Agranulocytosis

Other names:Granulocytopenia; Granulopenia

Neutrophils

White blood cells fight infections from bacteria, viruses, fungi, and other germs. One important type of white blood cell is the granulocyte, which is made in the bone marrow and travels in the blood throughout the body. Granulocytes sense infections, gather at sites of infection, and destroy the germs.

When the body has too few granulocytes, the condition is called agranulocytosis. This makes it harder for the body to fight off germs. As a result, the person is more likely to get sick from infections.

Cause

Agranulocytosis may be caused by:

• Autoimmune disorders
• Bone marrow diseases, such as myelodysplasia or large granular lymphocyte (LGL) leukemia
• Certain medicines used to treat diseases, including cancer
• Certain street drugs
• Poor nutrition
• Preparation for bone marrow transplant
• Problem with genes
• Spleen enlargement

Symptoms

Symptoms of this condition may include:

• Fever
• Chills
• Malaise
• General weakness
• Sore throat
• Mouth and throat ulcers
• Bone pain
• Pneumonia
• Shock

Diagnosis

A blood differential test will be done to measure the percentage of each type of white blood cell in your blood. The diagnosis is made after a complete blood count, a routine blood test. The absolute neutrophil count in this test will be below 500, and can reach 0 cells/mm³. Other kinds of blood cells are typically present in normal numbers.

Other tests to diagnose the condition may include:

• Bone marrow biopsy
• Biopsy of mouth ulcer
• Neutrophil antibody studies (blood test)

Treatment

Treatment depends on the cause of the low white blood cell count. For example, if a medicine is the cause, stopping or changing to another medicine may help. In other cases, medicines to help the body make more white blood cells will be used. Transfusion of granulocytes would have been a solution to the problem. However, granulocytes live only ~10 hours in the circulation (for days in spleen or other tissue), which gives a very short-lasting effect. In addition, there are many complications of such a procedure.

Prevention

If you are having treatment or taking medicine that could cause agranulocytosis, your health care provider will use blood tests to monitor you.

NIH genetic and rare disease info

• NIH info on Agranulocytosis

Agranulocytosis is a rare disease.

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