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Diseases » Agranulocytosis » Diagnosis

Diagnosis of Agranulocytosis

Agranulocytosis Diagnosis: Book Excerpts

Diagnostic Tests for Agranulocytosis: Online Medical Books

16 MEDICAL BOOKS ONLINE! Review excerpts from medical books online, free, without registration, for more information about diagnostis of Agranulocytosis.

Neutropenia: Differential Diagnosis
(In A Page: Pediatric Signs and Symptoms)

Extrinsic to bone marrow

Acute infection
–Viral (HAV, HBV, VZV, RSV, EBV)
–Bacterial (group B strep, typhoid, TB, tularemia), fungal
–Rickettsial (typhus, RMSF)
–Protozoal (malaria, toxoplasmosis)

Drug-induced
–Penicillin, sulfonamides
–Ibuprofen, indomethacin
–Ranitidine, cimetidine
–Penicillamine
–Barbiturates, benzodiazepines
–Phenothiazines
–Antithyroid medications
–Anticonvulsants
Environmental toxins (arsenic, benzene)
Autoimmune
Isoimmune neonatal

Splenic or hepatic sequestration
–Especially with concomitant mild thrombocytopenia or anemia

Metabolic disorders
–Glycogen storage diseases Ib

Intrinsic to bone marrow or myeloid cell progenitors

Chronic benign or idiopathic neutropenia
Cyclic neutropenia (autosomal dominant)
Marrow replacement with leukemia, lymphoma, or metastatic solid tumors
Kostmann syndrome
–Severe congenital neutropenia
Hypo- or dysgammaglobulinemia
Myelodysplastic syndrome
Myelofibrosis
Schwachman syndrome

Fanconi anemia
–May involve neutropenia, anemia, thrombocytopenia, or pancytopenia
–Associated with absent radius, thumb abnormalities, short stature

Cartilage-hair hypoplasia
Dyskeratosis congenita
Chédiak-Higashi
Reticular dysgenesis
Myelokathexis

Workup and Diagnosis

History
–Duration (acute or chronic)
–History and pattern of fever, chronic cough, wheezing
–Mucositis, aphthous ulcers, “cold sores”
–Adenitis, signs of malignancy
–Malabsorption
–Family history (leukopenia, unusual infections, immunodeficiencies, unexplained early death)
–Type and frequency of infections
–Exposure to toxins or drugs
–Delayed separation of umbilical cord

Physical exam: Growth, vital signs, pallor, toxic, phenotypic anomalies, scarred tympanic membranes, allergic shiners, pharyngeal cobblestoning, gingivitis, mucositis/ulcers, lymph nodes, wheeze, chest deformity, splenomegaly, hepatomegaly, rectal abscess, clubbing, cyanosis, skin/nail dystrophies, abnormal thumbs
Labs
–CBC with differential and smear
–Immunoglobulin levels
–Cultures (blood, urine, sputum, throat, oral, or skin )
–Lymphocyte subsets, specific antibody responses
–Folate level, vitamin B12, metabolic screening
–HIV, specific infection serologies
–Exocrine pancreatic function
Radiology: Chest X-ray, bone survey
Studies: Bone marrow biopsy (neutrophil production), liver biopsy (definitive for glycogen storage diseases)

» READ BOOK EXCERPT ONLINE »

Source: In A Page: Pediatric Signs and Symptoms, 2007

Granulocytopenia and lymphocytopenia: Diagnosis
(Professional Guide to Diseases (Eighth Edition))

Diagnosis of granulocytopenia necessitates a thorough patient history to check for precipitating factors. Physical examination for clinical effects of underlying disorders is also essential.

Confirming diagnosis A markedly decreased neutrophil count (less than 500/µl leads to severe bacterial infections) and a WBC count lower than 2,000/µl, with few observable granulocytes on complete blood count (CBC), confirm granulocytopenia.

Bone marrow examination shows a scarcity of granulocytic precursor cells beyond the most immature forms, but this may vary, depending on the cause.

A lymphocyte count below 1,500/µl in adults or below 3,000/µl in children indicates lymphocytopenia. Identifying the cause by evaluation of clinical status, bone marrow and lymph node biopsies, or other appropriate diagnostic tests helps establish the diagnosis.

» READ BOOK EXCERPT ONLINE »

Source: Professional Guide to Diseases (Eighth Edition), 2005

Granulocytopenia and lymphocytopenia: Diagnosis
(Handbook of Diseases)

Granulocytopenia is diagnosed by a thorough patient history to check for precipitating factors. Physical examination for clinical effects of underlying disorders is also essential. The following test results confirm the diagnosis:

❑ Complete blood count (CBC) reveals a marked reduction in neutrophils (less than 500/µl leads to severe bacterial infections) and a WBC count lower than 2,000/µl with few observable granulocytes.

❑ Examination of bone marrow generally shows a scarcity of granulocytic precursor cells beyond the most immature forms, but this finding may vary, depending on the cause.

❑ Lymphocyte count less than 1,500/µl in adults or less than 3,000/µl in children indicates lymphocytopenia. Identifying the cause by evaluation of the patient’s clinical status, bone marrow and lymph node biopsies, and other appropriate diagnostic tests helps establish the diagnosis.

» READ BOOK EXCERPT ONLINE »

Source: Handbook of Diseases, 2003