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If Granulocytes can no longer be treated through regular treatment, transplants can be chosen

Written By Hanny & Melissa on Tuesday, May 07, 2019 | Tuesday, May 07, 2019

The scientific term used when the bone marrow fails to form a subgroup of white blood cells that have granules in the cytoplasm, called Granulocytes. Granulocytes, which consist mostly of neutrophils, are a type of white blood cell that functions to fight infection.

The body lacking granulocytes or neutrophils will be susceptible to infection. Under normal circumstances, the bone marrow is able to form 1,500 neutrophils/ microliter of blood.

Where as in agranulocytosis, absolute neutrophil counts of up to 100 neutrophils per microliter of blood. Under conditions of low neutrophils, mild infections can develop into serious infections.

Harmless microbes or germs can develop and become dangerous for the body. Agranulocytosis, is a fairly serious condition. If not treated immediately can cause sepsis and death.

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Furthermore, people who experience agranulocytosis will be susceptible to infection, because of the lack of white blood cells responsible for fighting bacterial attacks. The symptoms that appear like an infection include :

1. Fever.
2. Limp.
3. Headaches.
4. Shivering and sweating.
5. Redness around the face.
6. Inflammation of the throat.
7. Thrush that does not improve.
8. Bleeding gums.
9. Boils arise on the skin.

However, if the infection becomes more severe, it certainly can result

1. Tachycardia.
2. Breath becomes fast.
3. Low blood pressure or hypotension.

Then, agranulocytosis can occur due to birth defects (Congenital) or acquired due to illness, drugs, and medical procedures. Congenital agranulocytosis is caused by a rare genetic disorder, namely Kostmann's syndrome. This disorder is passed on to children from parents.

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Research shows that as many as 70 percent of agranulocytosis cases are associated with the use of antipsychotic drugs (Eg clozapine), anti-malarials, anti-inflammatory, and antithyroid drugs (Eg carbimazole). In a nutshell, the causes of agranulocytosis are :

1. Autoimmune conditions, such as lupus and rheumatoid arthritis.

2. A disease affecting the bone marrow, such as aplastic anemia, leukemia, and myelodysplasia syndrome.

3. Hepatitis.

4. HIV.

5. Actions of chemotherapy and bone marrow transplant.

6. Exposure to chemical compounds, such as arsenic or mercury.

7. Medicines, such as antipsychotic drugs, malaria drugs, NSAIDs and hyperthyroid drugs (Example Thiamazole)

Infection that occurs in agranulocytosis, is treated using antibiotics. Antibiotics prescribed by a doctor will be given based on the severity of the infection.

Sometimes antibiotics have been given before the infection, which aims to prevent infection. In treating agranulocytosis, it is important to know the cause of agranulocytosis itself, so that it can be handled appropriately.

For example, if suspected agranulocytosis due to malaria drugs, will be given a substitute for the drug. If necessary, treatment can be stopped temporarily. Some drugs that will be recommended to suit the causes of agranulocytosis are :

1. Granulocyte Colony Stimulating Factor (GCSF).

- This method is done by injecting a hormone that stimulates the bone marrow to produce more granulocytes.

Injecting GCSF is usually given by injection under the skin (Subcutaneous) in agranulocytic patients due to chemotherapy drugs. An example of GCSF is filgrastim.

2. Immunosuppressants.

- If agranulocytosis is caused by an autoimmune condition, namely the presence of an immune system that attacks the body itself, it will be given drugs that can suppress the body's immunity. For example corticosteroids.

3. Bone marrow transplant.

- In the case of agranulocytosis which can no longer be treated through regular treatment, a bone marrow transplant can be an option.

This method generally provides the best results for patients under 40 years of age with the function of other organs such as the heart, kidneys, and good liver. Bone marrow transplant can be performed on leukemia patients.

Agranulocytosis sufferers are advised not to be in a crowded situation to minimize the risk of infection. Sufferers are also recommended to avoid foods that have the potential to be exposed to bacteria, such as fruits or vegetables that are not washed or peeled cleanly.

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