It is postulated that the various etiological factors lead to SA through one of three pathophysiological pathways: hemolysis, acute or chronic blood loss, and dyserythropoiesis.10,11 However, one of the few studies that specifically examined the pathophysiology of acute episodes of SA found that irrespective of the etiology, failure of production of red cells because of bone marrow failure was the common final pathway for SA in that population.11 The bone marrow failure was postulated to have been mediated by inflammatory mechanisms with downregulation of erythropoietin production. Here, EPO is linked to Bone marrow hypocellularity.