Rituximabe na síndrome de Felty refratária

Fragoso, Thiago Sotero; Dantas, Andréa Tavares; Pereira, Maria Roberta Melo Gomes; Marques, Cláudia Diniz Lopes; Cavalcanti, Fernando de Souza; Duarte, Angela P.

doi:10.1590/s0482-50042009000200010

Cited by 2 publications

(2 citation statements)

References 14 publications

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“…Data on leflunomide are conflicting. While Talip et al reported an increase in neutrophil counts and the possibility of stopping glucocorticoid treatment under leflunomide (starting with leflunomide 100 mg per day for 3 days, followed by 20 mg per day), other case reports did not show any significant efficacy ( 72 , 84 ).…”

Section: Treatmentmentioning

confidence: 99%

“…Until now, TNFα inhibitors like etanercept, infliximab and adalimumab have not shown any significant improvement in neutrophil counts in several case reports, although synovitis has been treated successfully with these agents ( 71 , 72 , 85 , 86 ). In this context it should be noted, that immunosuppressants with proven efficacy in Felty’s syndrome should be used in any case, even if arthritis is well controlled by the current treatment.…”

Section: Treatmentmentioning

confidence: 99%

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Felty’s syndrome

Wegscheider,

Ferincz,

Schöls

et al. 2023

Front. Med.

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Felty’s syndrome was first described in 1924 by the US-American physician Augustus Roi Felty as a triad of rheumatoid arthritis, splenomegaly and leucopenia. Even nearly 100 years later, this rare syndrome is still paralleled by diagnostic and therapeutic challenges and its pathogenesis is incompletely understood. Neutropenia with potentially life-threatening infections is the main problem and several pathomechanisms like Fas-mediated apoptosis, anti-neutrophil antibodies, anti-G-CSF antibodies, neutrophil consumption in the context of NETosis and suppression of granulopoiesis by T-LGLs have been suggested. Felty’s syndrome has various differential diagnoses as splenomegaly and cytopenia are common features of different infectious diseases, malignancies and autoimmune disorders. Additionally, benign clonal T-/NK-LGL lymphocytosis is increasingly noticed in Felty’s syndrome, which further complicates diagnosis. Today’s treatment options are still sparse and are largely based on case reports and small case series. Methotrexate is the mainstay of therapy, followed by rituximab, but there is less evidence for alternatives in the case of adverse reactions or failure of these drugs. This article gives an updated review about Felty’s syndrome including its pathogenesis and treatment options.

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Section: Treatmentmentioning

confidence: 99%