Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Sep 5;9(9):003479.
doi: 10.12890/2022_003479. eCollection 2022.

Acquired Amegakaryocytic Thrombocytopenia Progressing to Aplastic Anaemia

Syed Ather Hussain  1 , Huda Fatima  2 , Hafsa Faisal  1 , Meenakshi Bansal  3
Affiliations

Acquired Amegakaryocytic Thrombocytopenia Progressing to Aplastic Anaemia

Syed Ather Hussain et al. Eur J Case Rep Intern Med. .

Abstract

Acquired amegakaryocytic thrombocytopenia (AAMT) is a rare disorder of the bone marrow characterized by a lack of megakaryocytes and preservation of other cell lines. It can occur due to an intrinsic stem cell defect or secondary to viral infections, autoimmune disorders, lymphoproliferative disorders or environmental toxins. With time, it can progress to aplastic anaemia (AA) and can have a poor prognosis. No standard guidelines exist for the treatment of AAMT progressing to AA. Herein, we report a rare case of AAMT leading to AA and review the handful of cases previously published in the literature.

Learning points: Acquired amegakaryocytic thrombocytopenia can present as isolated severe thrombocytopenia which can initially be misdiagnosed as immune thrombocytopenia.Lack of response to steroids and intravenous immunoglobulin should raise suspicion for acquired amegakaryocytic thrombocytopenia.Over time, acquired amegakaryocytic thrombocytopenia can progress to aplastic anaemia, which confers a worse prognosis.

Keywords: Acquired amegakaryocytic thrombocytopenia; aplastic anaemia; haematopoietic stem cell transplant.

PubMed Disclaimer

Conflict of interest statement

Conflicts of Interests: The Authors declare that there are no competing interests.

Figures

Figure 1
Figure 1
(a) Haematoxylin and eosin stain of core bone marrow biopsy from March 2020 showing normocellular marrow with markedly absent megakaryocytes consistent with acquired megakaryocytic thrombocytopenia. (b) CD61 stain of core bone marrow biopsy from March 2020 revealing lack of megakaryocytes. (c) Haematoxylin and eosin stain of core bone marrow biopsy from May 2020 showing hypocellular marrow with no megakaryocytes. (d) Haematoxylin and eosin stain of core bone marrow biopsy from February 2021 showing less than 10% marrow cellularity consistent with aplastic anaemia.
See this image and copyright information in PMC

References

    1. Roy AM, Konda M, Sidarous GK, Atwal D, Schichman SA, Kunthur A. Acquired amegakaryocytic thrombocytopenia misdiagnosed as immune thrombocytopenia: a case report. Perm J. 2020;24:1–3. doi: 10.7812/TPP/19.203. - DOI - PMC - PubMed
    1. Levy I, Laor R, Jiries N, Bejar J, Polliack A, Tadmor T. Amegakaryocytic thrombocytopenia and subsequent aplastic anemia associated with apparent Epstein-Barr virus infection. Acta Haematol. 2018;139(1):7–11. doi: 10.1159/000484595. - DOI - PubMed
    1. Hoffman R. Acquired pure amegakaryocytic thrombocytopenic purpura. Semin Hematol. 1991;28(4):303–312. - PubMed
    1. Novotný JP, Köhler B, Max R, Egerer G. Acquired amegakaryocytic thrombocytopenic purpura progressing into aplastic anemia. Prague Med Rep. 2018 Jan 11;118(4):147–155. - PubMed
    1. Simkins A, Maiti A, Short NJ, Jain N, Popat U, Patel KP, et al. Acquired amegakaryocytic thrombocytopenia and red cell aplasia in a patient with thymoma progressing to aplastic anemia successfully treated with allogenic stem cell transplantation. Hematol Oncol Stem Cell Ther. 2019;12(2):115–118. - PubMed