General
Information
DEFINITION--Reduction in the normal number of circulating white blood cells
(granulocytes or neutrophils) in the bloodstream. These cells are the first to attack
bacterial infections.
BODY PARTS INVOLVED--Blood; bone marrow.
SEX OR AGE MOST AFFECTED--Both sexes; all ages.
SIGNS & SYMPTOMS
- Fever.
- Aching.
- Sore throat.
- Ulcers (especially in the mouth and throat), which do not produce pus.
- Any sign of infection in someone who has had agranulocytosis in the past. This may
signal a recurrence.
CAUSES--Increased destruction or impaired production of granulocytes (white
blood cells). The most common reason for this is an adverse reaction to medications,
including: anticancer drugs; anticonvulsants; antihistamines; antithyroid drugs; arsenic;
chloramphenicol; Dibenzyline; gold salts; indomethacin; nitrofurantoin; nitrous oxide;
phenothiazines; phenylbutazone; procainamide; sulfonamides; synthetic penicillins; and
thiazide diuretics.
RISK INCREASES WITH--Genetic factors. A rare form, infantile genetic
agranulocytosis, is inherited.
HOW TO PREVENT
- See your doctor if you have one infection after another (especially if you take
medications).
- Prevent recurrences by avoiding any suspect medicine or drug that may have triggered
agranulocytosis previously.
What To Expect
DIAGNOSTIC MEASURES--
- Your own observation of symptoms.
- Medical history and physical exam by a doctor.
- Laboratory studies of blood and bone marrow, and cultures of blood, nose, throat and
urine.
APPROPRIATE HEALTH CARE
- Doctor's treatment.
- Possible hospitalization for intensive treatment during the active phase, with strict
reverse isolation techniques (See Glossary) and
transfusions of white blood cells (sometimes).
- Self-care after diagnosis and hospitalization.
> Dangerous, sometimes fatal infections (bacterial, fungal, viral or others)--
PROBABLE OUTCOME--Depending on cause, usually curable with intensive treatment.
How To Treat
GENERAL MEASURES----Hospitalization may be necessary during the acute phase. The
following may be helpful after hospitalization:
- Be extra careful about personal cleanliness.
- Keep the mouth clean by rinsing frequently with warm salt water (1 teaspoon salt to 8
oz. water) or gargling with hydrogen peroxide.
- Pay particular attention to oral hygiene. Brush teeth gently with a very soft brush,
avoiding irritation of the gums.
- Avoid contact with harmful materials, such as cleaning chemicals, glue, insecticide,
fertilizer and paint remover.
MEDICATION--Your doctor may:
- Prescribe intravenous and oral antibiotics if the white blood cell count is very low.
- Prescribe lithium to stimulate bone marrow to produce more granulocytes.
- Stop prescribing any drug that is suspected of causing agranulocytosis.
ACTIVITY--Rest in bed during the acute stage. Resume normal activities gradually
after symptoms subside.
DIET--No restrictions.
Call Your Doctor If
- You have symptoms of agranulocytosis.
- The following occurs after treatment: Any sign of infection, especially fever. Swelling
of the feet and ankles. Painful urination or decreased urine output in 1 day.
- New, unexplained symptoms develop. Drugs used in treatment may produce side effects.
