Agran Ulocytosis

Agranulocytosis

Agranulocytosis is a syndrome characterized by a decrease in the number of leukocytes (less than 1000 in 1 μl of blood) or granulocytes (less than 750 in 1 μl of blood).

Agranulocytosis is usually a manifestation of some general disease. The most common are myelotoxic agranulocytosis and immune agranulocytosis. Myelotoxic agranulocytosis develops with a cytostatic disease. Immune agranulocytosis can be caused by autoantibodies (for example, in systemic lupus erythematosus) or by antibodies to granulocytes formed after taking certain medications.

The pathogenesis of agranulocytosis is not well understood. In autoimmune forms, the premature death of granulocytes and their precursors in the bone marrow is caused by autoantibodies. The mechanism of the body's response to drugs in hapten agranulocytosis is not clear.

Clinically, agranulocytosis is manifested by septic complications (angina, pneumonia, etc.) against the background of a decrease in the number of granulocytes. With hapten agranulocytosis, there are usually no granulocytes in the blood, but the number of lymphocytes and platelets is normal. With the autoimmune variant, the number of platelets sometimes decreases, which leads to the development of hemorrhagic syndrome.

Treatment of agranulocytosis includes the creation of aseptic conditions, treatment of septic complications, as well as the administration of glucocorticoids for autoimmune forms. The prognosis depends on the type of agranulocytosis and the effectiveness of treatment. With repeated use of the hapten drug, the prognosis sharply worsens. It is important to prevent recurrent episodes of agranulocytosis by lifelong exclusion of the suspected drug.