agranulocytosis

1. DEFINITION
• Agranulocytosis, also known as agranulosis or
granulopenia, is an acute condition involving a
severe and dangerous leukopenia (lowered white
blood cell count), most commonly of neutrophils
causing a neutropenia in the circulating blood.

2. ETIOLOGY
• The exact cause is unknown
• It may be because of either decreased
production of neutrophils or increased
destruction of neutrophils

3. decreased production of neutrophils
Aplastic anemia
Cancers, lymphoma and leukemia
Chemotherapy
Radiation therapy

4. increased destruction of neutrophils
• Hypersplenism
• Auto immune disorders
• Bacterial or viral infections
• Bone marrow diseases or destruction
• Use of drugs- psychotrophic medicines, anti thyroid
agents, anti coagulants and antibiotics

5. PATHOPHYSIOLOGY
ETIOLOGY
FAILURE OF NEUTROPHIL PRODUCTION OR
INCREASED DESTRUCTION OF NEUTROPHILS
NEUTROPHILS ARE LESS THAN 2000/MM3
SUSCEPTIBILITY TO INFECTION

6. CLINICAL FEATURES
THE EARLY SYMPTOMS ARE
• sudden fever
• chills
• sore throat
• weakness in your limbs
• sore mouth and gums
• mouth ulcers
• bleeding gums

7. LATE SYMPTOMS INCLUDE
• fast heart rate
• rapid breathing
• low blood pressure
• skin abscesses

8. DIAGNOSIS
• HISTORY COLLECTION AND PHYSICAL EXAMINATION
• BLOOD STUDIES
The diagnosis is made after a complete blood count,
a routine blood test. The absolute neutrophil count in this
test will be below 500, and can reach 0 cells/mm³
• CULTURE STUDIES
culture of urine, blood and ulcerative lesion in throat
are positive for bacteria

9. management
• 1. colony stimulating factors:
use of growth factors such as granulocyte-
colony stimulating factors or granulocyte-macrophage-
colony stimulating factor and erythropoiten can be effective
in increasing neutrophil production.

10. • 2, antibiotics
combination of broad spectrum antibiotics are
usually administered incase of viral and bacterial infections.
• 3. corticosteroids
corticosteroids may be used if the cause is an
immunological disorder

11. NURSING MANAGEMENT
• Monitor patients leukocyte count regularlly
• Maintain strict aseptic techniques during procedures
• Maintain proper isolation of the patient
• Administer proper antibiotics to the patient
• Provide skin care and prevent dryness of the skin

12. • Maintain proper hygiene
• Instruct to avoid acidic foods and alcoholic beverages
• Provide psychological support to the patients
• Encourage to avoid self medications

13. NURSING DIAGNOSIS
• Risk for infection related to neutropenia
• Risk for impaired skin integrity related to pancytopenia
• Knowledge deficit related to toxic agents that causes
agranulocytosis