A CASE OF FELTY'S SYNDROME WITH PORTAL HYPERTENSION

• Published in: Nihon Rinsho Geka Gakkai Zasshi (Journal of Japan Surgical Association) Vol. 59; no. 3; pp. 790 - 794
• Main Authors: YOSHIMOTO, Jiro, IWATA, Toyohito, KOJIMA, Kuniaki, FUKASAWA, Masaki, BEPPU, Tomoe, FUTAGAWA, Shunji
• Format: Journal Article
• Language: English
• Published: Japan Surgical Association 25.03.1998
• ISSN: 1345-2843; 1882-5133
• DOI: 10.3919/jjsa.59.790

A 51-year-old woman was admitted to another hospital because of repeated hematemesis which started on September 21, 1994, and was diagnosed as having Felty's syndrome. The patient had been suffering from rheumatoid arthritis for about 10 years and had been pointed out a splenomegaly and esophageal varices 3 years before. The patient was admitted to the hospital for close examination and treatment on January 4, 1995. Physical examination on admission revealed pigmentation in the skin of bilateral legs. Decreases in white blood cells and plateletes counts, positive response to antinuclear antibody, and an increased level of rheumatoid factor were noted. Abdominal CT visualized remarkable splenomegaly. On catheter examination via the hepatic vein, there were some findings suggestive of idiopathic portal hypertension (IPH). For the esophageal varices, endoscopic sclerotherapy was conducted the three times, and thereafter a Hassab operation and hepatic biopsy were performed on March 8. Histopathologic findings of the liver were compatible with IPH. Upper gastrointestinal endoscopic study conducted on the first month after the operation confirmed disappearance of the esophageal varices, and the white blood cells and platelets counts were normalized.