Neutropenia in rheumatoid arthritis: studies on possible contributing factors

Twenty-five patients with rheumatoid arthritis (RA) and neutropenia, of whom 19 had a palpable spleen, were compared with 24 patients with uncomplicated RA, and 16 patients with RA and associated splenomegaly without neutropenia. Clinically patients with neutropenia had evidence of a more systemic d...

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Bibliographic Details
Published in:Annals of the rheumatic diseases 1982-06, Vol.41 (3), p.242-247
Main Authors: Bucknall, R C, Davis, P, Bacon, P A, Jones, J V
Format: Article
Language:English
Subjects:
Agranulocytosis - etiology
Antibodies, Antinuclear - analysis
Antigen-Antibody Complex - analysis
Arthritis, Rheumatoid - complications
Arthritis, Rheumatoid - immunology
Complement System Proteins - analysis
Humans
Leukocyte Count
Middle Aged
Neutropenia - etiology
Neutropenia - immunology
Splenomegaly - etiology
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Summary:Twenty-five patients with rheumatoid arthritis (RA) and neutropenia, of whom 19 had a palpable spleen, were compared with 24 patients with uncomplicated RA, and 16 patients with RA and associated splenomegaly without neutropenia. Clinically patients with neutropenia had evidence of a more systemic disease as assessed by prevalence of rheumatoid nodules, weight loss, and recurrent infections. However, there was less evidence of active synovitis than in the other 2 groups. Marrow neutrophil reserve was studied by means of a hydrocortisone stimulation test and was found to be lower in all 3 groups than in normal persons but with most marked depletion in the neutropenic group. Removal of the spleen in some patients with neutropenia resulted in a significant increase in marrow neutrophil reserve. Circulating immune complexes as detected by anticomplementary activity and platelet aggregation tests were detected in 68% of the RA neutropenia group, 31% of the RA splenomegaly group, and 8% of the uncomplicated RA group. Our results show that, assessed both clinically and by the above tests, patients with neutropenia have a greater prevalence of abnormalities which may be directly related to their neutropenia. Patients with splenomegaly alone closely resemble patients with uncomplicated RA.
ISSN:0003-4967
1468-2060
DOI:10.1136/ard.41.3.242