The white blood cells known as neutrophils act as the body’s first defense against infections. Normally the neutrophils are produced in the bone marrow and are released into the bloodstream. In agranulocytosis, most or all of the neutrophils are destroyed, and there is a severe reduction in the number of neutrophils that are circulating in the blood. The result of this reduction in circulating neutrophils is decreased resistance to infection.The disease is often caused by a drug that you are taking for some other disorder. It can also be caused by a viral infection or by an antibody, or normally protective biochemical in your blood, that you develop against your own white blood cells. The disease may be the first sign of leukemia or aplastic anemia (previous article).

What are the Symptoms?

The characteristic symptom of the disease is susceptibility to infection. This is especially true in the mouth and throat, where ulcers often occur. Sometimes, if you have agranulocytosis, infections such as pneumonia progress unusually rapidly and are extremely severe, or even fatal.

What Should be Done?

If you have had one infection after another, see your physician, particularly if you are taking a prescription, VI even a non­prescription drug. Some drugs are known to carry a particular risk of damaging bone mar­row, and your physician will be alert to this possibility. The doctor will probably arrange for a blood test. If the results show that you may have agranulocytosis, a bone marrow biopsy, in which a small amount of bone marrow is removed and examined, will be necessary before your physician can make a definite diagnosis.

What is the Treatment?

Your physician will probably instruct you to stop taking any drug in case it is the cause of the disorder. If the level of granulocytes in your blood is very low, you will probably be given an antibiotic drug to prevent infection. If you already have an infection, or if you have a fever, you will probably be given antibiotics intravenously right away.

In most cases, the outlook for complete recovery from agranulocytosis is very good. Either the drug or the infection causing the disease is eliminated and recovery begins. Cases caused by one of the types of leukemia or aplastic anemia are more complex and so are those in which a difficult-to-control infection develops.