[Liver findings in Felty's syndrome. A review]

A reaction of the RES with its organs (lymph nodes, spleen, bone marrow and Kupffer's cells) is not uncommon in rheumatoid arthritis. Although these manifestations are pronounced in Felty's syndrome, reviewing articles about Felty's do not mention liver manifestations. This paper summarises the publications about liver findings in Felty's syndrome. Hepatomegaly, abnormal bromsulfalein tests, raised alkaline phosphatase and transaminases have been stated in many case reports. Among 34 patients, the frequency of hepatomegaly was 68%, of abnormal bromsulfalein tests 27%, of alkaline phosphatase 23% and of transaminases 18%, respectively (52). Alkaline phosphatase and transaminases were raised in almost all of 12 patients (3). The histological correspondence is an infiltration with lymphocytes of sinusoids and portal fields, a portal fibrosis and occasionally a cirrhosis. These histological abnormalities, as well as enlarged lymph nodes and splenomegaly, have to be considered as organic manifestations of rheumatoid arthritis. If the nodular regenerative hyperplasia of the liver, which has been reported also after use of contraceptives, is a manifestation of Felty's syndrome, remains unresolved.