What is an Acquired Agranulocytosis?

March 22 20:20 2019 Print This Article

It is defined as a condition in which there is a severe and low white blood cell count referred as a leucopenia. It is also known as the agranulosis. It most commonly affects the neutrophils leading to neutropenia. It occurs in the circulating blood. There is an absence of infection fighting white blood cells. The people with this disorder have a very compressed immune system which makes them prone to high risk infections. In this disorder the concentration of granulocytes comes below 100 cells per mili meter cube. It is less than the 5 percent of the normal value. This condition is more severe than the granulo cytopenia and can involve the other types of white blood cells.

What are the signs and symptoms of Acquired agranulocytosis?

This disorder is mainly asymptomatic. It shows clinical features like fever, rigors and sore throat. The infection present in any organ progresses rapidly and includes the pneumonia and urinary tract infections. There may also occur septicemia which can also progress rapidly. These disorders may also lead to the gums disease which includes the gingival bleeding, increase in the secretion of saliva and halitosis. It also shows the halitosis, osteoporosis and the injury to the periodontal ligament.

What is the classification of Acquired agranulocytosis?

The word agranulocytosis came from the Greek word. It means absence of granulocytes. It is a particular type of cell condition. It is also known as no granulocytes. There is no requirement for the complete absence of the granulocytes for this condition to occur. They are also known as the granulo cytopenia and neutropenia. The term agranulocytosis is more severe than the granulo cytopenia. The deficiency of neutrophils indicates neutropenia. The term neutropenia mainly denotes the absolute neutrophil count which is denoted as ANC. It is less than 500 cells per micro litre. The agranulocytosis is reserved for the cases in which the ANC is less than 100 cells per micro litre. There are few terms which describe the type of granulocyte. The inadequate number of nuetrophils is referred as a neutropenia. This is the most common form of agranulocytosis. The inadequate number of eosinophils is referred as an eosinopenia. This is not the most common form of agranulocytosis. The inadequate number of basophils is referred as a basoopenia. This is the rare form of agranulocytosis.

What are the causes of Acquired agranulocytosis?

There are many reasons which can cause this disorder. It includes the use of anti epileptic drugs, anti thyroid drugs and antibiotics. It also includes the use of gold, NSAIDs, cyto toxic drugs and mebendazole. There are also other drugs which are responsible for this disorder. In the US people use clozapine and it must be nationally registered. It helps o monitor the low WBC count and ANC. The reaction is idio syncratic not proportional. The patients must be told about the symptoms of this condition. It includes the sore throat and fever. In the U.S there is a Centre for Disease Control which keeps an eye on this disorder. It keeps a track of the cocaine users and the use of levamisole in the drug. There is a Drug Enforcement Administration which stated that around 70 percent of the cocaine which comes into the US contains the levamisole. It is mainly used in the animals and is anti helminthic. The reason of adding levamisole to the cocaine is not clear.

What is the diagnosis of Acquired agranulocytosis?

It is mainly done with the help of complete blood cell count. There is a routine blood test and the absolute neutrophil count in the test is below 500. It can even reach 0 cells per cubic mili meter. The other types of blood cells are mostly normal in numbers. To diagnose this condition the other pathologies with same presentation must be left. It includes the aplastic anemia, paroxysmal nocturnal hemoglobinuria, myelo dysplasia and leukemia. There should be the examination of bone marrow. It shows normal amount of cells which is referred as normo cellular. The marrow has blood and has under developed pro myelocytes. These cells if allowed to properly mature can form the missing granulocytes.

What is the treatment of Acquired agranulocytosis?

It can be treated with the multiple methods. Mainly it includes the use of close monitoring with the help of blood cell counts. The offending agent is with drawl of the medicines. A general advice must also be given. This is helpful in the patients which show no symptoms of infection. The infection in the patients which have low white blood cells must be treated as early as possible. It must be treated with the use of broad spectrum penicillin. One can also use the cephalo sporins in combination with the other antibiotics. After few days if the patient remains febrile and the causative agents are not identified than the antibiotics can be changed into glycopeptides. An anti fungal agent can also be added to the regimen. The hematological recovery can also be seen with the use of recombinant G CSF. This problem can be solved by the use of transfused granulocytes. But they survive for 10 hrs only in the blood. They can survive better in the spleen and other tissues. They give a short lasting effect. There are many complications associated with this procedure.

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