Síndrome de Felty: relato de caso e revisão da terapêutica

Abstract

relAto de cAso cAse rePort INTRODUÇÃO A síndrome de Felty (SF) compreende a tríade de artrite reumatóide (AR), neutropenia e esplenomegalia, ocorrendo em menos de 1% dos pacientes com AR. A faixa etária predominante é da quinta a sétima década, sendo dois terços dos pacientes mulheres. (1,2,3) Ocorre em pacientes portadoras de AR de longa evolução, com importante destruição articular e pouca ou nenhuma inflamação, além de manifestações extra-articulares exuberantes, como nódulos subcutâneos, úlceras de membros inferiores (MMII), linfadenopatia, vasculites e neuropatia periférica. Encontra-se fator reumatóide (FR) em altos títulos em 95% dos casos (4). A esplenomegalia é de tamanho variável, não sendo essencial para o diagnóstico (5) .

Síndrome de Felty e Calazar: um desafio para o reumatologista

“…The cause of neutropenia is multifactorial and includes granulocytopoiesis deficiency and peripheral neutrophil sequestration, with an increase in bacterial infections and consequent increase in mortality. 1 More than 95% of the patients have a positive rheumatoid factor, the antinuclear factor is positive in 47%-100% of the cases and 78% of the patients are HLA-DR4*0401-positive. 7 In 2009, 2 years after the diagnosis of Felty's syndrome, there was serological evidence of leishmaniasis in two indirect immunofluorescence tests, in addition to important epidemiological data.…”

“…After several months, the identification of Leishmania donovani amastigotes in the control myelogram changed the diagnosis of this case into visceral leishmaniasis. 10 Fernández-Guerrero ML et al described a series of ten immunocompromised patients with visceral leishmaniasis, of which two had SLE, three had had kidney Table 2 Causes of neutropenia 1,2,4,5,6 Autoimmune neutropenia is a rare immunohematological condition that can be idiopathic or associated with several diseases, such as rheumatoid arthritis (RA). It is caused by the appearance of autoantibodies against mature neutrophils or myeloid precursors 2,3 and can be classified as primary or secondary.…”