheumatoid arthritis, splenomegaly, and leucopenia was published in 1924,1 it was not until 1932 that hematologic remission following splenectomy was first reported by Hanrahan.2 Since then, 46 cases subjected to splenectomy have appeared in the literature. In 37 of these the leucopenia was relieved.3 The rheumatic manifestations, however, have been alleviated inconstantly by the procedure. The use of the steroid hormones in this disease had been reported only three times prior to the time of this case.* In all of these hematologic and rheumatic remissions were obtained. Normal white cell and differential counts were obtained together with regression of the splenomegaly in each case. However, after cessation of hormone therapy leucopenia, splenomegaly, and arthritic manifestations recurred. The case herein reported is unusual because of the failure of hematologic response to cortisone with subsequent success following splenectomy. REPORT OF References 1. References 4-6. 2. Felty, A. R.: Chronic Arthritis in the Adult, Associated with Splenomegaly and Leukopenia , Bull. Johns Hopkins Hosp. 35:16, 1924. 3. Hanrahan, E. M., and Miller, S. R.: Effect of Splenectomy in Felty's Syndrome , J. A. M. A. 99:1947, 1932. 4. Steinberg, C. L.: Splenectomy in Rheumatoid Arthritis , Ann. Int. Med. 38:787, 1953.Crossref 5. Bichel, J., and Kissmeyer-Nielsen, F.: Felty Syndrome Treated with ACTH (Adrenocorticotrophic Hormone) , Acta haemat. 6:65-70, 1951.Crossref 6. Freund, H. A.: Study of Immediate Effects of ACTH (Adrenocorticotrophic Hormone) on Histopathology of Felty Syndrome , J. Michigan M. Soc. 49:1065-1067, 1950. 7. Hammer, E.: Über die Bieninflussung des Felty Syndrome durch Cortison , Klin. Wchnschr. 30:90, 1952.Crossref 8. Goodman, L., and Gilman, A.: The Pharmacological Basis of Therapeutics: A Textbook of Pharmacology, Toxicology and Therapeutics for Physicians and Medical Students , New York, The Macmillan Company, 1941. 9. Wiseman, B. K., and Doan, C. A.: A Newly Recognized Granulopenic Syndrome Caused by Excessive Splenic Leukolysis and Successfully Treated by Splenectomy , J. Clin. Invest. 19:473, 1939. 10. Salassa, R. M.; Bennett, W. A.; Keating, F. R., Jr., and Sprague, R. F.: Postoperative Adrenal Cortical Insufficiency: Occurrence in Patients Previously Treated with Cortisone , J. A. M. A. 152:1509, 1953.Crossref

Journal

A.M.A. Archives of Internal MedicineAmerican Medical Association

Published: Feb 1, 1955

References