“If you can, please tell agranulocytosis. Could you tell us about the etiology, symptoms and treatment of this disease.”
Neutropenia (granulocytopenia, agranulocytosis) – reduction in blood neutrophils, often increases susceptibility to bacterial and fungal infections.
According to the number of neutrophils in the blood (the total number of white blood cells, multiplied by the percentage of neutrophils) and accordingly, the risk of infection to distinguish light (1000 – 2000 neutrophils in 1 mm), moderate (500 – 1000/mkl) and severe neutropenia (less 500/mkl) . Severe Acute neutropenia caused by a violation of the formation of neutrophils, is often life-threatening.
Reasons. Neutropenia is due to a breach of education neutrophils, regional state neutrophils (build the walls of blood vessels) to the redistribution of blood, their rapid recovery and reduction of the lifetime. The condition can be acute (developing over a few days) or chronic (lasts months or years). Sometimes it is an isolated anomaly, but in other cases – a manifestation of a hematological (blood-related) diseases.
The most common cause of neutropenia – inhibition of the formation of neutrophils drugs (such as cytotoxic antitumor agents, anticonvulsants, sulfonamides, etc.). Neutropenia is an unavoidable side effect of some anti-cancer agents (eg, alkylating agents, antimetabolites). Other drugs cause neutropenia as idiosyncratic reactions (regardless of dose or duration of this medication.)
Reduction of neutrophil production is also seen in some rare hereditary and congenital anomalies (eg, hereditary agranulocytosis in children during the first months of life, with a family of neutropenia, cyclic neutropenia, in certain diseases, in which the violation of neutrophil production is combined with severe immunosuppression). Sometimes the formation of neutrophils violated by bone marrow transplantation or lesion (eg, cancer and granulomatous disease) as well as the usual manifestation of severe deficiency of vitamin B12 and folic acid.
Manifestations. Neutropenia has no specific symptoms, with the exception of those associated with a leaking on its background infection and usually depend on the severity, duration and cause of neutropenia. In acute neutropenia uncommon fever, the appearance of painful ulcers in the mouth and the anus, the development of bacterial pneumonia. If you do not start treatment, there is a further developed bacteremia and septic shock. Chronic Neutropenia is often much more benign, especially if it occurs in mild or moderate form, the number of monocytes in the blood is normal, and the function of other components of the immune system (such as immunoglobulins, complement and lymphocytes) are not changed.
Treatment by a doctor. Gargling every few hours with saline solution or hydrogen peroxide, anesthetic lozenges (benzocaine, 15 mg every 3 – 4 hours) or rinsing the mouth with 1% solution of chlorhexidine ease discomfort associated with ulceration.
Chronic neutropenia – delaying tactics should be: the patient should be warned that he must immediately go to the doctor when the temperature and other signs of infection.
Neutropenia (agranulocytosis) develops (as a side effect) when using very high doses of captopril (Capoten), patients with connective tissue diseases and impaired renal function after 3 – 6 months of treatment. Usually the number of white blood cells is restored within three months after the abolition of the drug.