Agranulocytic quinsy

Description:

Agranulocytic quinsy is a septic disease at which into the forefront peculiar changes in a pharynx and blood act. At this disease dirty-gray plaques with necrotic disintegration on almonds, a uvula, on handles, and sometimes and on a back wall of a throat are observed at simultaneous strong swelling of cervical lymph nodes. In peripheral blood lack of granulocytes with existence only of lymphocytes and monocytes is noted.
Now the agranulocytosis is considered not as a separate nosological form, and as a syndrome with a certain reaction from a granulopoiesis.

Symptoms of Agranulocytic quinsy:

As the agranulocytosis represents as if group of the painful syndromes combined by a community of hematologic and clinical signs, and its clinic cannot be accurate.

Disease at an allergic form of an agranulocytosis usually acute and even fulminant, at other forms accepts subacute or recurrent character. At a pure form of an agranulocytosis of the phenomena of hemorrhagic diathesis it is not noted. However at adverse disease anemia and a thrombopenia develops that is followed by hemorrhages in various bodies and bleedings.

The disease can be complicated by a necrosis of glubzhelezhashchy fabrics and secondary sepsis as a result of, apparently, switching off leukocytic and other types of protection of an organism.

Reasons of Agranulocytic quinsy:

The etiology and pathogeny of an agranulocytosis are not found out. Were suggested about the allergic nature of this disease, about a role of hormonal influences, about a virus origin of a disease, about primary change of marrow by toxins. All these assumptions did not receive sufficient confirmation. In an etiology of an agranulocytosis influence of various pharmacological substances is of great importance (salvarsan, pyramidon, acetphenetidiene, antipyrine, analginum, novocaine, sulphamide drugs, veronal, quinine, quinophan, PASK, Butadionum, drugs of gold, bismuth, arsenobenzenes, etc.). The number of cases of an agranulocytosis especially increased in connection with unlimited, sometimes uncontrolled use of pyramidon, streptocides, antibiotics, especially levomycetinum.

Oppression of a granulopoiesis can be also observed at long influence of gasoline or benzene, at influence of a radiant energy (at non-compliance with rules of protection and a dosage), at consumption of the wintered cereals (millet, wheat, etc.), and also under the influence of some hormonal factors.

All listed factors can lead to oppression of a leukopoiesis in marrow at various stage of cellular differentiation (miyeloblastichesky, promiyelotsitarny, miyelotsitarny). In certain cases development of an agranulocytosis results from primary defeat of leukocytes of peripheral blood that usually takes place at a medicamentous agranulocytosis. In these cases in an organism antibodies which cause agglutination of leukocytes with the subsequent their destruction are formed.

It must be kept in mind that the crucial role in emergence of an agranulocytosis is played reactivity of system of blood, a giperergichesky condition of an organism, inborn low-value of the hemopoietic bodies and etiological factors of a disease concerning which these or those medicinal substances are applied.

Treatment of Agranulocytic quinsy:

Therapeutic actions have to be directed to activation of krovotvorny system and to elimination of consecutive infection, and also to elimination of etiological factors if they manage to be established. From the means stimulating a granulopoiesis use of 5% of nucleinic and acid sodium on 5 — 10 ml 2 times a day intramusculary within 10 — 14 days is recommended. Special stimulators of a leukopoiesis are applied: Thesanum on 0,01 — 0,02 g 3 times a day before recovery of normal composition of blood; pentoxyl on 0,2 — 0,3 g 3 times a day within 14 — 20 days. Injections of adrenocorticotropic hormone (AKTG) on 40 — 60 units or a cortisone on 50 — 100 mg a day are recommended. Hemotransfusion on 200 — 300 ml is applied, it is better to pour leukocytic weight. The quantity of transfusions from 3 to 8 and more at an interval of 3 — 4 days is desirable. Appoint about 2 billion leukocytes or 40 — 50 ml of the suspension containing 1,5 — 2,5 billion leukocytes and 15 — 25 billion thrombocytes to one introduction. At bleedings use the absorbable gelatin sponge moistened with normal saline solution, appoint vitamin C, vitamin K (Vikasolum) on 10 — 50 mg a day within several days, enter intravenously on 10 ml 10% of solution of Calcium chloratum. Use of campolon and antianemin (on 2 — 4 ml), and also B12 vitamin has auxiliary value. And their preventions apply penicillin of 600 000 — 800 000 PIECES a day to fight against the septic phenomena. For reduction of a dysphagy locally grease ulcers of 10% with cocaine solution, powder with anaesthesin powder. It is necessary to pay attention to care of an oral cavity, to apply rinsings by weak disinfecting solutions, to make irrigation of a pharynx weak solution of permanganate potassium, 1% soda solution, boiled water, to put to napkin gingivas, moistened with Rivanolum solution (in cultivation 1: 750 — 1: 500), Chinosolum solution (1: 1000), Furacilin (1: 5000), penicillin, hydrogen peroxide.
Use of all types of radiation therapy is contraindicated.