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Successful treatment of acquired amegakaryocytic thrombocytopenia with cyclosporine in adult onset Still’s disease

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Abstract

Acquired amegakaryocytic thrombocytopenia (AAT) is a rare disorder, characterized by severe thrombocytopenia and selective, marked decrease or absence of megakaryocytes in the bone marrow. We describe a 29-year-old female with adult onset Still’s disease preceding a diagnosis of AAT and autoimmune hemolytic anemia, which was successfully treated with cyclosporine. This is the first case of AAT in a patient with adult onset Still’s disease.

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References

  1. Hoffman R (1991) Acquired pure amegakaryocytic thrombocytopenic purpura. Semin Hematol 28:303–312

    PubMed  CAS  Google Scholar 

  2. Chaudhary UB, Eberwine SF, Hege KM (2004) Acquired amegakaryocytic thrombocytopenia purpura and eosinophilic fasciitis: a long relapsing and remitting course. Am J Hematol 75:146–150

    Article  PubMed  Google Scholar 

  3. Katsumata Y, Suzuki T, Kuwana M, Hattori Y, Akizuki S, Sugiura H, Matsuoka Y (2003) Anti-c-Mpl (thrombopoietin receptor) autoantibody-induced amegakaryocytic thrombocytopenia in a patient with systemic sclerosis. Arthritis Rheum 48:1647–1651

    Article  PubMed  Google Scholar 

  4. Kuwana M, Okazaki Y, Kajihara M, Kaburaki J, Miyazaki H, Kawakami Y, Ikeda Y (2002) Autoantibody to c-Mpl (thrombopoietin receptor) in systemic lupus erythematosus: relationship to thrombocytopenia with megakaryocytic hypoplasia. Arthritis Rheum 46:2148–2159

    Article  PubMed  CAS  Google Scholar 

  5. Grom AA (2004) Natural killer cell dysfunction: a common pathway in systemic-onset juvenile rheumatoid arthritis, macrophage activation syndrome, and hemophagocytic lymphohistiocytosis? Arthritis Rheum 50:689–698

    Article  PubMed  Google Scholar 

  6. Pouchot J, Sampalis JS, Beaudet F, Carette S, Decary F, Salusinsky-Sternbach M, Hill RO, Gutkowski A, Harth M, Myhal D (1991) Adult Still’s disease: manifestations, disease course, and outcome in 62 patients. Medicine (Baltimore) 70:118–136

    CAS  Google Scholar 

  7. Domingues RB, da Gama AM, Caser EB, Musso C, Santos MC (2003) Disseminated cerebral thrombotic microangiopathy in a patient with adult’s still disease. Arq Neuropsiquiatr 61:259–261

    PubMed  Google Scholar 

  8. Bray VJ, Singleton JD (1994) Disseminated intravascular coagulation in Still’s disease. Semin Arthritis Rheum 24:222–229

    Article  PubMed  CAS  Google Scholar 

  9. Quattrin N, Scalfi L (1963) Fatal subacute immuno-thrombocytopenia due to pure megakaryocytary aplasia. Acta Haematol 29:187–190

    Article  PubMed  CAS  Google Scholar 

  10. Manoharan A, Williams NT, Sparrow R (1989) Acquired amegakaryocytic thrombocytopenia: report of a case and review of literature. Q J Med 70:243–252

    PubMed  CAS  Google Scholar 

  11. King JA, Elkhalifa MY, Latour LF (1997) Rapid progression of acquired amegakaryocytic thrombocytopenia to aplastic anemia. South Med J 90:91–94

    PubMed  CAS  Google Scholar 

  12. Hoffman R, Briddell RA, van Besien K, Srour EF, Guscar T, Hudson NW, Ganser Al (1989) Acquired cyclic amegakaryocytic thrombocytopenia associated with an immunoglobulin blocking the action of granulocyte-macrophage colony-stimulating factor. N Engl J Med 321:97–102

    Article  PubMed  CAS  Google Scholar 

  13. Nagasawa T, Sakurai T, Kashiwagi H, Abe T (1986) Cell-mediated amegakaryocytic thrombocytopenia associated with systemic lupus erythematosus. Blood 67:479–483

    PubMed  CAS  Google Scholar 

  14. Azuno Y, Yaga K (2002) Successful cyclosporin A therapy for acquired amegakaryocytic thrombocytopenic purpura. Am J Hematol 69:298–299

    Article  PubMed  Google Scholar 

  15. Khurana V, Bradley TP (1998) Adult-onset Still’s disease associated with G6PD deficiency: a case report and literature review. J Assoc Acad Minor Phys 9:56–58

    PubMed  CAS  Google Scholar 

  16. Chung JW, Suh YJ, Song HJ, Choi JH, Park HS, Cho SR, Suh CH (2004) Pure red cell aplasia and adult-onset Still’s disease. Clin Rheumatol 23:368–370

    Article  PubMed  Google Scholar 

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Correspondence to Dae-Hyun Yoo.

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Her, MY., Kim, TH., Chang, HK. et al. Successful treatment of acquired amegakaryocytic thrombocytopenia with cyclosporine in adult onset Still’s disease. Rheumatol Int 27, 295–298 (2007). https://doi.org/10.1007/s00296-006-0202-8

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  • DOI: https://doi.org/10.1007/s00296-006-0202-8

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