SPLENECTOMY IN RHEUMATOID ARTHRITIS
Authors: C L STEINBERG
Journal: Annals of Internal Medicine (1953)

Article1 April 1953SPLENECTOMY IN RHEUMATOID ARTHRITISCHARLES LEROY STEINBERG, B.S., M.D., F.A.C.P.CHARLES LEROY STEINBERG, B.S., M.D., F.A.C.P.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-38-4-787 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptThe purpose of this paper is to suggest a new cause and effect for the beneficial sequelae produced by splenectomy in Felty's syndrome. Felty1 described a syndrome of mild rheumatoid arthritis associated with fever, secondary anemia (in four of five cases reported), leukopenia ranging from 1,000 to 4,200 leukocytes, splenomegaly and tachycardia. Rheumatologists are practically unanimous in believing that this syndrome is a variant of rheumatoid arthritis.Forty-six papers1-46have been published on the value of splenectomy in rheumatoid arthritis; 37 patients have been described in these papers as having undergone splenectomy successfully. The effects of splenectomy in these cases...Bibliography1. Felty AR: Chronic arthritis in the adult, associated with splenomegaly and leucopenia, Bull. Johns Hopkins Hosp. 35: 16, 1924. Google Scholar2. HanrahanMiller EMSR: Effect of splenectomy in Felty's syndrome, J. A. M. A. 99: 1947, 1932. Google Scholar3. Craven EB: Splenectomy in chronic arthritis, associated with splenomegaly and leucopenia (Felty's syndrome), J. A. M. A. 102: 823, 1934. CrossrefGoogle Scholar4. Alessandrini P: Felty's syndrome, Minerva med. 1: 310, 1934. Google Scholar5. Fritz R: Painful joints, splenomegaly and anemia, M. Clin. North America 18: 1053-1066, 1935. Google Scholar6. PriceSchoenfeld AEJB: Felty's syndrome (report of a case with complete postmortem findings), Ann. Int. Med. 7: 1230, 1934. LinkGoogle Scholar7. Williams RH: Felty's syndrome; report of a case with necropsy findings, Ann. Int. Med. 9: 1247, 1936. LinkGoogle Scholar8. CurtisPollard ACHM: Felty's syndrome; its several features, including tissue changes, compared with other forms of rheumatoid arthritis, Ann. Int. Med. 13: 2265, 1940. LinkGoogle Scholar9. Benchimol AS: Indication for splenectomy, Prensa méd. argent. 37: 2738-2742 (Nov. 10) 1950. MedlineGoogle Scholar10. Böhlke E: Pathogenetic and hematologic observations on Felty's syndrome in a case of sepsis lenta, Aerztl. Wchnschr. 5: 1001-1004 (Dec.) 1950. MedlineGoogle Scholar11. Cremer J: Felty syndrome; report of a case and review of literature, Deutsches Arch. f. klin. Med. 187: 269-280, 1941. Google Scholar12. Jiménez DiazMoralesdeOyaRodaLópez García CMJCEE: Nature of so-called Felty's syndrome and similar disorders; polyarthritic reticulosis, Rev. Clin. Españ. 23: 368-378 (Dec. 15) 1946. Google Scholar13. Donner M: Felty's syndrome; with a contribution to the differential diagnosis of primary chronic disease of the joints, Deutsche med. Wchnschr. 75: 1253-1255 (Sept. 22) 1950. CrossrefMedlineGoogle Scholar14. Ekelund C: Felty's syndrome in connection with 2 cases, Nord. med. 17: 434-436 (March 13) 1943. Google Scholar15. FershtandHolsapple JBCK: Rheumatoid arthritis with neutropenia and splenomegaly (Felty's syndrome) with improvement after splenectomy, Texas State J. Med. 46: 842-845 (Nov.) 1950. MedlineGoogle Scholar16. Francesco R: La sindrome di Felty, Gazz. d. osp. 49: 33-39, 1948. Google Scholar17. Freund HA: A study of the immediate effects of ACTH on the histopathology of Felty's syndrome, J. Michigan M. Soc. 49: 1065-1067 (Sept.) 1950. MedlineGoogle Scholar18. Gabler E: Felty's syndrome in chronic hematogenous tuberculosis; splenectomy, Wien. Ztschr. inn. Med. 32: 24-30 (Jan.) 1951. MedlineGoogle Scholar19. Gould WR: Hypersplenism with arthritis; case (relation to Felty's syndrome), Lancet 2: 989-991 (Nov. 26) 1949. CrossrefMedlineGoogle Scholar20. Gyntelberg I: Felty's syndrome treated with splenectomy, Case, Nord. med. (Hospitalstid.) 13: 927-930, 1942. Google Scholar21. HuttRichardsonStaffurth MSJSJS: Felty's syndrome. Report of 4 cases treated with splenectomy, Quart. J. Med. 20: 57-74 (Jan.) 1951. MedlineGoogle Scholar22. KanarHarkinsCroneLyterRobinson EAHNRICSAH: Felty's syndrome: report of 2 cases treated by splenectomy, West J. Surg. 58: 670-681, 1950. Google Scholar23. Klausgraber F: Zur Therapie der Feltyschen Erkrankung, Wien. klin. Wchnschr. 60: 708 (Oct. 29) 1948. MedlineGoogle Scholar24. LarizzaRovello PF: Felty's syndrome; leukopenic, adenosplenomegalic chronic polyarthritis, Arch. pat. e clin. med. 27: 115-165, 1949. Google Scholar25. LayaniGatellierAschkenasyHamard FJAG: Felty's syndrome; immediate and late results of splenectomy; case, Bull. et mém. Soc. méd. d. hôp. de Paris 63: 914-922, 1947. MedlineGoogle Scholar26. Lindeboom GA: Felty's syndrome, Nederl. tijdschr. v. geneesk. 93: 4085-4092 (Dec. 3) 1949. MedlineGoogle Scholar27. Lindeboom GA: Felty's syndrome, Gastroenterologia 75: 129-137, 1949-50. CrossrefGoogle Scholar28. LöfflerMaier WC: Felty's syndrome with cyclic agranulocytosis; conception of infectious rheumatism as manifestation of individual reaction, Cardiologia 12: 195-210, 1947-48. Google Scholar29. LockieSanesVaughan LMSSL: Chronic arthritis associated with neutrophilic leukopenia, splenomegaly and hepatomegaly. Felty's syndrome, Am. J. Clin. Path. 12: 372-379, 1942. CrossrefGoogle Scholar30. Nyström G: Felty's syndrome with recovery after splenectomy, Nord. med. 32: 2567-2570 (Nov. 8) 1946. Google Scholar31. PetridesSchmengler PFE: Hematologic peculiarities in complex chronic rheumatic disease (Felty syndrome), Aerztl. Forsch. 3: 314-317 (June 25) 1949. Google Scholar32. Pliess G: Morphology and pathogenesis of the Felty syndrome as contribution to problem of rheumatism, Frankf. Ztschr. f. Path. 62: 284-306, 1951. MedlineGoogle Scholar33. Quattrin N: Relation between Felty's syndrome and riboflavin deficiency, Arch. "E. Maragliano" pat. e clin. 2: 61-70 (Jan.-Feb.) 1947. Google Scholar34. RogersLangley HMFH: Neutropenia associated with splenomegaly and atrophic arthritis (Felty syndrome): case in which splenectomy was performed, Ann. Int. Med. 32: 745-754, 1950. LinkGoogle Scholar35. Rovello F: Felty's syndrome; clinical and therapeutic remarks, Rheumatism 6: 149-156 (Oct.) 1950. MedlineGoogle Scholar36. Rovello F: Felty syndrome, Gazz. d. osp. 69: 33-39 (Feb.) 1948. Google Scholar37. SmithMcCabe SES: Primary splenic neutropenia with arthritis (so-called Felty syndrome); treatment by splenectomy, Ann. Int. Med. 29: 445-455, 1948. LinkGoogle Scholar38. Steinberg CL: Value of splenectomy in Felty syndrome, Ann. Int. Med. 12: 26-40, 1942. Google Scholar39. SteinbrockerSesit OMF: Chronic rheumatoid arthritis with granuloma of spleen and lymph nodes in patient presenting clinical picture of Felty's syndrome, New York State J. Med. 40: 1795-1797, 1940. Google Scholar40. Tarnowski CE: Felty syndrome; case, Nord. med. 26: 891-892 (April 27) 1945. Google Scholar41. VanBalen GF: Rheumatoid arthritis with hypertrophy of spleen and lymph nodes (Still-Felty syndrome), Geneesk. gids. 18: 1080-1088, 1940. Google Scholar42. Waitzkin L: Complication and sequels—Felty syndrome, Virginia M. Monthly 69: 80-84, 1942. Google Scholar43. Ytrehus O: Felty syndrome, 3 cases, Acta med. Scandinav. 126: 437-448, 1947. CrossrefGoogle Scholar44. Zimmer J: Felty syndrome: splenomegalia, leucopenia and chronic polyarthritis,—familial occurrence, Acta med. Scandinav. 120: 543-567, 1945. CrossrefGoogle Scholar45. CollerBlainAndrews FAAG: Indications for and results of splenectomy, 1950, Chas. C. Thomas, Springfield, Ill., pp. 69-73. Google Scholar46. BachJacobs FJH: Splenectomy in rheumatoid arthritis, Ann. Rheumat. Dis. 10: 320, 1951. CrossrefMedlineGoogle Scholar47. WisemanDoan BKCA: A newly recognized granulopenic syndrome caused by excessive splenic leukolysis and successfully treated by splenectomy, J. Clin. Investigation 19: 473, 1939. Google Scholar48. DameshekEstren WS: The spleen and hypersplenism, 1947, Grune and Stratton, New York. Google Scholar49. Perla D: Relation of the hypothesis to the spleen, J. Exper. Med. 30: 599, 1936. CrossrefGoogle Scholar50. Hirschboeck JS: Hematologic effects of splenectomy in Still-Chauffard-Felty's syndrome. A report of 2 cases, Blood 1: 247, 1946. CrossrefMedlineGoogle Scholar51. Friedgood HF: The effect of an alkaline extract of the anterior hypothesis upon the weight of the spleen and adrenal gland and upon the blood calcium level, Endocrinology 20: 159, 1936. CrossrefGoogle Scholar52. Smith PE: Hypophysectomy and replacement therapy in rats, Am. J. Anat. 45: 205, 1930. CrossrefGoogle Scholar53. HoussayLascano-Gonovales BAJM: Spleen in hypophysectomized dogs, Compt. rend. Soc. de biol. 118: 485, 1934. Google Scholar54. Waugh TR: Acquired hemolytic jaundice in a woman previously splenectomized by essential thrombocytopenia, Folia haemat. 48: 248, 1932. Google Scholar55. Barcroft J: Alterations in volume of normal spleen and their significance, Am. J. M. Sc. 179: 1-10, 1930. Google Scholar56. BarcroftStevens JJG: Effect of pregnancy and menstruation on size of spleen, J. Physiol. 66: 32-36 (Sept.) 1928. CrossrefMedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: Rochester, N. Y.*Received for publication October 11, 1952. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byThe spleen in Felty's syndrome: A histological, morphometrical, and immunohistochemical studyThe rarity of felty's syndrome in blacksSplenectomy for hematologic disordersClinical and Serologic Observations on 27 Patients with Felty's SyndromeHematologic disorder in Felty's syndromeThe variable features of Felty's syndromeIndikationen zur Splenektomie bei BlutkrankheitenFELTY'S SYNDROMERHEUMATISM AND ARTHRITIS REVIEW OF AMERICAN AND ENGLISH LITERATURE OF RECENT YEARS (ELEVENTH RHEUMATISM REVIEW)* Part IIWILLIAM D. ROBINSON, M.D., F.A.C.P., JOSEPH J. BUNIM, M.D., F.A.C.P., WILLIAM S. CLARK, M.D., DARRELL C. CRAIN, M.D., F.A.C.P., EPHRAIM P. ENGLEMAN, M.D., F.A.C.P., DONALD C. GRAHAM, M.D., F.R.C.P. (C), MAX M. MONTGOMERY, M.D., F.A.C.P., BERNARD M. NORCROSS, M.D., F.A.C.P., CHARLES RAGAN, M.D., F.A.C.P., MARIAN W. ROPES, M.D., F.A.C.P., EDWARD F. ROSENBERG, M.D., F.A.C.P., CHARLEY J. SMYTH, M.D., F.A.C.P.The Anemia of Rheumatoid Arthritis 1 April 1953Volume 38, Issue 4Page: 787-813KeywordsAnemiaFelty syndromeFeversPhotographyRheumatoid arthritisSplenectomySplenomegalyTachycardia ePublished: 1 December 2008 Issue Published: 1 April 1953 PDF downloadLoading ...