Acquired amegakaryocytic thrombocytopenic purpura (AATP) is characterized by decreased or absent megakaryocytes in an otherwise normal bone marrow and is a rare cause of thrombocytopenia. We report a case of a 39-year-old woman, who was admitted to a tertiary care hospital for platelet transfusions. She gave history of severe recurrent epistaxis, pupura, bleeding gums and menorrhagia for the past four years, for which she had been investigated in various medical centers. She was eventually diagnosed as having acquired amegakaryocytic thrombocytopenia; her bone marrow study revealed a normocellular marrow with absent megakaryocytes and no abnormal cells; and she was advised an allogeneic peripheral blood stem cell transplant. We report this rare cause of thrombocytopenia in view of its potential interest to physiologists and we also review the literature regarding its pathogenesis and treatment.
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