An unusual association of Felty syndrome and TCR gamma delta lymphocytosis.
Felty syndrome, comprised of neutropenia, rheumatoid arthritis and splenomegaly, occurs in approximately 1% of patients with rheumatoid arthritis. Up to one third of these patients have an increased number of large granular lymphocytes. The usual immunophenotype of these cells is CD3+, CD8+, CD57+, T cell receptor (TCR) alpha beta. A patient with Felty syndrome and large granular lymphocytosis, who had an unusual immunophenotype CD3+, CD4-, CD8-, TCR gamma delta, is described. Her neutropenia responded to treatment with granulocyte colony stimulating factor (G-CSF), which was given in order to raise her neutrophil count prior to bilateral knee replacement surgery. Thus, Felty syndrome with large granular lymphocytosis is a heterogeneous condition, one in which TCR gamma delta large granular lymphocytosis may be found, and also shows a response to treatment with G-CSF.
Stanworth
S J
SJ
Department of Immunology, St Mary's Hospital, Manchester.
Green
L
L
Pumphrey
R S
RS
Swinson
D R
DR
Bhavnani
M
M
D000328:Adult; D005258:Felty Syndrome / Q000150:complications*; D005260:Female; D005500:Follow-Up Studies; D016179:Granulocyte Colony-Stimulating Factor / Q000627:therapeutic use; D006801:Humans; D016130:Immunophenotyping; D008218:Lymphocytosis / Q000209:etiology* / Q000276:immunology; D009503:Neutropenia / Q000209:etiology / Q000628:therapy; D016692:Receptors, Antigen, T-Cell, gamma-delta / Q000032:analysis*
D016692:Receptors, Antigen, T-Cell, gamma-delta; D016179:Granulocyte Colony-Stimulating Factor