Protocolo diagnóstico de las alteraciones leucocitarias en la artritis reumatoide

Abstract

IntroductionPatients with RA can present a wide variety of hematological disorders. ClassificationWithin leukocyte alterations we can find three groups: leukopenia, leukocytosis and lymphoproliferative disorders. Among the leukopenias, there is the Felty syndrome, which is the most frequent and consists of the triad of neutropenia, splenomegaly and RA; LGL leukemia, which is a proliferation of large granular lymphocytes associated with neutropenia and drug-induced neutropenia, since most of the agents used for treating RA can induce it (methotrexate, cyclophosphamide...). In the presence of leukocytosis, RA can develop neutrophilia in the context of an inflammation or an associated bacterial infection, or eosinophilia, which is related to greater extra-articular involvement. Lymphoproliferative disorders have a higher occurrence in these patients, with an incidence and mortality due to leukemia and lymphoma which doubles the expected values, mainly in those patients with long-term arthritis.