Agranulocytosis
Granulocytopenia; Granulopenia; Neutropenia
White blood cells fight infections from bacteria, viruses, fungi, and other germs. One important type of white blood cell is the granulocyte, which is made in the bone marrow and travels in the blood throughout the body. Granulocytes sense infections, gather at sites of infection, and destroy the germs.
When the body has too few granulocytes, the condition is called agranulocytosis. This makes it harder for the body to fight off germs. As a result, the person may get sick from infections.
Blood is comprised of red blood cells, platelets, and various white blood cells.
Causes
Agranulocytosis may be caused by:
- Autoimmune disorders
- Bone marrow diseases, such as myelodysplasia or large granular lymphocyte (LGL) leukemia
- Certain medicines used to treat diseases, including cancer
- Certain street drugs
- Poor nutrition
- Preparation for bone marrow transplant
- Benign familial neutropenia
- Genetic variants, especially in people of certain African and Caribbean ethnicities
Symptoms
Exams and Tests
A white blood cell differential test will be done to measure the percentage of each type of white blood cell in your blood.
Other tests to diagnose the condition may include:
- Bone marrow biopsy
- Biopsy of mouth ulcer
- Neutrophil antibody tests (blood test)
Treatment
Treatment depends on the cause of the low white blood cell count. For example, if a medicine is the cause, stopping or changing to another medicine may help. In other cases, medicines to help the body make more white blood cells will be used. If the cause is due to normal genes, no treatment is required.
Outlook (Prognosis)
Treating or removing the cause often results in a good outcome.
Prevention
If you are having treatment or taking medicine that could cause agranulocytosis, your health care provider will use blood tests to monitor you.
References
Berliner N. Leukocytosis and leukopenia. In: Goldman L, Cooney KA, eds. Goldman-Cecil Medicine. 27th ed. Philadelphia, PA: Elsevier; 2024:chap 153.
Klokkevold PR, Mealey BL, Hernandez-Kapila YL. Influence of systemic conditions on the periodontium. In: Newman MG, Klokkevold PR, Elangovan S, Hernandez-Kapila YL, eds. Newman and Carranza's Clinical Periodontology and Implantology. 14th ed. Philadelphia, PA: Elsevier; 2023:chap 25.
Murphy MF, Pasi KJ, Roy N. Haematology. In: Feather A, Randall D, Waterhouse M, eds. Kumar and Clark's Clinical Medicine. 10th ed. Philadelphia, PA: Elsevier; 2021:chap 16.
Rice L, Zieske AW, Jung M. Neutrophilic leukocytosis, neutropenia, monocytosis, and monocytopenia. In: Hoffman R, Benz EJ, Silberstein LE, et al, eds. Hematology: Basic Principles and Practice. 8th ed. Philadelphia, PA: Elsevier; 2023:chap 49.
Version Info
Last reviewed on: 6/17/2024
Reviewed by: Todd Gersten, MD, Hematology/Oncology, Florida Cancer Specialists & Research Institute, Wellington, FL. Review provided by VeriMed Healthcare Network. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
