Splenectomy for Felty's syndrome. Clinicopathological study of 27 patients

Abstract

The major clinical and pathological features and the long-term follow-up of 27 patients with Felty''s syndrome who were treated with splenectomy for severe granulocytopenia and for acute, chronic or recurrent infection were studied. Granulocyte counts rose within days in most patients, although slow responses and transient granulocytopenia did occur; only 12% of the patients had persistent or recurrent granulocytopenia. Infections resolved promptly in 77% of the patients, more slowly in the remainder, and only 1 patient had new problems of infection after splenectomy. Splenic enlargement, present in all but 1 case, was attributable to expansion of the sinusoidal pulp. The most substantial pathological features of immune stimulation included germinal center hyperplasia and prominent clusters of plasma and preplasma cells within sinuses.