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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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Similar inflammatory processes occur in the gastrointestinal tract. Here, ulcerative-necrotic enteropathy, specific for agranulocytosis, colchicine, which is characterized by the formation of necrosis of the mucous membrane of the esophagus, stomach and intestines.

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A characteristic symptom of agranulocytosis is the rapid formation of ulcers. In this case, the process of necrotization spreads to neighboring surfaces, and often takes on the character of noma (the so-called water cancer - the transition of the ulcerative-necrotic process to the mucous membrane of the cheeks with the development of colchicine of the facial tissues).

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The mucous membrane is abundantly supplied with blood, therefore, bacterial toxins and other waste products of microorganisms enter the general bloodstream en masse, leading to severe intoxication, which is clinically manifested by high fever (up to 40 degrees and above), weakness, nausea and headache.

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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.

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The course and prognosis of acute and chronic agranulocytosis.

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