Felty Syndrome, Síndrome De Felty, Syndrome De Felty
Resumo
Introdução: A Síndrome de Felty (SF) é uma manifestação extra-articular da artrite reumatoide que inclui a neutropenia e esplenomegalia. O objetivo do tratamento é reduzir a dor e retardar uma maior quantidade de danos, visto que, não há estudos de ensaios clínicos randomizados, sendo o manejo terapêutico da literatura advindo de relatos de casos. Objetivos: Abordar os manejos terapêuticos da SF descritos na literatura. Material e Métodos: Trata-se de uma revisão de literatura integrativa, retrospectiva, qualitativa, com intuito descritivo de estudos nacionais e internacionais da base de dados PubMed. A fórmula de busca utilizou as palavras-chave do artigo, com o operador booleano “OR”, resultando em 42 artigos nos últimos 5 anos. Após aplicação de critérios de inclusão e exclusão, restaram 26 artigos, dentre os quais, 6 foram escolhidos para compor esta revisão por melhor se relacionarem ao tema. Resultados: O tratamento de primeira linha mencionado em 83,5% (n=5) dos artigos incluiu o metotrexato (MTX), pelo seu mecanismo de ação na neutropenia, além da ação na prevenção na recorrência da infecção. Outros medicamentos antirreumáticos modificadores da doença (DMARD) foram citados nos artigos, como a leflunomida, inibidores de fator de necrose tumoral e terapia parental de ouro (não mais utilizada hoje). O agente biológico rituximabe, anticorpo monoclonal contra o antígeno CD20, demonstrou boa opção para SF refratária. Os glicocorticóides podem ser utilizados em terapias a curto prazo, fornecendo uma melhora rápida na contagem de neutrófilos, mas devem ser evitados a longo prazo. O uso de fator estimulador de colônias de granulócitos (G-SFC) foi indicado para quantidade inferior a 1000/mm3 de neutrófilos absolutos. Outro artigo, relatou sobre a consequência do sequestro esplênico, recomendando a esplenectomia para os casos mais graves de esplenomegalia. Conclusão: Portanto, o manejo terapêutico da SF possui diversas vertentes direcionadas por estudos observacionais, sendo necessário a realização de ensaios clínicos e novas pesquisas no âmbito científico, para consolidar a melhor terapêutica para a síndrome.
Publicado
2021-04-24
Como Citar
Cabral, A. J. M., Lima, C. A. N., Filho , E. F. C. C., Alves, F. A., & Soares, . G. L. D. C. (2021). MANEJO DA SÍNDROME DE FELTY: TERAPIAS PROPOSTAS E DESAFIOS ENCONTRADOS. Revista Multidisciplinar Em Saúde, 2(2), 61. https://doi.org/10.51161/rems/1004
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