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Hematological manifestations of rheumatoid arthritis
1Rheumatology Department, Division of Immunity and Infection, The Medical School, University of Birmingham, UK. s.j.bowman@bham.ac.uk
Objective:
To inform clinical rheumatologists about the common and rarer hematological manifestations of rheumatoid arthritis with an emphasis on diagnosis and therapy and a particular reference to Felty's syndrome.
Methods:
Literature review.
Results:
The hematological manifestations can be conveniently categorized into the broad areas of; anemia, particularly NSAID induced iron deficiency anemia and the anemia of chronic disease, neutropenia, particularly Felty's syndrome and the large granular lymphocyte syndrome and drug induced neutropenia; thrombocytopenia, particularly autoimmune and drug induced thrombocytopenia; and hematological malignancy. Rarer conditions, their diagnosis and therapy are also described in this review.
Conclusion:
Hematological manifestations of rheumatoid arthritis are very common. A logical approach using easily available tests should allow straightforward decisions about diagnosis and therapy to be made, even in patients with some of the rarer manifestations.