PSEUDO FELTYS-SYNDROME - A POLYCLONAL DISEASE WITH A FAVORABLE PROGNOSIS - REPORT OF 2 CASES WITH SOUTHERN BLOT ANALYSIS OF TCR

The authors report two patients with large granular lymphocyte (LGL) e xpansion associated with rheumatoid arthritis corresponding to pseudo Felty's syndrome. These cells have natural killer and T cell surface a ntigen markers. LGL are a heterogeneous population and expansion of th ese cells is responsible for leukemia, which is generally a monoclonal proliferation. It has been suggested that Epstein-Barr virus (EBV) is a putative agent in this leukemia. No EBV DNA was found with a polyme rase chain reaction analysis in the lymphocyte DNA of our two patients . Some cases of pseudo Felty's syndrome have exhibited a monoclonal pa ttern on Southern blot analysis of the T cell receptor. On the contrar y, our two cases showed a polyclonal pattern with TCR beta chain South ern blot analysis. This fact, associated with the mild course seen in both over more than twenty years, suggest that pseudo Felty's syndrome is a disease with a good prognosis.