Agranulocytosis
Agranulocytosis | |
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myelodysplasia, leukemia |
Agranulocytosis, also known as agranulosis or granulopenia, is an acute condition involving a severe and dangerous lowered white blood cell count (leukopenia, most commonly of neutrophils) and thus causing neutropenia in the circulating blood.[1] It is a severe lack of one major class of infection-fighting white blood cells. People with this condition are at very high risk of serious infections due to their suppressed immune system.
In agranulocytosis, the concentration of
Signs and symptoms
Agranulocytosis may be
Causes
A large number of drugs
Although the reaction is generally idiosyncratic rather than proportional, experts recommend that patients using these drugs be told about the symptoms of agranulocytosis-related infection, such as a sore throat and a fever.[citation needed]
The
Diagnosis
The diagnosis is made after a
Classification
The term "agranulocytosis" derives from the Greek: a, meaning without; granulocyte, a particular kind of white blood cell (containing granules in its cytoplasm); and osis, meaning condition [esp. disorder]. Consequently, agranulocytosis is sometimes described as "no granulocytes", but a total absence is not required for diagnosis. However, "-osis" is commonly used in blood disorders to imply cell proliferation (such as in "leukocytosis"), while "-penia" to imply reduced cell numbers (as in "leukopenia"); for these reasons, granulocytopenia is a more etymologically consistent term, and as such, is sometimes preferred to "agranulocytosis" (which can be misinterpreted as "agranulocyt-osis", meaning proliferation of agranulocytes (i.e. lymphocytes and monocytes). Despite this, "agranulocytosis" remains the most widely used term for the condition.[citation needed]
The terms agranulocytosis,
To be precise, neutropenia is the term normally used to describe absolute neutrophil counts (ANCs) of less than 500 cells per microlitre, whereas agranulocytosis is reserved for cases with ANCs of less than 100 cells per microlitre.[citation needed]
The following terms can be used to specify the type of granulocyte referenced:
- Inadequate numbers of neutrophils: neutropenia (most common)
- Inadequate numbers of eosinophils: eosinopenia (uncommon)
- Inadequate numbers of basophils: basopenia (very rare)
In a general sense the pathogenesis of neutropenia can be divided into two categories;
- Inadequate or ineffective formation of granulocytes. This can be due to bone marrow failure associated with aplastic anemia, leukemia, or chemotherapeutic agents. There can also be isolated neutropenias where only differentiated granulocyte precursors are affected as in the case of neoplastic proliferation of cytotoxic T cells or NK cells
- Accelerated destruction of neutrophils. Immune-mediated reactions to neutrophils which can be caused by drugs. An enlarged spleen can lead to splenic sequestration and accelerated removal of neutrophils. Utilization of neutrophils can occur in infections[9]
Treatment
In patients that have no symptoms of infection, management consists of close monitoring with serial blood counts, withdrawal of the offending agent (e.g., medication), and general advice on the significance of fever. Transfusion of granulocytes would be 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.[citation needed]
See also
References
- ^ Neutropenia at eMedicine
- S2CID 15585536.
- )
- .
- ISBN 978-0132815604.
- PMID 32815018.
- ^ U.S. Department of Justice; National Drug Intelligence Center (February 2010). "Colombian Cocaine Producers Increase Use of a Harmful Cutting Agent". National Drug Threat Assessment 2010. Archived from the original on 2012-05-18. Retrieved 2020-11-22.
- PMID 20019655. Archived from the original on 2018-10-09. Retrieved 2017-09-08. Cited in Hsu, Jeremy (18 December 2009). "Majority of U.S. Cocaine Supply Cut with Veterinary Deworming Drug". Popular Science. Archivedfrom the original on 25 February 2018. Retrieved 21 December 2009.
- ^ Kumar, Vinay (2007). Robbins Basic Pathology (8 ed.). Elsevier. p. 441.