Agranulocytosis
Agranulocytosis is a term used when bone marrow fails to form granulocytes. Granulocytes, consisting mainly of neutrophils, are a type of white blood cell that is responsible for fighting infection. The body that lacks granulocytes or neutrophils will be vulnerable to infection.
Under normal circumstances, bone marrow is able to form 1,500 neutrophils per microliter of blood. Whereas in agranulocytosis, the absolute neutrophil count has less than 100 neutrophils per microliter of blood. When neutrophil counts are low, benign infections can turn into serious infections. Non-invading germs can develop and become dangerous to the body.
Agranulocytosis is a fairly serious condition. If left untreated, it can cause sepsis and death.
Symptoms of agranulocytosis
People with agranulocytosis are susceptible to infection because of the small number of white blood cells responsible for fighting bacterial attacks.
Symptoms that look like an infection include:
If the infection worsens, this can cause:
Causes of agranulocytosis
Agranulocytosis can occur due to congenital abnormalities (congenital) or can be obtained due to disease, drugs or medical procedures. Congenital agranulocytosis is caused by a rare genetic disease, Kostmann's syndrome. This disorder is transmitted to parents' children.
One study showed that as many as 70% of agranulocytosis cases were related to the use of antipsychotics (such as clozapine), antimalarials, anti-inflammatory and antithyroid drugs (such as carbimazole).
The causes of acquired agranulocytosis are:
The doctor will check the patient's medical history and do a physical examination. If there is suspicion of agranulocytosis, the doctor will do a complete blood count and an absolute neutrophil count to check the total blood count, especially white blood cells.
Blood test results are used to confirm the next diagnosis. Other investigations are aimed at determining the cause of agranulocytosis, such as bone marrow aspiration and bone marrow biopsy, which consists of blood and tissue samples taken from bone in the pelvic region. . Bone marrow is a place where blood cells are produced. If a genetic disease is suspected, the doctor will request a genetic test.
Treatment with agranulocytosis
Infections related to agranulocytosis are treated with antibiotics. Antibiotics prescribed by the doctor will be given according to the severity of the infection. Sometimes antibiotics have been given before infection, which is intended to prevent infection. When treating agranulocytosis, it is important to know the cause of agranulocytosis itself, so that it can be treated appropriately. For example, if agranulocytosis is suspected to be due to antimalarial drugs, a substitute for the drug will be given. If necessary, maintenance can be stopped temporarily.
Some recommended drugs that are suitable for the cause of agranulocytosis include:
It is recommended that people with agranulocytosis not be in a crowd to minimize the risk of infection. Patients are also advised to avoid foods that are potentially exposed to bacteria, such as fruits or vegetables that are not washed or peeled.
Under normal circumstances, bone marrow is able to form 1,500 neutrophils per microliter of blood. Whereas in agranulocytosis, the absolute neutrophil count has less than 100 neutrophils per microliter of blood. When neutrophil counts are low, benign infections can turn into serious infections. Non-invading germs can develop and become dangerous to the body.
Symptoms of agranulocytosis
People with agranulocytosis are susceptible to infection because of the small number of white blood cells responsible for fighting bacterial attacks.
Symptoms that look like an infection include:
- fever
- transmission
- Headache
- Shivering and sweating.
- Redness around the face.
- Sore throat.
- Sprue that does not improve.
- Bleeding gums.
- Boils appear on the skin.
If the infection worsens, this can cause:
- Tachycardia.
- Breathing becomes fast.
- Low blood pressure or hypotension.
Causes of agranulocytosis
Agranulocytosis can occur due to congenital abnormalities (congenital) or can be obtained due to disease, drugs or medical procedures. Congenital agranulocytosis is caused by a rare genetic disease, Kostmann's syndrome. This disorder is transmitted to parents' children.
One study showed that as many as 70% of agranulocytosis cases were related to the use of antipsychotics (such as clozapine), antimalarials, anti-inflammatory and antithyroid drugs (such as carbimazole).
The causes of acquired agranulocytosis are:
- Autoimmune disorders, such as lupus and rheumatoid arthritis.
- Diseases that attack the bone marrow, such as aplastic anemia, leukemia, and myelodysplasia syndrome.
- Hepatitis.
- HIV.
- Chemotherapy and bone marrow transplantation actions.
- Exposure to chemical compounds such as arsenic or mercury.
- Drugs, such as antipsychotics, anti-malaria drugs (such as quinine pills), NSAIDs, and hyperthyroid drugs (for example, tiamazole).
The doctor will check the patient's medical history and do a physical examination. If there is suspicion of agranulocytosis, the doctor will do a complete blood count and an absolute neutrophil count to check the total blood count, especially white blood cells.
Blood test results are used to confirm the next diagnosis. Other investigations are aimed at determining the cause of agranulocytosis, such as bone marrow aspiration and bone marrow biopsy, which consists of blood and tissue samples taken from bone in the pelvic region. . Bone marrow is a place where blood cells are produced. If a genetic disease is suspected, the doctor will request a genetic test.
Treatment with agranulocytosis
Infections related to agranulocytosis are treated with antibiotics. Antibiotics prescribed by the doctor will be given according to the severity of the infection. Sometimes antibiotics have been given before infection, which is intended to prevent infection. When treating agranulocytosis, it is important to know the cause of agranulocytosis itself, so that it can be treated appropriately. For example, if agranulocytosis is suspected to be due to antimalarial drugs, a substitute for the drug will be given. If necessary, maintenance can be stopped temporarily.
Some recommended drugs that are suitable for the cause of agranulocytosis include:
- Granulocyte (G-CSF) colony stimulation factor. This method involves injecting hormones that stimulate the production of more granulocytes in the bone marrow. G-CSF injection is usually given by subcutaneous injection (subcutaneous) to patients with agranulocytosis due to chemotherapy. Filgrastim is an example of G-CSF.
- Immunosuppressants. If agranulocytosis is caused by an autoimmune disease, which is the immune system that attacks the body itself, then drugs will be given that can suppress its immunity. For example, corticosteroids.
- Bone marrow transplantation. In the case of agranulocytosis which can no longer be treated with ordinary drugs, bone marrow transplantation may be an option. This method usually provides the best results for patients under 40 years with other organ functions such as the heart, kidneys and liver. Bone marrow transplantation can be done in patients with leukemia.
It is recommended that people with agranulocytosis not be in a crowd to minimize the risk of infection. Patients are also advised to avoid foods that are potentially exposed to bacteria, such as fruits or vegetables that are not washed or peeled.
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