Liver in Felty's syndrome

Area of Science:

• Rheumatology
• Hematology
• Hepatology

Background:

• Felty's syndrome is a rare autoimmune condition characterized by rheumatoid arthritis, splenomegaly, and neutropenia.
• The syndrome can lead to various systemic complications, including hematological and hepatic abnormalities.

Purpose of the Study:

• To investigate liver function, histology, and hematological changes in patients with Felty's syndrome.
• To understand the spectrum of liver involvement and its association with hematological parameters in this condition.

Main Methods:

• Studied 12 patients diagnosed with Felty's syndrome.
• Assessed liver function tests and liver histology.
• Evaluated hematological parameters, including red cell mass and plasma volume.
• Measured splenic blood flow in a subset of patients.

Main Results:

• Six patients presented with anemia, primarily attributed to increased plasma volume rather than decreased red cell mass.
• Two patients exhibited increased hemolysis and red cell sequestration due to enlarged spleens.
• Eight patients had abnormal liver function tests.
• Liver histology revealed lymphocytic infiltration, sinusoidal and portal tract fibrosis in five patients; one progressed to macronodular cirrhosis.
• Apparent nodular changes in the liver were observed in three patients without definitive cirrhosis.

Conclusions:

• Felty's syndrome is associated with significant hematological alterations, including anemia and hemolysis.
• Hepatic involvement is frequent, ranging from functional abnormalities to structural changes like fibrosis and cirrhosis.
• Enlarged spleens play a role in red cell sequestration and may contribute to the observed hematological and hepatic manifestations.