What Is Agranulocytosis? Symptoms, Causes, & How It's Managed

Two Types of Agranulocytosis Exist

The inherited form of agranulocytosis is caused by a genetic disease that alters the production of neutrophils in the body. It is more prevalent in infants and young children.

Although acquired agranulocytosis can have a variety of reasons, up to 70% of instances are related to pharmaceutical side effects. The majority of cases of this type of agranulocytosis occur in adults.

Conditions that Cause Agranulocytosis

• Medications: Drugs like antipsychotics (e.g., clozapine), chemotherapy, and antibiotics (e.g., sulfa drugs) can suppress white blood cell production.
• Autoimmune Disorders: Conditions like lupus or rheumatoid arthritis can cause the immune system to attack white blood cells.
• Infections: Viral infections like hepatitis or HIV can damage bone marrow, leading to agranulocytosis.
• Bone Marrow Disorders: Diseases like leukemia or aplastic anemia can affect white blood cell production.
• Radiation Exposure: High radiation levels (e.g., from radiation therapy) can damage bone marrow.
• Nutritional Deficiencies: Lack of vitamins like folate or B12 can hinder white blood cell production.
• Genetic Factors: Inherited conditions like Shwachman-Diamond syndrome can lead to agranulocytosis.
• Other Conditions: Chronic stress, liver disease, or severe infections can also contribute to agranulocytosis.

Common Causes of Agranulocytosis

Agranulocytosis can result from various factors that disrupt white blood cell production or function:

• Chemotherapy: Chemotherapy drugs can damage the bone marrow, significantly lowering white blood cell counts.
• Myelodysplastic Syndromes (MDS): These conditions affect the bone marrow and impair the production of blood cells, including white blood cells.
• Radiation Therapy: Exposure to high doses of radiation during cancer treatment can lead to agranulocytosis by damaging bone marrow.
• Hypersensitivity Reactions: Some allergic reactions to drugs or environmental factors can trigger agranulocytosis as part of an immune response.
• Parasitic Infections: Certain parasitic diseases can impact bone marrow function, contributing to agranulocytosis.
• Chronic Alcohol Use: Long-term heavy drinking can lead to bone marrow suppression, which may result in agranulocytosis.
• Heavy Metals Exposure: Exposure to metals like arsenic or lead may interfere with the bone marrow's ability to produce white blood cells.

Related Symptoms

Infection symptoms brought on by agranulocytosis might manifest quickly or gradually. Among the symptoms could be:

• Fever and chills
• Quicker respiration and heart rate
• Weariness and weakness of the muscles
• Sore gums that are inflamed and bleeding (pharyngitis)
• Sores in your throat and mouth that interfere with swallowing
• Unexpectedly low blood pressure, or hypotension, can make you feel weak or dizzy or even make you pass out.

When to Visit a Doctor?

You should seek medical help immediately if you:

• Develop unexplained fevers or persistent infections.
• Experience mouth ulcers or sore throats that do not heal.
• Are on medications known to reduce white cell count.
• Feel excessively tired without clear reason.
• Have been exposed to toxic chemicals or radiation.

Diagnosis for Agranulocytosis

Doctors use a range of tools to diagnose this condition:

• Complete Blood Count (CBC): Shows very low white blood cell (neutrophil) count.
• Bone Marrow Biopsy: Checks for bone marrow damage or disease.
• Medical History Review: Includes past medications and infections.
• Infection Screening: Cultures or imaging to find source of infections.
• Genetic Testing: In congenital cases.

Treatment and Management for Agranulocytosis

• Antibiotics: In order to treat your illness and reduce your symptoms, your doctor may recommend antibiotics in addition to other drugs.
• Immunosuppressants: Your doctor may prescribe immunosuppressive medications, such as prednisone if agranulocytosis is brought on by an autoimmune disease.
• Bone marrow transplant: You might require a bone marrow transplant if all other therapies fail. You acquire bone marrow from a donor during this process, so your body has more neutrophils to produce.

Agranulocytosis patients should take precautions to prevent infection. Avoid crowds, wash your hands frequently, and cover your face when you're out in public. Discuss more preventative measures you can take with your healthcare professional.

Prevention for Agranulocytosis

To prevent complications and manage agranulocytosis risk, follow these precautions:

• Regular Blood Monitoring: When taking high-risk medications.
• Avoid Unnecessary Drug Use: Use only prescribed medicines.
• Immediate Reporting: Alert your doctor if signs of infection appear.
• Protective Measures: Mask-wearing and hygiene in vulnerable individuals.
• Routine Checkups: Especially with autoimmune or bone marrow conditions.

Lifestyle Changes for Agranulocytosis

Adopting supportive habits can help manage symptoms and recovery:

• Nutritious Diet: Rich in B12, folate, and protein to support immune function.
• Good Hygiene: Regular hand washing and oral care to prevent infections.
• Avoid Crowded Places: Lower exposure risk to germs.
• Stress Management: Meditation or yoga to maintain immunity.
• Adherence to Treatment: Follow prescribed therapies without interruption.

Home Remedies for Agranulocytosis

These can support recovery alongside medical treatment:

• Garlic and Ginger: May help boost immunity due to natural antibacterial properties.
• Vitamin-Rich Juices: Like carrot or beetroot juice to nourish the blood.
• Warm Saltwater Gargle: For sore throat and mouth ulcers.
• Hydration: Drink plenty of fluids to support overall health.
• Rest and Sleep: Essential for healing and immune function.