ʻO Felty Syndrome

ʻO ka maʻi ʻo Felty kahi maʻi e pili pū me ka rheumatoid arthritis, kahi maʻi āhū, hoʻemi i ka helu o ke koko keʻokeʻo, a me nā maʻi hou. Kākaʻikahi wale nō.

ʻAʻole ʻike ʻia ke kumu o ka maʻi ʻo Felty. ʻOi aku ka nui o nā poʻe i loaʻa i ka rumatika (RA) no ka manawa lōʻihi. Kūpono ka poʻe me kēia maʻi maʻi no ka maʻi maʻi no ka mea he haʻahaʻa koko keʻokeʻo ka helu o lākou.

ʻO nā hōʻailona me:

• ʻO ka manaʻo nui o ka hōʻoluʻolu (malaise)
• Ka luhi
• Nāwaliwali i ka wāwae a lima paha
• Loaʻa ka ʻai ʻole
• Ka hoʻohaʻahaʻa kaumaha ʻole
• Ulcer i loko o ka ʻili
• Huʻi hui, ʻoʻoleʻa, ʻeha, a me ke kīnā ʻole
• Nā maʻi hou
• ʻO ka maka ʻulaʻula me ka puhi ʻana a i ʻole ka hoʻokuʻu ʻana

E hōʻike ʻia kahi hoʻokolohua kino:

• ʻLepala nunui
• Nā hui e hōʻike i nā hōʻailona o RA
• Pahu paha ke ake a me nā aka lymph

ʻO kahi helu piha o ke koko (CBC) me ka ʻokoʻa e hōʻike i kahi helu haʻahaʻa o nā hunaola keʻokeʻo i kapa ʻia he neutrophil. Ma kahi kokoke i nā poʻe āpau me ka maʻi Felty i loaʻa kahi hōʻoia maikaʻi no ka mea rheumatoid.

Hiki paha i kahi ultrasound ʻōpū ke hōʻoia i ka maʻi pehu.

I ka hapanui o nā hihia, ʻaʻole loaʻa nā poʻe i loaʻa i kēia maʻi i ka lāʻau lapaʻau no RA. Pono paha lākou i nā lāʻau ʻē aʻe e kāohi i kā lākou ʻōnaehana pale maʻi a hoʻemi i ka hana o kā lākou RA.

Hiki i ka Methotrexate ke hoʻomaikaʻi i ka helu neutrophil haʻahaʻa. Ua kūleʻa ka lāʻau rituximab i ka poʻe i pane ʻole i ka methotrexate.

Hiki i ka Granulocyte-colony stimulate factor (G-CSF) ke hoʻāla i ka helu neutrophil.

Pōmaikaʻi kekahi poʻe i ka hemo ʻana o ka spleen (splenectomy).

Me ka ʻole o ka lapaʻau ʻana, e hoʻomau ʻia nā maʻi.

Maliʻa paha e mānoanoa ʻo RA.

ʻO ka mālama ʻana i ka RA, akā, pono e hoʻomaikaʻi i ka maʻi ʻo Felty.

Loaʻa paha iā ʻoe nā maʻi e hoʻi hou ana.

Ua hoʻonui kekahi poʻe me ka maʻi Felty i ka nui o nā lymphocytes granular nui, i kapa ʻia hoʻi ʻo LGL leukemia. E mālama ʻia kēia me ka methotrexate i nā manawa he nui.

Kāhea i kāu lawelawe mālama ola inā hoʻomohala ʻoe i nā ʻōuli o kēia maʻi.

ʻO ka mālama koke ʻana iā RA me nā lāʻau i manaʻo ʻia i kēia manawa e hoʻoliʻiliʻi nui i ka makaʻu o ka hoʻomohala ʻana i ka maʻi Felty.

Seropositive rheumatoid arthritis (RA); ʻO Felty's Syndrome

• Nā Antibodies

Bellistri JP, Muscarella P. Splenectomy no nā maʻi hematologic. I: Cameron JL, Cameron AM, eds. ʻO ke kaʻoki lāʻau lapaʻau o kēia manawa. 12th ed. Piladelapia, PA: Elsevier; 2017: 603-610.

Erickson AR, Cannella AC, Mikuls TR. Nā hiʻohiʻona olakino o ka rheumatoid arthritis. I: Firestein GS, Budd RC, Gabriel SE, McInnes IB, O'Dell JR, nā hua. ʻO Kelley lāua ʻo Firestein's Bookbook of Rheumatology. 10 o ka lā. Piladelapia, PA: Elsevier; 2017: chap 70.

ʻO Gazitt T, Loughran TP Jr. Nā neutropenia maʻi ma LGL leukemia a me ka rheumatoid arthritis. Polokalamu Hematology Am Soc Hematol Educ. 2017; 2017 (1): 181-186. PMID: 29222254 www.ncbi.nlm.nih.gov/pubmed/29222254.

Myasoedova E, Turesson C, Matteson EL. Nā hiʻohiʻona keu o ka rheumatoid arthritis. I: Hochberg MC, Gravallese EM, Silman AJ, Smolen JS, Weinblatt ME, Weisman MH, eds. Rheumatology. ʻEpekema 7 Piladelapia, PA: Elsevier; 2019: chap 95.

Savola P, Brück O, Olson T, et al. Somatic Kānāwai3 mutations in Felty syndrome: kahi hopena no kahi pathogenesis maʻamau me ka leukemia lymphocyte granular nui. Haematologica. 2018; 103 (2): 304-312. PMID: 29217783 www.ncbi.nlm.nih.gov/pubmed/29217783.

ʻO Wang CR, Chiu YC, Chen YC. ʻO ka mālama kūleʻa ʻana i ka neutropenia refactory i ka maʻi o Felty me ka rituximab. Scand J Rheumatol. 2018; 47 (4): 340-341. PMID: 28753121 www.ncbi.nlm.nih.gov/pubmed/28753121.