Agranulocytosis is a condition that results from failure of an individual's bone marrow to produce a sufficient quantity of white blood cells, or increased destruction of the white blood cells. Thus the white blood cell count will be low. Acquired agranulocytosis occurs most often as a result of medications or treatments rather than a congenital condition. Agranulocytosis usually responds well to treatment, so contact your doctor if you think you may have this condition.
Causes
Agranulocytosis can be caused by a variety of factors, including:
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Congenital genetic abnormality
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Tumors, infections or other inflammations, or fibrosis of the bone marrow
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Toxins, autoimmune diseases, infections, and other causes
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Aplastic anemia
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Certain medications or treatments
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Risk Factors
A risk factor is something that increases your chance of getting a disease or condition. The following factors increase your chances of developing agranulocytosis. If you have any of these, tell your doctor:
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Undergoing chemotherapy treatment for cancer
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Taking certain drugs
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Infection
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Exposure to certain chemical toxins or radiation
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Autoimmune diseases
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Enlargement of the spleen
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Vitamin B-12 or folate deficiency
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Leukemia or myelodysplastic syndromes
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Aplastic anemia or other diseases of the bone marrow
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Family history of certain genetic diseases
Symptoms
If you experience any of these symptoms do not assume it is due to agranulocytosis. These symptoms may be caused by other, less serious health conditions. If you experience any one of them, see your physician.
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Rapid onset of fever, chills, jaundice, weakness, or sore throat
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Bacterial pneumonia
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Ulcers in the mouth
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Bleeding gums
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Low white blood cell count
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Infections, including fungal
Diagnosis
Your doctor will ask about your symptoms and medical history, and perform a physical exam. Tests may include the following:
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Blood test to determine white blood cell count
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Urine or other fluids may be tested for infectious agents if the person has a fever
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Bone marrow test (biopsy and aspiration)
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Genetic tests may be needed in some people
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Antineutrophil antibodies may need to be tested for in people with autoimmune disease
Treatment
Talk with your doctor about the best treatment plan for you. Treatment options include the following:
Leukocyte Transfusion
Transfusion of white blood cells to replace deficit may be of benefit in certain people.
Antibiotic Treatment
Used to treat infection that could be causing agranulocytosis or resulting from agranulocytosis.
White Blood Cell-stimulating Factors
Depending on the cause, some people may benefit from treatments with granulocyte colony-stimulating factor (G-CSF) or granulocyte-macrophage colony-stimulating factor (GM-CSF).
Remove Causative Agent
Remove toxin/drug or treat primary disorder.
Prevention
To help reduce your chances of getting agranulocytosis, take the following steps:
RESOURCES:
Marquette University School of Dentistry
http://www.dental.mu.edu/oralpath/lesions/agranulocytosis/agranulocytosis.htm
National Organization for Rare Disorders, Inc.
http://www.rarediseases.org/search/rdbdetail_abstract.html?disname=Agranulocytosis%2C%20Acquired
US National Library of Medicine
http://www.nlm.nih.gov/medlineplus/ency/article/001295.htm
CANADIAN RESOURCES:
British Columbia Ministry of Health
http://www.bchealthguide.org/kbase/nord/nord209.htm
References:
Boulton F, Cooper C, Hagenbeek A, et al. Neutropenia and agranulocytosis in England and Wales: incidence and risk factors. American Journal of Hepatology. 2003 Apr;72(4):248-54. PubMed website. Available at: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Abstract&list_uids=12666135. Accessed December 18, 2006.
Tajiri J, Noguchi S, MurakamiT, Murakami N. Antithyroid drug-induced agranulocytosis. The usefulness of routine white blood cell count monitoring. Arch Intern Med. 1990 Mar 1;150(3). Archives of Internal Medicine website. Available at: http://archinte.ama-assn.org/cgi/content/abstract/150/3/621. Accessed December 18, 2006.
Tyson MC, Rosenthal N, Vogel P. The value of penicillin in the treatment of agranulocytosis caused by thiouracil. Blood, 1946;1(1):53-66. Blood Journal website. Available at: http://www.bloodjournal.org/cgi/content/abstract/1/1/53. Accessed December 18, 2006.
