血液研究と血液疾患ジャーナル

Acquired Amegakaryocytic Thrombocytopenic Purpura: A Masquerader of Immune Thrombocytopenic Purpura

Ho S, Gowan JM and Javdan F

Acquired amegakaryocytic thrombocytopenic purpura is a rare form of thrombocytopenia that presents with the absence of megakaryocytes in the bone marrow. The pathogenesis of AATP is still unknown, although both serum inhibitors and cell mediated phenomena have been implicated. Diagnosing AATP is difficult, as it is often mistaken for immune thrombocytopenic purpura (ITP). Diagnosis of ATTP is usually made only once a patient fails to respond to steroids, warranting further investigation with bone marrow biopsy studies yielding complete absence of megakaryocytes. Here we report a previously healthy 19-year-old male with no medical history, presenting with a diffuse spot-like, pruritic, rash, associated with nausea and mild abdominal pain. We emphasize the importance of acquiring additional diagnostic investigations in those initially presenting with ITP-like symptoms, who ultimately fail to improve with traditional ITP treatments.