[Acquired amegacaryocytic thrombocytopenic purpura hiding acute myeloid leukemia]

Abstract

Acquired amegakaryocytic thrombocytopenic purpura is a very rare condition characterized by severe thrombocytopenia linked to the reduction or disappearance of megakaryocytes in the bone marrow. It may be primary idiopathic or secondary to many pathological conditions including hematologic disorders. We report the case of a 24-year-old patient admitted for haemorrhagic syndrome caused by immunological thrombocytopenic purpura. The diagnosis was acquired amegakaryocytosis after the failure of corticotherapy and the performance of myelography. The patient was treated with ciclosporin with rapid progression to acute myeloblastic leukemia. The progression of acquired amegakaryocytosis to acute leukemia is reported but it is generally not so rapid and above all it is preceded by myelodysplastic syndrome or medullary aplasia. This study highlights the importance of a close follow-up of these pathologies with a benign-like appearance.

Keywords: Acquired amegakaryocytosis; acute leukemia; thrombocytopenic purpura.

Figure 1

Frottis sanguin confirmant la présence d’une thrombopénie (coloration MGG (x100))

Figure 2

Frottis médullaire montrant une cellularité normal avec absence de mégacaryocytes (coloration MGG (X 40))

Figure 3

Coupe d’une biopsie ostéo-médullaire montrant une moelle de richesse normal avec absence de mégacaryocytes (HE x 100)

Figure 4

Frottis médullaire montant un envahissement par des blastes granulaires (coloration MGG (x 100))