Antidepressants cause agranulocytosis much less frequently. There is evidence of the development of a similar complication with the use of amitriptyline and imizine. Mianserin causes agranulocytosis in elderly people (mean age 67 years), and lithium carbonate - mainly in young and middle-aged men.
Back in the 80s of the last century, transient leukopenia was found in 10% of patients taking carbamazepine. Cases of severe granulocytopenia and agranulocytosis when taking carbamazepine are described mainly in elderly patients. Therefore, many experts advise with great care to prescribe this drug to patients over 60 years of age. The human body is inhabited by many microorganisms that coexist peacefully with it, and even quite often enter into symbiosis (they perform one or another positive function - they produce vitamin K in the intestines, prevent the growth of pathogenic bacteria, etc.).
Leukocytes, mainly granulocytes, have a inhibitory effect on the microflora and do not allow it to multiply excessively. With the development of agranulocytosis, uncontrolled multiplication of these microorganisms occurs, which leads to the development of infectious complications.
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Clinically, this is manifested by bloating and severe cramping abdominal pain, vomiting and diarrhea, sometimes with blood. With deep necrotic lesions of the alimentary tract, severe bleeding occurs that threatens the patient's life. In severe cases, jaundice may develop due to liver infection. Perforation of the resulting ulcers with the development of an acute abdomen clinic is rare.
The course and prognosis of acute and chronic agranulocytosis.
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