Chandra Preeti A, Margulis Yevgeniya, Schiff Carl
Departments of Internal Medicine, Maimonides Medical Center, Brooklyn, NY 11219, USA.
Am J Ther. 2008 Jul-Aug;15(4):321-2. doi: 10.1097/MJT.0b013e318164bf32.
Felty's syndrome is regarded as a severe variant of rheumatoid arthritis (RA) that develops in less than 1% of patients with RA. It consists of a triad of RA, splenomegaly, and leukopenia, which tends to develop after a long course of RA. Treatment of neutropenia is mainly comprised of disease-modifying antirheumatic drugs including methotrexate, hydroxychloroquine, auronofin, penicillamine, glucocorticoids, and granulocyte monocyte colony stimulating factor. Recently, there has been a growing interest in the biologic agent rituximab in the treatment of Felty's syndrome. To our knowledge, only one previous case of rituximab being beneficial in the treatment of Felty's syndrome has been reported. We report the case of a 60-year-old man with Felty's syndrome in whom treatment with rituximab led to a sustained neutrophil response and marked symptomatic improvement in the form of decrease in the size of rheumatoid nodules and better pain control.
费尔蒂综合征被视为类风湿关节炎（RA）的一种严重变体，在不到1%的RA患者中发生。它由RA、脾肿大和白细胞减少三联征组成，往往在RA病程较长后出现。中性粒细胞减少症的治疗主要包括改善病情的抗风湿药物，如甲氨蝶呤、羟氯喹、金诺芬、青霉胺、糖皮质激素和粒细胞-单核细胞集落刺激因子。最近，生物制剂利妥昔单抗在费尔蒂综合征治疗中的应用越来越受到关注。据我们所知，此前仅有一例利妥昔单抗治疗费尔蒂综合征有效的报道。我们报告一例60岁患有费尔蒂综合征的男性患者，使用利妥昔单抗治疗后中性粒细胞持续反应，类风湿结节大小减小，疼痛得到更好控制，症状显著改善。
