Felty's syndrome: Succesful therapy with cyclosporine A and granulocyte colony stimulating factor

Felty sendromu: Siklosporin A ve granülosit koloni uyarıcı faktör ile başarılı tedavi

Abstract

Felîy's syndrome: Succesful therapy with cyclosporine A and granulocyte colony stimulating factor: FeltyV syndrome (FS) is a rare disorder characterized as a systemic manifestation of severe rheumatoid arthritis (RA) associated with granulocytopenia and splenomegaly. Because of this rarity, controlled studies of different treatment modalities are not available. Herein we present a patient with FS who was admitted with splenomegaly and leukopenia in addition to chronic polyarthritis. Initial treatment of the patient consisted of corticosteroids, hidroxychlo-roquine, granulocyte colony stimulating factor (G-CSF) and cyclosporine A with improvement of leukopenia and arthritis. The dose of corticosteroids were tapered and G-CSF was administered in gradually increased intervals. During the follow-up, the patient was in remission with low-dose corticosteroid, hydroxychloroquine, cyclosporine A (3 mg/kg/day) treatment after six months.

Özet

Felty sendromu (FS) romatoid artritin (RA) nadir bir komplikasyonu olup nötropeni ve spleno-megali ile karakterizedir. Nadir görülmesi nedeniyle farklı tedavi yöntemlerini içeren kontrollü çalışmalar yoktur. Burada, kronik poliartrite ilaveten splenomegali ve lökopeni ile başvuran bir hasta sunuldu. Tedavinin başlangıcında yüksek doz kortikosteroid, hidroksiklorokin, granülosit koloni uyarıcı faktör (G-CSF) ve siklosporin A birlikte kullanılarak lökopeni düzeldi ve artrit kontrol altına alındı. Steroid dozu azaltıldı, G-CSF aralıkları açılarak kesildi. Hasta halen takibinin altıncı ayında düşük doz kortikosteroid, hidroksiklorokin ve 3mg/kg/g siklosporin A tedavisi.ile remisyonda izlenmektedir.