Agranulocytosis
Contents:
Description:
The agranulocytosis is a clinic - the hematologic syndrome which is characterized by a leukopenia and considerable reduction, sometimes up to total disappearance, granulocytes from peripheral blood. The agranulocytosis, as a rule, represents a syndrome of some general disease. Occurs at children rather seldom, more often as a symptom of hypoplastic anemia. The myelotoxic agranulocytosis and immune meets more often. The last can be caused by emergence of autoantibodies (for example, at a system lupus erythematosus) and antibodies to granulocytes after reception of the medicines which appeared haptens (at hit in an organism these medicines, connecting to protein, find properties of antigen).
Agranulocytosis symptoms:
The general weakness, ulitis, stomatitis, ulcer and necrotic damage of mucous membranes of a mouth, throat, digestive tract, high temperature of a body, sometimes moderate increase in a liver, spleen and regional lymph nodes are characteristic. In peripheral blood: a leukopenia (1-2) • 10*9/l and below, a relative lymphocytosis, a granulocytopenia (from 20% to 0 granulocytes, with rough toxic granularity), moderate anemia, an anisocytosis, a polychromatophilia. In hard cases (from - an autoimmune panmyelophthisis) - the thrombocytopenia which is followed by a hemorrhagic syndrome. The picture of marrow is changeable - from insignificant functional oppression of a granulocytopoiesis to the expressed hypoplasia of a granulotsitarny sprout. System of red blood and мегакариоцитарньй the device are surprised seldom. The current is acute, sometimes subacute.
Agranulocytosis reasons:
The agranulocytosis can be caused by a number of factors: infectious diseases (a typhoid, malaria, sepsis, measles in the period of a rash); some medicines of Diacarbum (Diamoxum), pyramidon, antipyrine, acetylsalicylic acid, barbiturates, an isoniazid (Tubazidum), Meprotanum (meprobamate), acetphenetidiene, Butadionum, a novokainamid (procaineamide), indometacin, levamisole, streptocides, Methicillinum, Trimethoprimum (is a part of Bactrimum), Chingaminum (chloroquine), insecticides, clozapine (leponexum), etc.), and also himiopreparatam with the expressed myelotoxic action (vinblastine, Cyclophosphanum, Myelosanum, 6 Mercaptopurinum, etc.); beam influence. Perhaps strengthened destruction of granulocytes in peripheral blood owing to the increased individual sensitivity to this or that factor (immunoallergic and autoimmune agranulocytoses). The agranulocytosis can develop under action not only antibodies to granulocytes, but also the circulating cell-bound immune complexes.
Treatment of the Agranulocytosis:
Patients with an agranulocytosis are urgently hospitalized and whenever possible are located in the most sterile conditions (the insulator, ultra-violet radiation of air with protection of the patient, the personnel enter in masks, hats, boot covers). Treatment of septic complications at an agranulocytosis in general is similar to therapy of similar defeats at an acute radial illness. At an autoimmune agranulocytosis oppression of autoimmune aggression is made, glucocorticoids in high doses (60-100 mg/days) before normalization of number of granulocytes in blood with the subsequent gradual cancellation of hormones are shown to the patient. At a gaptenovy afanulotsitoz introduction of glucocorticoids is not effective. Treatment of similar patients is effective only in the conditions of a specialized hospital where there is a possibility of ensuring sufficient level of sterility for minimization of risk of accession of consecutive infections.
