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Angina in agranulocytosis
Last reviewed: 23.04.2024
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[Causes of angina in agranulocytosis
Distinguish agranulocytosis myelotoxic and immune. The first can occur when the formation of granulocytes in the bone marrow, for example, under the influence of ionizing radiation, benzene vapors, cytotoxic agents. The second type of agranulocytosis is observed in the destruction of granulocytes of the blood, which is possible in persons with increased sensitivity to certain medicines (amidopyrine, phenacetin, analgin, butadione, phenobarbital, barbitol, methylthiouracil, sulfonamides, some antibiotics, arsenic, bismuth, gold, mercury). The second mechanism is based on an immune conflict, in which immune complexes or autoantibodies are formed, which take part in the antigen-antibody reaction that destroy granulocytes.
Symptoms of angina in agranulocytosis
Agranulocytosis is manifested most often septic fever and purulent-inflammatory processes of various localization (stomatitis, necrotic tonsillitis, pneumonia, abscesses and phlegmon). With myelotoxic agranulocytosis due to a decrease in the amount of blood platelets in the blood, bleeding (nasal, gastric, intestinal, etc.) is possible. In the blood, progressive leukopenia is determined (0.1-3) x10 12 / l, absence of basophilic granulocytes and eosinophils with a certain number of neutrophils present and a practically normal number of monocytes and lymphocytes. The average duration of the disease in the preantibiotics period was from 2 to 5 weeks, the fulminant forms resulted in death within 3-4 days. Recovery was rare.
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Treatment of angina with agranulocytosis
If suspected of agranulocytosis, the patient is immediately hospitalized in the hematology unit 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 of exclusively symptomatic nature. The general treatment is to prescribe large doses of antibiotics. In the immune form, glucocorticoid hormones are also prescribed. With myelotoxic agranulocytosis, transfusion of blood and donor granulocytes is indicated. In some cases, a bone marrow transplant is performed. To stimulate the function of the bone marrow, injections of amino acid preparations (leukomax) are prescribed. Currently, the disease with timely and proper treatment often ends in recovery. Prevention with a known etiologic factor consists in eliminating contact with it.