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Adv Skin Wound Care 2022 Jul;35(7):1-4

In Queensland, Australia, Belinda Burgess, MD, is Intern, Darling Downs Hospital and Health Service, Toowoomba; Lisa Cummins, MBBS, FRACP, is Senior Lecturer, University of Queensland, and Staff Specialist Rheumatologist, Mater Hospital Brisbane; David Wong, MBBS, FRCPA, is Anatomical Pathologist, Mater Hospital Brisbane; and John Bingley, PhD, MBBS, MMedSci, FRACS (Vasc), is Senior Visiting Specialist, Mater Hospital Brisbane. The authors have disclosed no financial relationships related to this article. Submitted June 24, 2021; accepted in revised form August 11, 2021.

Abstract: The authors report the case of a 55-year-old patient with a chronic lower-limb wound thought to be secondary to vasculitis. This case illustrates the importance of maintaining a high index of suspicion for vasculitic ulcers in patients with autoimmune disease. Management considerations in this context are also discussed. Read More

Front Oncol 2022 13;12:869205. Epub 2022 May 13.

University of Virginia Cancer Center, University of Virginia School of Medicine, Charlottesville, VA, United States.

Large granular lymphocyte (LGL) leukemia, a rare hematologic malignancy, has long been associated with rheumatoid arthritis (RA), and the diseases share numerous common features. This review aims to outline the parallels and comparisons between the diseases as well as discuss the potential mechanisms for the relationship between LGL leukemia and RA. RA alone and in conjunction with LGL leukemia exhibits cytotoxic T-cell (CTL) expansions, HLA-DR4 enrichment, RA-associated autoantibodies, female bias, and unknown antigen specificity of associated T-cell expansions. Read More

Cureus 2022 Apr 29;14(4):e24593. Epub 2022 Apr 29.

Internal Medicine, Methodist Health System, Dallas, USA.

We present a case of a 56-year-old female patient who presented to the emergency department with a one-day history of fever and confusion. She was found to have splenomegaly, multiple swan neck deformities, and pancytopenia. Chart review revealed that she had a three-year history of pancytopenia with two prior non-diagnostic bone marrow biopsies. Read More

J Dermatol 2022 06 21;49(6):e208-e209. Epub 2022 Feb 21.

Department of Nephrology and Rheumatology, Kido Hospital, Niigata, Japan.

Cureus 2021 Dec 26;13(12):e20713. Epub 2021 Dec 26.

Department of Medicine, University of Utah, School of Medicine, Salt Lake City, USA.

Felty syndrome (FS) and infective endocarditis (IE) can present with similar signs and symptoms. FS is a diagnosis of exclusion, which poses a challenge for the clinician since accurate diagnosis is required to treat this condition effectively. A 52-year-old woman with a 15-year history of rheumatoid arthritis (RA) was admitted due to dyspnea and pain in the right ankle and left arm for two weeks. Read More

Z Rheumatol 2022 Apr 11;81(3):240-243. Epub 2021 Oct 11.

Klinik für Rheumatologie und Immunologie, Klinikum Bad Bramstedt, Oskar-Alexander-Straße 26, 24576, Bad Bramstedt, Deutschland.

Visceral leishmaniasis (VL) is a chronic parasitic disease caused by pathogens of the genus Leishmania, which can mimic numerous diseases. The leading symptoms of VL (splenomegaly, pancytopenia, fever) can be misinterpreted, especially if autoantibodies are detected, and lead to the misdiagnosis of an underlying rheumatic disease (e.g. Read More

Cureus 2021 Aug 15;13(8):e17206. Epub 2021 Aug 15.

Hematology and Medical Oncology, Rutgers Health/Trinitas Regional Medical Center, Elizabeth, USA.

Felty syndrome (FS), an uncommon manifestation seen in patients with rheumatoid arthritis (RA), usually presents as a triad of erosive arthritis, splenomegaly, and neutropenia. It is extremely rare for RA to present as FS or develop after initially presenting as neutropenia and splenomegaly. In this report, we describe a case of a 55-year-old woman who initially presented with fever and vaginal pain. Read More

Am J Blood Res 2021 15;11(3):227-237. Epub 2021 Jun 15.

Laboratory of Molecular Hematology, National Research Center for Hematology Moscow, Russia.

T cell large granular lymphocytic (T-LGL) leukemia is a rare type of mature T cell neoplasm. The typical features of T-LGL leukemia include an increased number of large granular lymphocytes in the peripheral blood, cytopenia (most commonly neutropenia), and mild-to-moderate splenomegaly. Up to 28% of patients with T-LGL leukemia have rheumatoid arthritis (RA). Read More

Autops Case Rep 2021 8;11:e2020225. Epub 2020 Dec 8.

Dartmouth-Hitchcock Medical Center, Department of Pathology and Laboratory Medicine, Lebanon, NH, USA.

Tumor lysis syndrome is a well-characterized and potentially deadly complication of spontaneous or treatment-related tumor destruction, and it is most commonly associated with hematologic malignancies. Our case illustrates a rare example of fatal tumor lysis syndrome in the setting of metastatic gastric adenocarcinoma treated with radiation therapy. This case highlights the critical importance of identifying patients with solid organ malignancies at risk for tumor lysis syndrome and of early recognition and treatment of this syndrome. Read More

J Med Case Rep 2021 May 27;15(1):273. Epub 2021 May 27.

Orange Regional Medical Center, Middletown, NY, USA.

Background: Felty syndrome is a rare manifestation of chronic rheumatoid arthritis in which patients develop extraarticular features of hepatosplenomegaly and neutropenia. The typical presentation of Felty syndrome is in Caucasians, females, and patients with long-standing rheumatoid arthritis of 10 or more years. This case report presents a patient with an early-onset and atypical demographic for Felty syndrome. Read More

J Clin Apher 2021 Aug 4;36(4):658-663. Epub 2021 May 4.

Department of Pathology, Division of Transfusion Medicine and Hemostasis, University of Texas Southwestern Medical Center, Dallas, Texas, USA.

Hyperviscosity syndrome (HVS) is a life-threatening syndrome caused by high concentrations of large plasma proteins like IgM, rheumatoid factor, and other immune complexes, leading to increased blood viscosity and symptoms such as visual abnormalities, neurological impairment, bleeding diathesis, and thrombosis. While Waldenström's macroglobulinemia accounts for 80% to 90% of cases, HVS may develop in other clinical settings characterized by elevations in plasma proteins. Limited evidence currently exists describing the safety and efficacy of therapeutic plasma exchange (TPE) for the management of HVS secondary to non-neoplastic conditions. Read More

Laryngoscope 2022 Jan 30;132(1):17-19. Epub 2021 Mar 30.

Department Otolaryngology Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, U.S.A.

Delayed tracheal rupture following total thyroidectomy (TT) is rare and represents a potential airway emergency. A 34-year-old female with Felty Syndrome underwent TT for Hashimoto's thyroiditis. On post-operative day 10, she presented with subcutaneous emphysema and an anterolateral tracheal perforation on CT scan. Read More

Intern Med J 2021 02;51(2):303-304

Department of Immunology, Nepean Hospital, Sydney, New South Wales, Australia.

Medicine (Baltimore) 2020 Dec;99(51):e23608

Department of traditional Chinese medicine, southern theater general hospital, the Chinese People's Liberation Army, Guangzhou, China.

Rationale: Felty syndrome is a rare and life-threatening type of rheumatoid arthritis (RA).

Patient Concerns: A patient with RA had skin rash and subcutaneous hemorrhage, with a significant decrease in blood hemoglobin (Hb), white blood cell count (WBC), and blood platelet count (BPC).

Diagnoses: The patient had a history of RA, splenomegaly, decreased Hb, WBC, BPC, and normal immunological indexes, combined with a series of bone marrow related tests and genetic tests. Read More

Rheumatol Int 2021 Jan 5;41(1):147-156. Epub 2020 Dec 5.

Laboratory of Molecular Hematology, National Research Center for Hematology, Moscow, Russia.

T-cell large granular lymphocytic leukemia (T-LGLL) is a lymphoproliferative disorder characterized by a persistent increase in the number of large granular lymphocytes (LGLs), neutropenia, and splenomegaly. Clinical manifestations of T-LGLL in the setting of rheumatoid arthritis (RA) are often identical to those in which one would suspect Felty's syndrome (FS). These disorders are distinguished by the presence of T-cell clonality, which is present in T-LGLL but not in FS. Read More

Acta Haematol 2021 20;144(4):403-412. Epub 2020 Nov 20.

Institute of Rheumatology, Rabin Medical Center, Beilinson Hospital, Petach Tikva, Israel.

Background: Rheumatic diseases have many hematological manifestations. Blood dyscrasias and other hematological abnormalities are sometimes the first sign of rheumatic disease. In addition, novel antirheumatic biological agents may cause cytopenias. Read More

Mod Rheumatol Case Rep 2020 07 30;4(2):168-170. Epub 2020 Jan 30.

Department of Immuno-Rheumatology Center, Arisawa General Hospital, Hirakata, Osaka, Japan.

We report the case of a 69-year-old man with a 38-year history of rheumatoid arthritis (RA), who developed Felty's syndrome, successful treatment with abatacept (ABT). He was treated with etanercept 50 mg/w and methotrexate 8 mg/w for the past 5 years. He was suffered from febrile neutropenia 6 months ago. Read More

Biomed Res Int 2020 1;2020:2618260. Epub 2020 Jul 1.

Center of Liver Diseases, Beijing Ditan Hospital of Capital Medical University, Beijing, China.

Felty's syndrome (FS) is a disorder wherein patients with rheumatoid arthritis develop splenomegaly, neutropenia, and in some cases, portal hypertension without underlying cirrhosis. Esophageal variceal bleeding is a complication of FS in patients with portal hypertension. In contrast to splenectomy, few reports exist on the management of variceal bleeding with endoscopic therapy. Read More

J Investig Med High Impact Case Rep 2020 Jan-Dec;8:2324709620941303

Nassau University Medical Center, East Meadow, NY, USA.

Large granular lymphocyte leukemia (LGL) is a clonal, lymphoproliferative disorder with an indolent disease course. T-cell LGL (T-LGL) is the most common type of LGL driven from T-cell lineage (85%). The coexistence of T-LGL with several types of autoimmune disorders, mostly rheumatoid arthritis (RA), has been reported. Read More

Open Access Rheumatol 2020 28;12:65-71. Epub 2020 May 28.

Internal Medicine Department, Imam Khomeini Hospital, Ardabil University of Medical Sciences (ARUMS), Ardabil, Iran.

Background And Aims: Familial Mediterranean fever (FMF) is a prototype of autoinflammatory disease and mainly associated with gene mutations. This single-center study as an experience represents FMF-coexisting disease in the FMF registration database.

Methods: Four hundred patients who had FMF based on clinical criteria (Tel-Hashomer) and/or mutations enrolled the study. Read More

J Clin Rheumatol 2021 Dec;27(8S):S829-S831

Department of Rheumatology, University of Cincinnati Medical Center, Cincinnati, OH.

Rheumatol Int 2020 Jul 28;40(7):1143-1149. Epub 2020 Apr 28.

Department of Rheumatology and Immunology, Jingzhou Central Hospital, Jingzhou Hospital Affiliated to Tongji Medical College, Huazhong University of Science and Technology, Jingzhou, 434000, China.

Felty's syndrome (FS) is a deforming disease, characterized by the triad of rheumatoid arthritis (RA), neutropenia, and splenomegaly. Currently, FS patients are treated mainly with immunosuppressants, such as methotrexate and glucocorticoids, which however are not suitable to some patients and may cause severe side effects. Here we report a clinical FS case that was treated with Tocilizumab (TCZ) successfully. Read More

BMC Pediatr 2020 04 7;20(1):153. Epub 2020 Apr 7.

Department of Rheumatology, Children's Hospital of Fudan University, 399 Wan-yuan Road, Shanghai, 201102, China.

Background: Felty's syndrome (FS) is characterized by the triad of rheumatoid arthritis (RA), splenomegaly and neutropenia. The arthritis is typically severe and virtually always associated with high-titer rheumatoid factor. The presence of persistent neutropenia is generally required to make the diagnosis. Read More

Rheumatology (Oxford) 2020 01;59(1):256-259

Department of Endocrinology, Metabolism, Nephrology and Rheumatology, Kochi Medical School Hospital, Kochi University, Nankoku, Japan.

Med Clin (Barc) 2020 05 4;154(10):420-421. Epub 2019 Jun 4.

Servicio de Medicina Interna, Consorci Hospitalari de Vic, Vic, Barcelona, España.

Mayo Clin Proc 2019 06;94(6):1073-1078

Advisor to residents and Consultant in Hematology, Mayo Clinic, Rochester, MN. Electronic address:

Cureus 2019 Feb 15;11(2):e4079. Epub 2019 Feb 15.

Internal Medicine, University of South Dakota, Sioux Falls, USA.

Felty syndrome, a rare extra-articular manifestation of rheumatoid arthritis (RA), usually affects patients with long-standing disease. Patients with this syndrome typically present with neutropenia, splenomegaly, in addition to erosive RA. The development of unexplained neutropenia in healthy patients should prompt the work up for Felty syndrome, especially in patients with suggestive demographics, signs, and symptoms. Read More

J Clin Rheumatol 2021 Dec;27(8S):S613-S614

Med Princ Pract 2018 2;27(6):501-507. Epub 2018 Sep 2.

Larkin Community Hospital, Miami, Florida, USA.

Rheumatoid arthritis (RA) is a chronic, inflammatory, systemic autoimmune disease, affecting the joints with varying severity among patients. The risk factors include age, gender, genetics, and environmental exposure (cigarette smoking, air pollutants, and occupational). Many complications can follow, such as permanent joint damage requiring arthroplasty, rheumatoid vasculitis, and Felty syndrome requiring splenectomy if it remains unaddressed. Read More