费尔蒂综合征的临床分析(附五例报告)

目的 总结费尔蒂综合征(FS)的临床特点.方法 回顾性分析我院收治的5例FS综合征患者的临床资料,并进行文献复习.结果 ①临床特点:5例均有类风湿性关节炎病史、脾大、贫血;4例发热或反复感染,2例轻度肝大;1例继发性干燥综合征,体重下降4例;②实验室检查:5例均有血细胞降低、血沉增快、免疫球蛋白增高、手足骨质破坏;类风湿因子高滴度阳性、抗核抗体阳性及低补体血症各4例.③5例均用激素和免疫抑制剂联合治疗,2例行脾切除.结论 FS是类风湿关节炎的特殊类型,具有独特的临床表现,激素和免疫抑制剂可治疗本病,必要时予以脾切除.

The retrospective analysis of 5 cases with Felty's syndrome

Objective To study the clinical features of Felty's syndrome,to understanding and to clarify the diagnosis way of Felty's syndrome.Methods The clinical data of five cases with Felty's syndrome in PUMCH from January 1998 to January 2006 were reviewed.Results(1)All the five patients were female,whose age ranged from 30 to 60(the mean age was 45.8),and they suffered from the disease for a mean period of 13.2 years(4-30 years)(2)The major clinical traits and presentations include the history of rheumatoid arthritis(5 cases),splenomegaly(5 cases),anemia(5 cases),fever or infection(4 cases),hepatomegaly(2 cases,mildly),secondary xerosis(1 case)and weight loss(4 cases).The laboratory examination showed hemocytopenia(5 cases),high level ESR(5 cases),RF positivity in high titers(4 cases),ANA positive(4 cases),Hypergammaglobulinemia(5 cases),hypocomplementemia(4 cases),joints destructions of hands or feet(5 cases)(3)All the five patients accepted combined therapy of glucocorticoid and immunosuppresant,and two of them had lienectomy.Conclusions Felty's syndrome,which was infrequent on clinic,had its special characteristics.It is necessary to differ FS from RA.Internists should attach importance to it to decrease the misdiagnosis.