Acquired amegakaryocytic thrombocytopenia as a rare cause of thrombocytopenia during pregnancy

Abstract

A rare case of acquired amegakaryocytic thrombocytopenia (AATP) in a 35-year-old woman who presented with anaemia and thrombocytopenia at 22 weeks gestation. The first diagnostic impression was of an evolving aplastic anaemia; however, the patient was simultaneously diagnosed with severe vitamin B12 deficiency in the setting of vegetarianism. Once the cyanocobalamin deficiency was corrected, a repeat bone marrow biopsy revealed an isolated depletion of megakaryocytes, which suggested the diagnosis of AATP. Supportive care was provided for her anaemia and thrombocytopenia and she delivered a healthy baby girl with a normal platelet count. The patient was subsequently started on romiplostim with steady improvement in her platelet counts. This rare AATP case presentation highlights the importance of a well-structured diagnostic approach to thrombocytopenia during pregnancy and supports the successful use of thrombopoietin agonists for the management of AATP.

Transient Acquired Amegakaryocytic Thrombocytopenia in the Setting of Severe Sepsis: A Case Report

“…Amegakaryocytic thrombocytopenia (AAT) is a rare hematologic disorder presenting with fewer than 100 published cases. It is characterized as a severe thrombocytopenia with reduced or complete absence of megakaryocytes in the bone marrow and normal hematopoiesis [ 1 ]. The acquired variation, or acquired amegakaryocytic thrombocytopenia (AATP), is often seen later in life with previously documented associations in pregnancy, autoimmune disorders, viral infections including hepatitis C virus (HCV) and Epstein-Barr virus (EBV), environmental toxins such as benzenes, lymphoproliferative disorders and nutritional deficiencies including vitamin B12 [ 2 ].…”