Understanding the Causes of Agranulocytosis and How to Treat It

Agranulocytosis is the term used when the bone marrow fails to form granulocytes, which are a type of white blood cell that help fight infection. If the body lacks granulocytes, a person can be more susceptible to infection.

Granulocytes or neutrophils contain enzymes that can kill bacteria and other organisms, as well as break down substances that can harm the body. Without the presence of sufficient granulocytes, the body is at high risk of severe or repeated infections.

Recognizing the Causes of Agranulocytosis

In general, there are 2 types of agranulocytosis. The first type is agranulocytosis that occurs due to birth and the second type is agranulocytosis caused by certain drugs, poisons, or medical procedures.

Approximately 70% of cases of agranulocytosis are related to the effects of treatment. The types of drugs that can cause agranulocytosis are clozapine, antimalarials, drugs to treat hyperthyroidism and anti-inflammatory drugs.

In addition, there are several other factors that can cause agranulocytosis to occur, namely:

  • Bone marrow dysfunction
  • Chemotherapy
  • Radiation exposure
  • Exposure to toxic substances, such as insecticides, arsenic, or mercury
  • Autoimmune disease
  • Nutritional deficiency

Agranulocytosis can occur in anyone, although it is more common in older people. In children, agranulocytosis is usually of congenital origin.

Signs and Symptoms of Agranulocytosis

Most people with agranulocytosis will have no obvious symptoms. Even so, the symptoms of infection can be seen clearly. Generally, the symptoms that often arise are fever and:

  • Headache
  • Sweating
  • Redness on the face
  • Shivering
  • Swollen lymph nodes
  • Weak
  • Sore throat

Patients who are known to have agranulocytosis need to be checked immediately if they have a fever so that the source of the infection can be found and treated immediately. This is important to prevent the infection from developing into life-threatening sepsis.

How to Treat Agranulocytosis

If agranulocytosis is caused by medication, discontinuation of the drug can gradually reverse the agranulocytosis. These drugs can be replaced with other drugs, but must be under the supervision of a doctor.

To prevent bacterial infection, patients with agranulocytosis can be given antibiotics, especially when they are in a situation where the risk of infection is high. Antibiotics are also used to treat an ongoing infection.

There are several other agranulocytosis treatments, including:

Immune suppressant drugs

If your agranulocytosis is caused by an autoimmune disease, your doctor may consider giving you drugs that suppress your immune system (immunosuppressants), such as prednisone.

Granulocyte Colony-Stimulating Factor (G-CSF)

If other treatments do not work, the production of granulocytes by the bone marrow can be stimulated by injection of G-CSF hormone, so that there are more granulocytes. G-CSF is usually given by injection under the skin.

Bone marrow transplant

In cases of agranulocytosis that can no longer be treated with medication, a bone marrow transplant may be necessary. However, a suitable donor is needed. Bone marrow transplantation generally gives the best results for patients under 40 years of age with a good medical history.

If you have agranulocytosis, you are advised to avoid crowds and contact with people who have an infectious disease. Also avoid doing activities that have a lot of contact with dust and dirt, such as farming without gloves or going outside barefoot.

In severe conditions, patients with agranulocytosis may be advised to undergo treatment in isolation rooms to avoid infection.

Although agranulocytosis is difficult to prevent, the cause of this condition can be quickly found with proper examination. That way, patients with agranulocytosis can get appropriate treatment and know what steps need to be taken to prevent themselves from infectious diseases, so that they avoid fatal complications.

If you really need a drug that has the side effect of agranulocytosis, do treatment with a doctor's control regularly to check your blood neutrophil levels. If neutrophil levels drop, your doctor may suggest stopping or changing your medication.