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Agranulocytosis is also immune in nature, developing as a complication of infectious diseases, in particular: poliomyelitis; viral hepatitis; typhoid fever; yellow fever; malaria; infectious mononucleosis; flu. With agranulocytosis, the body is unable to resist infection, which often becomes a factor in the occurrence of purulent-septic complications. At presentI often diagnosed haptenic form of agranulocytosis. Haptens are chemicals whose molecular weight does not exceed 10,000 Da. These include many medications. Haptens by themselves are not immunogenic and acquire this property only after combining with antibodies. The resulting compounds can have a toxic effect on granulocytes, causing their death.
Once developed, hapten agranulocytosis will recur each time the same hapten (Zyloprim) is taken.
Allopurinol agranulocytosis occurs as a result of disruption of the process of myelopoiesis in the bone marrow and associated with the suppression of the production of progenitor cells.
With myelotoxic agranulocytosis, the number of not only granulocytes in the blood decreases, but also platelets, reticulocytes, lymphocytes, therefore this condition is called cytotoxic disease.
Congenital is associated with genetic factors and is extremely rare.
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The genuinic (Zyloprim) form is also known, in which the cause of the development of agranulocytosis cannot be established.
By the nature of the course, agranulocytosis is acute and chronic.
The first symptoms of agranulocytosis are:
severe weakness; pallor of the skin; joint pain; excessive sweating; increased body temperature (up to 39-40 ° C).
Characterized by ulcerative necrotic lesions of the mucous membrane of the oral cavity and pharynx, which can take the form of the following diseases: angina; pharyngitis; stomatitis; gingivitis; necrotization of the hard and soft palate, uvula.
These processes are accompanied by a spasm of the chewing muscles, difficulty Zyloprim, sore throat, increased salivation. With agranulocytosis, an increase in the spleen and liver occurs, and regional lymphadenitis develops.
Features of the course of myelotoxic agranulocytosis. For myelotoxic agranulocytosis, in addition to the symptoms listed above, moderate hemorrhagic syndrome is characteristic: To confirm agranulocytosis, a complete blood count and bone marrow puncture are performed.
In the general analysis of blood, pronounced leukopenia is determined, in which the total number of leukocytes does not exceed 1-2 x 10 9 / l (the norm is 4-9 x 10 9 / l). In this case, either granulocytes are not detected at all, or their number turns out to be less than 0.75 x 10 9 / l (the norm is 47–75% of the total number of leukocytes).
When examining the cellular composition of the bone marrow, the following are revealed: decrease in the number of myelokaryocytes; an increase in the number of megakaryocytes and plasma cells; violation of maturation and a decrease in the number of cells of a neutrophilic germ.