What Is Autoimmune Neutropenia?

Acute leukopenia, the medical pathological name, is based on the white blood cell count as the main experimental diagnosis.

Acute leukopenia

Acute leukopenia, the medical pathological name, is based on the white blood cell count as the main experimental diagnosis.

Chinese name

Acute leukopenia

Foreign name

no

Nature

, Medical pathology name,

Explanation

White blood cell count

Surrounding blood

White blood cell count is the most important basis for laboratory diagnosis. The white blood cell count can fluctuate greatly due to various factors, so it is often necessary to repeat the test several times before diagnosis. Granulocyte plasma can have toxic particles and

Those with secondary granulocytopenia should actively treat the underlying disease and discontinue suspicious drug or poison exposure. The treatment method is selected according to different pathological mechanisms.
(1) Drug treatment of lithium carbonate can increase granulocyte production, but it is not effective for patients with chronic bone marrow failure. The adult dose is 300 mg, which is taken orally three times a day. After the effect is reduced, the dose is 200 mg twice a day and maintained for 2 to 4 weeks. Side effects can include tremors, upset stomachs,

According to granulocyte dynamics and pathophysiology, the disease can be divided into four categories:
(1) Decreased neutrophil production in bone marrow injury Normal adults generate a large number of neutrophils in the bone marrow every day, about 1011 or more. Colony-stimulating factors IL-3 and GM-CSF can promote G0 phase hematopoietic stem cells to enter the cell proliferation cycle, and G-CSF specifically induces granulocyte progenitor cells to further proliferate and differentiate in the bone marrow proliferation pool. Late promyelocytic cells ceased to proliferate and continued to differentiate into mature nucleus cells and neutrophils. These cells can stay in the bone marrow storage tank for about 5 days before entering the surrounding blood. Due to some pathogenic factors that directly damage the bone marrow, the number or quality of CFU-GM is abnormal or hematopoietic dysfunction is often the most common cause of neutropenia:
1. Drug-induced damage Anti-tumor drugs and immunosuppressants can directly kill proliferating cell populations. Drugs inhibit or interfere with granulocyte nucleic acid synthesis, affect cell metabolism, and hinder cell division. The direct toxic effect of the drug on granulocytopenia is related to the dose of the drug. Many other types of drugs can also have direct cytotoxicity or reduce granulocyte production through immune mechanisms. (Table 1)
Table 1 Commonly used drugs that can cause neutropenia Drugs Antitumor drugs Nitrogen mustard, mare blue, cyclophosphamide, methotrexate, cytarabine, fluorouracil, doxorubicin, azomycin Anti-infectives antibiotics such as penicillin G, hydroxyurea, and other -lactams, chloramphenicol, metronidsulfonamide compound sinomethoxine, salicylazosulfapyridine, sulfadiazine anti-tuberculosis drug isoniazid, Isoniazid, rifampicin, thiothiourea, parasalicylic acid antimalarial drugs quinine, primary aminoquinoline, quinoline chloride, pyrimethamine immunosuppressant azathioprine antiarrhythmic drug procainamide , Propranolol, quinidine antihypertensive drug reserpine, hydralazine, methyldopa, Kaibotong antithyroid drug methylthiouracil, propylthiouracil, tabazol,

Leukopenia is often secondary to a variety of systemic diseases, and the clinical manifestations are mainly primary disease. The course of most leukocytopenia is often self-limited, without obvious clinical symptoms or non-specific manifestations such as dizziness, fatigue, low fever, and laryngitis. Neutrophils are the body's first line of defense against infections, so the clinical symptoms of granulocytopenia are mainly prone to repeated infections. The risk of infection in a patient is directly related to neutrophil count, reduced time, and reduced rate. When agranulocytosis (granulocytes <500 / mm3) is completely different from ordinary leukopenia, the onset is rapid. Due to the destruction of a large number of granulocytes in a short period of time, patients may suddenly experience chills, high fever, sweating, and general discomfort. Almost all severe infections occur within 2 to 3 days. Lungs, urinary system, oropharynx and skin are most susceptible to infection. Mucosa may have necrotic ulcers. Due to the lack of granulocytes that mediate the inflammatory response, the signs and symptoms of infection are usually not obvious; such as severe pneumonia, only a slight infiltration on the chest radiograph, and no purulent sputum; severe skin infections do not cause bloatedness; pyelonephritis does not see pyuria Wait. The infection spreads quickly and progresses to sepsis. The mortality rate is very high. The most common cause of this disease is a drug response, which may have a related medical history. After the withdrawal of the drug, the body temperature returned to normal and the peripheral white blood cells recovered, indicating that the condition has improved. Chronic idiopathic neutropenia is the most common type of chronic neutropenia. It is more common among young and middle-aged women, and there is no clear history of special medication and chemical exposure. Clinically asymptomatic or with fatigue, low fever, night sweats, or insomnia. No special findings were found in peripheral blood cells and bone marrow smears. Recurrent neutropenia is characterized by repeated neutropenia accompanied by general weakness, fever, and mild infections. Most patients start onset in infancy, but can also start later. Can affect several members of the family. The onset period is about 4 to 14 days, and the intermittent period is 12 to 35 days. The symptoms can completely disappear. Familial benign granulocytopenia is a dominant autosomal hereditary disease with a high age of onset, intermittent episodes, moderate reduction in granulocytes, and a good process. Bone marrow phagocytosis is arrested in the young and late stages, and may be associated with hypogammaglobulinemia. With age, it can relieve itself. Patients with only neutropenia, without primary disease and repeated infections can be collectively referred to as benign neutropenia, including familial, congenital and pseudo-neutropenia.