Acquired amegakaryocytic thrombocytopenia as a rare cause of thrombocytopenia during pregnancy. Issue 6 (21st June 2019)

• Record Type: Journal Article
• Authors: Zimmerman, Brittney S; Marcellino, Bridget; El Jamal, Siraj M; Renteria, Anne S
• Is Part Of: BMJ case reports. Volume 12:Issue 6(2019)
• Publication Date: 2019-06-21
• Subjects: haematology (incl blood transfusion) -- obstetrics and gynaecology -- pregnancy; Medicine -- Case studies -- Periodicals; 610.5
• DOI: 10.1136/bcr-2019-230361
• Languages: English
• ISSNs: 1757-790X

Abstract

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.