A dangerous decrease in white blood cells: What you need to know about Agranulocytosis

Do you feel tired and lethargic all the time? Do you get a fever, mouth sores, and feel like you're getting sick from even the smallest things? There could be a medical condition behind these things that we don't talk about much, but can be very serious. Today we're going to talk about one such condition, which is Agranulocytosis. Don't worry, let's explain everything in simple terms.

What exactly is Agranulocytosis?

Simply put, this is a dangerous decrease in a type of white blood cell in our blood. Imagine that our body is like a country. Then the germs that cause diseases in our body are the enemies that attack the country. The army that fights these enemies is the white blood cells in our blood.

A special force within this white blood cell army is called granulocytes . There are three main types of soldiers in this force:

• Neutrophils
• Basophils
• Eosinophils

These cells contain small granules, which contain enzymes that destroy germs such as bacteria that enter the body. These most important cells are produced in our bone marrow.

So, agranulocytosis is when these fighting cells called granulocytes, especially the most abundant neutrophil cells, are greatly reduced in the blood. When that happens, our body's defense system almost completely breaks down. We start to get sick easily even from the smallest germ.

Normally, a healthy person should have more than 1,800 white blood cells per microliter of blood. If this number falls below 500, it is called Agranulocytosis. This is a very dangerous condition.

What are the causes of agranulocytosis?

There are two main categories of causes for this condition: congenital and acquired.

1. Congenital Agranulocytosis:

This is caused by a genetic defect. Some children are born with a reduced ability to produce white blood cells in their bone marrow. For example, there is a rare condition called Kostmann syndrome. Such children often have fevers, infections, and bone problems.

2. Agranulocytosis that occurs later:

This is the most common condition. It can occur later in life for a variety of reasons.

How does medication cause this condition?

Medications are the biggest cause of this. When you take things like some anti-cancer drugs, everyone's white blood cells decrease. But there are some medications that, while not causing problems for most people, can cause agranulocytosis in a small number of people.

• Drugs that act through the immune system: Some drugs cause our bodies to produce antibodies that attack our own white blood cells.
• Bone marrow suppressant drugs: Some drugs (e.g. valproic acid, carbamazepine, some antibiotics such as amoxicillin) stop the production of white blood cells in the bone marrow.
• Anticancer drugs and some medications for mental illness: These are also a major cause of low white blood cell counts.

What are the symptoms of this condition?

Most of the time, there are no symptoms specific to this condition. It is discovered incidentally when a blood test is done for another reason. However, symptoms appear through infections caused by low immunity.

• Sudden high fever
• Feeling cold and shivering
• Mouth ulcers
• Headache
• Sweating
• Swollen lymph nodes
• Swelling of the liver or spleen
• Constant fatigue and exhaustion

The most dangerous thing about this situation is that even a minor infection can quickly develop into a serious, life-threatening condition called sepsis . Sepsis is a condition in which an infection spreads throughout the body, blood pressure drops dangerously, and even the body's internal organs can fail. This is a situation that requires emergency medical treatment.

People over the age of 65, those with other medical conditions such as kidney disease or heart disease, are at a much higher risk of developing complications if they develop an infection with agranulocytosis.

How is it treated?

The first and most important step in treating this is to find the cause .

• Treating the Cause: If this condition is caused by a medication, the condition usually improves within 2-3 weeks after stopping the medication as directed by your doctor. If the cause is an infection, it should be treated.
• Stimulating white blood cell production: Special injections such as Filgrastim are given to increase white blood cell count. These stimulate the bone marrow and increase neutrophil production.
• Treating infections: If you have a bacterial infection, your doctor will prescribe antibiotics. For viral or fungal infections, they will give you specific medications. If the infection is severe, you may need to be hospitalized and given intravenous (IV) treatment.
• Bone marrow transplant: If no other treatment is effective, a bone marrow transplant from a matched donor may be considered as a last resort.

How should someone with agranulocytosis take care?

If you have this condition, your immune system is very weak, so you need to take extra care to protect yourself from infections.

Although agranulocytosis is a serious condition, it can often be cured if the cause is identified and treated properly. The most important thing is to see your doctor as soon as you notice the slightest sign of infection (fever, body aches). Taking prompt action can help prevent serious complications.

Agranulocytosis, low white blood cell count, neutropenia, decreased immunity, frequent illness, bone marrow, Sri Lanka Health