We report a 32-year-old pregnant patient, presented with palpitation and generalized weakness. She was found to have a severe anemia with haemoglobin of 4.2 gm/dL.She gave a history of recurrent anaemia, which only occurred during pregnancy. bone marrow aspirate showed sideroblastic anaemia. Further investigation revealed significantly low pyridoxine level.

Acquired Amegakaryocytic Thrombocytopenia is a rare hematologic condition, with <50 cases reported. It is characterized by severe thrombocytopenia with complete absence or severe reduction of megakaryocytes in the bone marrow with otherwise normal hematopoiesis. Its mechanism is not fully understood but is suggested to be related to anti-thrombopoietin antibodies.