Blendis L M, Lovell D, Barnes C G, Ritland S, Cattan D, Vesin P
Ann Rheum Dis. 1978 Apr;37(2):183-6. doi: 10.1136/ard.37.2.183.
Four patients with Felty's syndrome developed massive upper gastrointestinal bleeding due to oesophageal varices. The underlying hepatic pathology in all 4 was nodular regenerative hyperplasia. This appears to be a difficult histological diagnosis to make, having been initially reported as normal on percutaneous biopsy or as fibrosis or cirrhosis on wedge biopsy. This series brings the total number of cases reported in the English literature of this association to 12, suggesting a definite symptom complex. The portal hypertension seems to be due to a combination of increased splenic blood flow and postsinusoidal resistance. The clinical importance of this syndrome is that the appropriate therapy for bleeding oesophageal varices appears to be shunt procedure such as a splenorenal shunt with splenectomy, which should be well tolerated.
4例费尔蒂综合征患者因食管静脉曲张发生大量上消化道出血。所有4例患者潜在的肝脏病理改变均为结节性再生性增生。这似乎是一种难以做出的组织学诊断，最初经皮活检报告为正常，楔形活检报告为纤维化或肝硬化。该系列病例使英文文献中报道的这种关联的病例总数达到12例，提示存在一种明确的症状复合体。门静脉高压似乎是脾血流量增加和窦后阻力增加共同作用的结果。该综合征的临床意义在于，对于出血性食管静脉曲张，合适的治疗方法似乎是分流手术，如脾肾分流加脾切除术，患者对此耐受性良好。
