White-cell Antibodies and the Aetiology of Felty's Syndrome

Abstract

By means of the indirect anti-human globulin consumption test for leucocytes IgG antibodies have been demonstrated against white blood cells in 13 out of 15 patients diagnosed as having Felty's syndrome. In cases of rheumatoid arthritis without white-cell abnormalities, IgG antibodies against white cells were shown to be present in 17 out of 31 patients. Absorption studies indicate that in Felty's syndrome the antibody is specifically directed against white blood cells. The antibody in the patients with rheumatoid arthritis without white-cell abnormalities is different and is directed against IgG. The literature on Felty's syndrome is reviewed, and attention is drawn to the close parallel between Felty's syndrome and cases of idiopathic thrombocytopenic purpura in which antibody coating of platelets is known to occur. That the antibody specifically directed against white blood cells is responsible for the neutropenia of Felty's syndrome remains unproven, but the possibility that a circulating antibody is its cause would correlate satisfactorily with the present knowledge of the syndrome. No clinical disability appears to result from the presence of the antibody directed against IgG.