The large granular lymphocyte syndrome with rheumatoid arthritis. immunogenetic evidence for a broader definition of felty's syndrome

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Abstract
Objective. To assess whether the HLA—DR4 association found in rheumatoid arthritis (RA) is also seen in the large granular lymphocyte (LGL) syndrome.Methods. HLA—DR genotyping was performed using restriction fragment length polymorphism and polymerase chain reaction analysis.Results. LGL syndrome patients with RA showed the same HLA–DR4 association seen in RA/Felty's syndrome (FS), while LGL syndrome patients without arthritis did not.Conclusion. It is proposed that FS and the LGL syndrome represent different variants of a broader syndrome comprising RA, neutropenia, LGL expansions, HLA—DR4 positivity, and splenomegaly.