FS has a poorer prognosis than uncomplicated rheumatoid arthritis (RA). FS patients have increased morbidity and mortality from infections and malignancy. Five-year mortality has been estimated to be between 25% and 36%, with infection being the main cause of death.[2]Campion G, Maddison PJ, Goulding N, et al. The Felty syndrome: a case-matched study of clinical manifestations and outcome, serologic features, and immunogenetic associations. Medicine (Baltimore). 1990;69:69-80.
http://www.ncbi.nlm.nih.gov/pubmed/1969604?tool=bestpractice.com
[3]Balint GP, Balint PV. Felty's syndrome. Best Pract Res Clin Rheumatol. 2004 Oct;18(5):631-45.
http://www.ncbi.nlm.nih.gov/pubmed/15454123?tool=bestpractice.com
In addition, as with all patients with RA, patients with FS also have an increased risk of cardiovascular disease.
The degree of neutropenia in FS varies with time, and spontaneous remission of neutropenia can occur in up to 40% of patients without specific treatment.[31]Bowman SJ, Bhavnani M, Geddes GC, et al. Large granular lymphocyte expansions in patients with Felty's syndrome: analysis using anti-T cell receptor V beta-specific monoclonal antibodies. Clin Exp Immunol. 1995;101:18-24.
http://www.pubmedcentral.nih.gov/picrender.fcgi?artid=1553309&blobtype=pdf
http://www.ncbi.nlm.nih.gov/pubmed/7621587?tool=bestpractice.com
However, these patients remain at increased risk of infection despite normal neutrophil counts.[2]Campion G, Maddison PJ, Goulding N, et al. The Felty syndrome: a case-matched study of clinical manifestations and outcome, serologic features, and immunogenetic associations. Medicine (Baltimore). 1990;69:69-80.
http://www.ncbi.nlm.nih.gov/pubmed/1969604?tool=bestpractice.com