Agranulocytosis is a condition when the bone marrow fails to form granulocytes, which are a type of white blood cell that fights infection. Agranulocytosis must be treated immediately because it can cause serious, even life-threatening complications.
Granulocytes are a group of white blood cells consisting of neutrophils, eosinophils, and basophils. Of the three types of cells, neutrophils are the most abundant in the blood. Therefore, neutrophils are used as a benchmark for the diagnosis of agranulocytosis.
Under normal circumstances, the bone marrow is able to form 1,500 neutrophils per microliter of blood. Whereas in agranulocytosis, the absolute neutrophil count is less than 100 per microliter of blood. In this condition, the body will be more susceptible to infection.
Causes of Agranulocytosis
Agranulocytosis can occur due to genetic disorders that are inherited from parents, so the problem has been present since birth. Congenital agranulocytosis is also known as Kostmann syndrome .
In addition to genetic disorders, agranulocytosis can also be caused by certain conditions. The following are some of the conditions that can cause agranulocytosis:
- Autoimmune diseases, such as lupus and rheumatoid arthritis
- Diseases of the bone marrow, such as aplastic anemia , leukemia, and myelodysplastic syndromes
- Viral infections, such as viral hepatitis, HIV, and cytomegalovirus (CMV)
- Bacterial infections, such as typhoid fever and tuberculosis
- Parasitic infections, such as malaria
- Exposure to chemical compounds, such as arsenic or mercury
- Use of certain medications, such as antipsychotic drugs, malaria drugs, NSAIDs , chemotherapy for cancer, and medications for hyperthyroidism
Symptoms of Agranulocytosis
People who have agranulocytosis will be susceptible to infection because of the low number of white blood cells in the body that are responsible for fighting bacteria, viruses, or other disease-causing microorganisms. Symptoms that can appear when a person has agranulotosis are:
- Coughs and colds
- Hard to breathe
- Shivering and sweating
- Rash on the skin
- Sore throat
- Canker sores that don't get better
- Pain in the bones
When to go to the doctor
Consult a doctor if you experience any of the symptoms listed above, especially if you have a condition that can cause agranulocytosis. Also, check with your doctor if you have frequent infections or if your infection is difficult to heal.
Agranulocytosis is a fairly serious condition. If not treated immediately can lead to sepsis and death.
To diagnose, the doctor will ask about the symptoms experienced, the patient's medical history, then proceed with a physical examination. If a patient is suspected of having agranulocytosis, the doctor will perform the following additional tests to confirm the diagnosis:
- Complete blood cell count, to check the total number of blood cells, especially white blood cells
- An absolute neutrophil count, as a follow-up to a complete blood cell count
- Bone marrow aspiration , to check the condition of the tissue that produces blood cells
- Genetic testing, to determine the possibility of a genetic disease that causes agranulocytosis
Treatment of agranulocytosis will be tailored to the cause. Some treatment options that can be given by doctors to treat agranulocytosis are:
- Giving antibiotics
Antibiotics will be prescribed by the doctor depending on the severity of the infection. In patients with agranulocytosis with very low neutrophil counts, antibiotics can be given prior to infection to reduce the risk of severe infection.
- Injecting granulocyte c olony- s timulating f actor (G-CSF)
G-CSF is given by injection under the skin of the patient. This is done to stimulate the bone marrow to produce more granulocytes.
- Administration of immunosuppressants
If agranulocytosis is caused by an autoimmune disease, the doctor will prescribe drugs that suppress the body's excessive immune response.
- Transplant s umsum t reset
If it can not be treated with medication, the doctor will perform a bone marrow transplant . This procedure is generally performed on patients under 40 years of age with good organ function.
If the agranulocytosis is caused by certain medications, the doctor may stop the medication, adjust the dose, or replace the medication with an alternative.
Complications of Agranulocytosis
If not treated properly, agranulositis can lead to sepsis . Sepsis is an infection reaction that can make blood pressure drop drastically and damage to many organs. This condition is a dangerous condition and can lead to death.
Prevention of Agranulocytosis
Agranulocytosis cannot be prevented, unless the condition is caused by replaceable drugs. The important thing that needs to be prevented in the condition of agranulocytosis is infection.
You can reduce your risk of infection by avoiding crowded places and foods that have the potential to be exposed to bacteria, such as unwashed or peeled fruit or vegetables. In addition, you also need to pay more attention to the cleanliness of your body.