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Angina with agranulocytosis.
Last reviewed: 05.07.2025
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[ Causes of angina in agranulocytosis
A distinction is made between myelotoxic and immune agranulocytosis. The first may occur when granulocyte formation in the bone marrow is disrupted, for example, by ionizing radiation, benzene vapors, or cytotoxic agents. The second type of agranulocytosis is observed when blood granulocytes are destroyed, which is possible in people with increased sensitivity to certain medications (amidopyrine, phenacetin, analgin, butadion, phenobarbital, barbital, methylthiouracil, sulfonamides, certain antibiotics, arsenic, bismuth, gold, and mercury preparations). The second mechanism is based on an immune conflict, in which immune complexes or autoantibodies are formed, participating in the antigen-antibody reaction, which destroys granulocytes.
Symptoms of angina in agranulocytosis
Agranulocytosis most often manifests itself as septic fever and purulent-inflammatory processes of various localizations (stomatitis, necrotic tonsillitis, pneumonia, abscesses and phlegmons). In myelotoxic agranulocytosis, due to a decrease in the number of platelets in the blood, bleeding is possible (nasal, gastric, intestinal, etc.). Progressive leukopenia is determined in the blood - (0.1-3) x 10 12 /l, the absence of basophilic granulocytes and eosinophils with a certain amount of neutrophils and a virtually normal number of monocytes and lymphocytes. The average duration of the disease in the pre-antibiotic period is from 2 to 5 weeks, fulminant forms ended in death within 3-4 days. Recovery was rare.
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Treatment of angina in agranulocytosis
If agranulocytosis is suspected, the patient is urgently hospitalized in the hematology department in a separate ward. First of all, it is necessary to eliminate the damaging factor that caused agranulocytosis. Treatment of local manifestations of agranulocytosis (ulcerative necrotic tonsillitis, necrotic gingivitis, etc.) is exclusively symptomatic. General treatment consists of prescribing large doses of antibiotics. In the immune form, glucocorticoid hormones are also prescribed. In myelotoxic agranulocytosis, blood transfusion and donor granulocytes are indicated. In some cases, a bone marrow transplant is performed. To stimulate bone marrow function, injections of amino acid preparations (leukomax) are prescribed. Currently, with timely and proper treatment, the disease often ends in recovery. Prevention with a known etiologic factor consists of eliminating contact with it.