Agranulocytosis is a condition that is dangerous for the body and leads to a serious weakening of its defense mechanisms. Although it is easy to diagnose this disease, it is more difficult to treat it as it can be triggered by a number of factors. Find out how agranulocytosis manifests itself, what is its treatment and prevention.

Agranulocytosisis a significant decrease in blood granulocytes. Significant - that is, less than 500 / μl. If it is lower than 1500 / µl, it is called granulocytopenia. The normal level of granulocytes in an adult oscillates between 1800-8000 / µl, which is a figure that determines this level in general, because granulocytes are divided into three groups and each of them must meet certain standards.

What are granulocytes and what role do they play in the body?

Let's recall the structure of blood from biology. This most important fluid in our body consists of plasma and morphotic elements, i.e. platelets (thrombocytes), red blood cells (erythrocytes) and white blood cells (leukocytes). We divide leukocytes into granulocytes (neutrophils, eosinophils and basophils) and agranulocytes (monocytes and lymphocytes). The vast majority of granulocytes are neutrophils, or neutrophils (60-70% of all leukocytes); eosinophils (eosinophils) are 2-4% and basophils (basophils) 0-1%. Since there are so many neutrophils, their decrease mainly affects the formation of agranulocytosis and is often also called neutropenia, although they are two different disease entities. So granulocytes are a type of leukocytes, or white blood cells. They are produced by the bone marrow. Since they are short lived - 6 to 12 hours - they must be produced constantly and in great quantities. Their task is to fight the potential threats to the body. As guardians of our immunity, they destroy foreign bodies such as bacteria, viruses, fungi and other pathogens. But for this, there must be enough of them. When the number of granulocytes drops, the body becomes weak and susceptible to all types of infections.

Symptoms of agranulocytosis

Agranulocytosis may be asymptomatic, but usually accompanied by:

  • high fever
  • sore throat and mouth ulceration and tonsil ulceration
  • headaches
  • weakness, fatigue
  • generalsmash
  • respiratory tract infections
  • dental diseases, periodontitis, bleeding gums, bad breath

Above all, however, agranulocytosis causes a drastic decrease in the overall immunity of the organism. The patient constantly catches viral and bacterial infections that are difficult to treat and become seriously inflamed. Often they end in pneumonia, urinary tract inflammation or meningitis. The patient is also very susceptible to any parasitic infections. In extreme cases, agranulocytosis can lead to sepsis.

Reasons for the decline in granulocyte levels

Getting the diagnosis right doesn't require a lot of complicated research. A complete blood count with a smear is enough. However, this is only the beginning of the hard way to find the cause of such a drastic drop in white blood cell levels. Among them, there are mainly various types of drugs that can damage the bone marrow:

  • cytostatic drugs
  • anticonvulsants and antipsychotics
  • antidepressant
  • antibiotics
  • non-steroidal anti-inflammatory drugs
  • antiparasitic, mainly mebendazole
  • interferons
  • drugs for the treatment of hyperthyroidism

In addition, agranulocytosis can be caused by chemotherapy and radiotherapy, aplastic anemia, autoimmune diseases, as well as inherited factors such as Kostmann's syndrome or cyclic neutropenia. The cause of agranulocytosis can also be viral infections, myelodysplastic syndromes, bone marrow fibrosis and leukemias.

A decrease in the number of white blood cells also occurs during stem cell transplantation, when the donor's marrow has not yet started to function and the recipient's marrow is completely destroyed. However, this is an expected and temporary process that takes several days. During this time, the patient is supported with granulocyte colony growth factors (G-CSF).

Another cause of agranulocytosis may be bone marrow damage as a result of poisoning with toxic substances, such as benzene, trinitrotoluene, herbicides and insecticides, as well as heavy metals. Research has also shown that cocaine use can lead to agranulocytosis.

Agranulocytosis: treatment

Agranulocytosis is an indication for hospitalization, as the patient must be protected against microbes. After the diagnosis is made, a bone marrow biopsy is usually performed to determine the cause of the marrow damage. The therapy is based on the elimination of the harmful factor. If it is a drug, it should be discontinued or replaced with another. If the disease - e.g.myelodysplastic syndrome - its treatment will balance the level of granulocytes. In the case of agranulocytosis after a viral infection or some poisoning, one should only wait for the restoration of the correct number of granulocytes. Sometimes the patient is assisted by infusing granulocyte concentrates or with granulocyte growth factor. Patients who develop a bacterial infection should immediately undergo appropriately selected antibiotic therapy and treatment aimed at minimizing the development of sepsis or, when it occurs, mitigating its effects.

It is comforting that, in most cases, agranulocytosis is a reversible condition. The white blood cells are rebuilt and the body's natural defense returns. Improvement usually occurs within a few days to a week of starting treatment, and patients fully recover quickly.

Category:

Cardiology