Open AccessAcquired amegakaryocytic thrombocytopenia as a rare cause of thrombocytopenia during pregnancy
Author(s) -
Brittney S. Zimmerman,
Bridget K. Marcellino,
Siraj M. El Jamal,
Anne S. Renteria
Publication year - 2019
Publication title -
bmj case reports
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.231
H-Index - 26
ISSN - 1757-790X
DOI - 10.1136/bcr-2019-230361
Subject(s) - medicine , thrombopoietin , pregnancy , pediatrics , romiplostim , rare disease , bone marrow failure , aplastic anemia , gestation , presentation (obstetrics) , surgery , bone marrow , disease , genetics , stem cell , haematopoiesis , biology
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 B 12 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.