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Agranulocytosis

Agranulocytosis: Causes, Symptoms, Diagnosis, Treatment, and Prevention

In agranulocytosis, white blood cells, known as granulocytes, are not made enough by the body, causing a serious condition called agranulocytosis. The white blood cells are a crucial part of the immune system, so a person with this condition is at risk of developing a severe or even life-threatening infection.

Causes and Risk Factors of Agranulocytosis

The two types of agranulocytosis are acquired and congenital. Acquired agranulocytosis occurs as a result of a person's development, while congenital agranulocytosis results from birth.

Certain conditions or medications that affect the immune system can cause acquired agranulocytosis. These include:

  • chemotherapy

  • bone marrow transplant

  • autoimmune disorder

  • bone marrow disease or leukemia

  • infections such as HIV

  • taking certain medications, such as Clozapine (an antipsychotic)

  • taking medications for an overactive thyroid gland

The risk of developing agranulocytosis is higher for people with these conditions, so agranulocytosis should be monitored periodically. If a person has agranulocytosis or any of these risk factors, he or she should report any signs of infection to their doctor immediately to prevent a more serious infection.

Symptoms of Agranulocytosis

The symptoms of agranulocytosis are usually similar to those of an underlying infection and can include:

  • fever and chills

  • faster heart rate and breathing

  • muscle weakness and fatigue

  • sore throat (pharyngitis) and bleeding, inflamed gums

  • sores in your mouth and throat that make it difficult to swallow

Without prompt treatment, the infection can quickly spread throughout the body and even into the blood, resulting in sepsis, a life-threatening condition. Additionally, sepsis may cause a change in mental state, a rapid heartbeat, and fast breathing.

Diagnosis of Agranulocytosis

By testing the number of white blood cells in the blood, agranulocytosis can be diagnosed. An absolute neutrophil count (ANC) of less than 100 per microliter (mcL) of blood is typically a sign of agranulocytosis. It is normal for the ANC to be at least 1,500 neutrophils per milliliter.

A neutrophil count between 100 and 1,500 per microliter of blood is called neutropenia. This means that there are too few neutrophils in the blood, which increases the risk of infection.

Sometimes, doctors may also check other types of white blood cells or perform other tests to determine the cause or severity of agranulocytosis.

Treatment of Agranulocytosis

The treatment for agranulocytosis depends on whether it is acquired or congenital. Acquired cases usually require hospitalization and intravenous antibiotics to prevent or treat infections. If the patient has severe symptoms or complications, they may also require supportive care, such as fluids, oxygen therapy, or blood transfusions.

A congenital condition may not require specific treatment unless it leads to bleeding disorders or infections. Bone marrow transplantation may be recommended in some cases to restore normal granulocyte production.

Prevention of Agranulocytosis

It is only possible to prevent agranulocytosis by avoiding drugs that may trigger the condition. If you need to take a drug that triggers the condition, you need to get regular blood tests to check your neutrophil levels. If your neutrophil count has fallen, your doctor may advise you to stop taking the drug.

It is also important to practice good hygiene habits, such as washing your hands frequently, avoiding contact with sick people or animals, covering your mouth when you cough or sneeze, and getting vaccinated against common illnesses.

Following certain medications or procedures such as chemotherapy or bone marrow transplant, you should seek immediate medical attention if you experience any symptoms of infection such as fever, sore throat, coughing up blood, or abdominal pain.

When left untreated, agranulocytosis can be life-threatening. By understanding its causes, symptoms, diagnosis, treatment, and prevention, you can prevent this potentially fatal condition.

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