Acquired Amegakaryocytic Thrombocytopenic Purpura that Presented as Cyclic Thrombocytopenia Associated with Anti-Phospholipid Antibody Syndrome

A 52-year-old female, who had been taking prednisolone (PSL) for anti-phospholipid antibody syndrome (APS), was admitted to our hospital because of repeated nasal bleeding, purpura and petechiae of the extremities, and a platelet count of 7,000/μL. The PSL dose was increased due to a tentative diagnosis of idiopathic thrombocytopenic purpura (ITP), but she presented with cyclic thrombocytopenia independent of the PSL dose and repeated nasal, oral, and gastrointestinal bleeding.