Agranulocytosis

BLOOD DISORDERS

1. Agranulocytosis RATHEESH.R.L

2. 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.

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

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

5. 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

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

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

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

9. 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 cells/mm³ CULTURE STUDIES culture of urine, blood and ulcerative lesion in throat are positive for bacteria

10. 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.

11. 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

12. 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

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

14. 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