Agranulocytosis is an uncommon condition in which bone marrow doesn’t make enough neutrophils. Neutrophils are white blood cells your body needs to fight infections. They make up the largest portion of white blood cells in your body.
Neutrophils are a critical part of your body’s immune system. They’re often the first immune cells to arrive at the site of infection. They consume and destroy harmful invaders like bacteria.
Agranulocytosis can enable minor infections to progress into serious ones. Weak microbes or tiny organisms (germs) that usually cause no harm suddenly can become strong enough to attack your body.
The early symptoms of agranulocytosis may include:
- sudden fever
- sore throat
- weakness in your limbs
- sore mouth and gums
- mouth ulcers
- bleeding gums
Other signs and symptoms of agranulocytosis can include:
- fast heart rate
- rapid breathing
- low blood pressure
- skin abscesses
Agranulocytosis can be congenital, meaning you’re born with the condition. You can also acquire it from certain drugs or medical procedures.
Acquired forms of agranulocytosis can be caused by:
- drugs, such as clozapine and antithyroid medication
- exposure to chemicals, such as the insecticide DDT
- diseases that affect bone marrow, such as cancer
- serious infections
- exposure to radiation
- autoimmune diseases, such as systemic lupus erythematosus
- nutritional deficiencies, including low levels of vitamin B-12 and folate
- bone marrow transplants
Women are more likely to develop agranulocytosis than men are. It can occur at any age. However, inherited forms of the condition are more often found in children. Acquired agranulocytosis occurs most frequently in older adults.
Your doctor will likely take a detailed medical history. This will include questions about recent drug treatments or illnesses. Blood and urine samples are needed to check for infection and white blood cell counts. Your doctor may take a marrow sample if they suspect a problem with your bone marrow.
Genetic testing is necessary to check for a hereditary form of agranulocytosis. You may need to get tested for possible autoimmune disorders.
If agranulocytosis has arisen from an underlying illness, that condition will be treated first.
If a drug needed for another condition causes agranulocytosis, your doctor may prescribe a substitute treatment. If you’re taking several different drugs, you may need to stop taking them. This could be the only way to find what medication is causing the problem. Your doctor may advise you to take antibiotics or antifungal drugs to treat infection.
A treatment called a colony-stimulating factor can be used for some people, such as those who have acquired agranulocytosis from chemotherapy. This treatment encourages the bone marrow to produce more neutrophils. It can be used along with your chemotherapy cycles.
Although not widely used, a transfusion of neutrophils may be the best treatment for some.
Without treatment, agranulocytosis can lead to death by sepsis. However, the outlook is positive if you receive appropriate and timely treatment. People who develop agranulocytosis following a viral infection often find the condition resolves itself.
The only way to prevent agranulocytosis is to avoid the drugs that may cause it. If you must take a drug known to trigger the condition, you’ll need to get regular blood tests to check your neutrophil levels. If you have lowered neutrophil counts, your doctor may advise you to stop taking the drug.