Are your body's defenses weakened? Let's learn about agranulocytosis.

Do you often get colds and flu and feel very sick? Sometimes, even a minor illness can become serious and take a long time to recover? The main reason for this may be a weakness in your body's immune system, that is, the army that protects us from diseases. Today we are talking about a condition that can be suspected at such times, which may be a little dangerous, but can be treated.

Simply put, what is Agranulocytosis?

Agranulocytosis (pronounced: "a-gra-nu-lo-cy-to-sis") is a life-threatening condition in which the number of neutrophils, a type of white blood cell, in our blood is severely reduced.

Imagine that our body is like a country. Then the white blood cells are the army that protects that country. There are various battalions in this army. Among them , neutrophils are a special commando group that goes to attack germs as soon as they see them . So when the number of these commandos decreases greatly, even a small germ from outside can easily attack our body and make us sick.

This condition can make you more susceptible to serious infections, even from germs that don't usually harm us.

So what is the difference between Neutropenia and Agranulocytosis?

You may have also heard the term neutropenia. Although these two sound similar, there is a slight difference.

• Neutropenia: Any condition in which the number of neutrophils is lower than normal.
• Agranulocytosis: This is the most severe and dangerous form of neutropenia.

Simply put, when neutrophil levels drop too low, we call it Agranulocytosis.

What are the reasons that cause this situation?

Agranulocytosis can occur in two main ways.

1. Inherited Agranulocytosis: This is caused by a defect in the genes that make neutrophils. This is very rare and is most common in young infants and children.

2. Acquired Agranulocytosis: This is the most common type. There can be several causes for this. But in about 70% of cases, it is a side effect of certain medications we take. This type is more common among adults.

The main causes of subsequent agranulocytosis

• Certain medications: This condition can be caused by medications such as some antibiotics, medications for mental illnesses (e.g. clozapine), and medications for thyroid disorders (e.g. methimazole).
• Chemotherapy: When cancer cells are destroyed, neutrophils, which are healthy cells that divide rapidly, can also be damaged.
• Autoimmune diseases: This is when our body's own immune system misbehaves and attacks its own healthy cells. Examples include diseases like Lupus and Rheumatoid Arthritis.
• Bone Marrow Diseases: The bone marrow is the factory that produces all of our blood cells. So, diseases that affect this factory, such as cancers like leukemia or aplastic anemia, can impair neutrophil production.
• Some infections: This condition can also be caused by severe infections such as malaria and tuberculosis.
• Nutritional deficiencies: This risk also exists with long-term deficiencies of nutrients like vitamin B12 and folate.
• Toxic chemicals: Ingestion of toxic chemicals such as lead or mercury.

What are the symptoms of agranulocytosis?

Because of the low neutrophil count, the primary symptoms of this condition are those of an infection . These can appear suddenly or develop gradually.

The main visible features are these:

• Feeling very cold, shivering, and having a fever .
• Increased heart rate and breathing rate.
• Feeling of fatigue and weakness in the body that was not there before .
• Sore throat, swollen and bleeding gums.
• Difficulty swallowing due to mouth and throat ulcers .
• Sudden drop in blood pressure (hypotension) leading to feelings of fainting and dizziness.

How does a doctor diagnose this condition?

If you have any of the symptoms listed above, especially if you have frequent infections, a doctor will examine you. The most important test to find out if you have this condition is a complete blood count (CBC) . Sometimes we also call this a full blood count (FBC).

This test measures the exact number of neutrophils in your blood. If the neutrophil count is less than 100 per microliter, it is diagnosed as Agranulocytosis.

In addition, the doctor may order further tests to find the cause.

• Bone Marrow Biopsy: This test is done to see if there is any problem in the bone marrow, the factory that makes blood cells.
• Genetic Testing: If there is a suspicion that this is a congenital condition, you may be referred for this test.

What are the treatments for agranulocytosis?

Although this is a dangerous condition, the good news is that there are effective treatments for it. The treatment depends on what is causing the condition.

• Stopping the Causative Medication: If the cause of this condition is a medication you are taking, the first and most important thing to do is to stop taking that medication. However, never stop taking your medication on your own. Be sure to talk to your doctor and follow his or her instructions to do so safely.

• Antibiotics: If you already have an infection in your body, your doctor will prescribe strong antibiotics to fight it.

• G-CSF injections: These are called Granulocyte Colony-Stimulating Factor (G-CSF). These injections stimulate the bone marrow and help it produce neutrophil cells more quickly.

• Immunosuppressants: If the cause is an autoimmune disease, medications such as prednisone may be given to calm the overactive immune system.

• Bone Marrow Transplant: If other treatments are unsuccessful, a bone marrow transplant from a healthy person can be performed as a last resort.

How can I protect myself from infections during treatment?

It is very important to avoid infections while treating someone with this condition.

• Always wash your hands thoroughly with soap.
• Minimize going to crowded places as much as possible.
• Wear a face mask when going out.
• Eat only well-cooked, clean food.

Is it possible to fully recover from this condition?

Yes, most of the time it is possible. The recovery time depends on the cause.

If the cause is a medication, neutrophil counts usually return to normal within 1 to 3 weeks after stopping the medication.

If diagnosed and treated early, this condition can be completely controlled. However, if left untreated, it can lead to severe infections and life-threatening conditions such as sepsis . People over the age of 65 and those with other heart, kidney, or lung diseases are at higher risk of complications.

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