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Anemia at Felti's syndrome

Felti in 1924 the first described a syndrome which was called by his name later [Felty, 1924]. The clinical signs described by Felti include a leukopenia, pigmentation of open sites of skin and a limfoadenopatiya in a combination to a splenomegaly and a pseudorheumatism. Between the sizes of a spleen and expressiveness of a leukopenia, apparently, there is no direct correlation, and at most of patients with a pseudorheumatism some increase in a spleen which can be is observed and it is not distinguished clinically. The leukopenia is result of decrease in number both neutrophils, and lymphocytes. The number of thrombocytes can also decrease, but seldom falls lower than 100·109/l. Often there are bacterial infections which can hard proceed, and they occur not only at patients with the expressed splenomegaly.

This syndrome, at first sight, reminds a hypersplenism, but at it there are no symptoms of hemolitic anemia, and the reason of a splenomegaly is unknown. It is not connected with the hyperplasia of marrow which is observed at a true hypersplenism and some delay of maturing of cells of a granulotsitarny row is in most cases noted. Increase of activity of a spleen which is probably connected with presence of antibodies to leukocytes can be the possible cause of a leukopenia. There are data on reduced formation of granulotsitarny colonies marrow cells [Greenberg, Schrier, 1973; Abdou et al., 1978]. Existence at many sick antinuclear antibodies, high levels of a rhematoid factor and immunoglobulins testifies to a contribution of immunologic mechanisms to development of a leukopenia.

Sometimes resort to a splenectomy, but it is shown only when leukopenias accompany heavy recurrent infections. There are no evidences of the fact that operation reduces the frequency or weight of infections, but in 60% of cases the number of leukocytes increases [Barnes et al., 1971; Seinknicht et al., 1977]. Occasionally as the indication to a splenectomy thrombocytopenia can serve.

Treatment by steroid hormones in high doses, for example 50 or 60 mg of Prednisolonum a day, also normalizes number of leukocytes. However at a drug dose decline to the safe supporting level the number of leukocytes, as a rule, falls again. Small increase in number of leukocytes can be reached by administration of drugs of lithium [Gupta et al., 1975], however this gain is unstable and seldom remains after drug withdrawal.

Literature: Blood diseases at elderly: The lane with English / Under the editorship of M. J. Denham, I. Chanarin. — M.: Medicine, 1989

 
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