Felty's syndrome: effects of splenectomy upon granulocyte count and granulocyte-associated IgG

Clinical parameters and laboratory studies including granulocyte-associated IgG were documented in 15 patients with Felty's syndrome treated by splenectomy. Five patients did not benefit from splenectomy, six responded partially, and four completely. Response to splenectomy could not be predicted from age, sex, splenomegaly, preoperative granulocyte count, platelet count, lymphocyte count, bone marrow lymphocytosis, or granulocyte bound IgG. In contrast, marked elevation in preoperative serum granulocyte binding IgG predicted response to splenectomy. Furthermore, a postoperative fall in serum granulocyte binding IgG was associated with response. Thus, one beneficial effect of splenectomy in some Felty's syndrome patients is reduction of serum granulocyte binding immunoglobulin.