Sideroblastic anemia

Sideroblastic anemia

Updated: 07/13/2024

© Jun Wang, MD, PhD

 

General features

  • Defects in heme synthesis
  • Inherited and acquired microcytic anemia
  • Congenital: Various
  • Acquired

o   Clonal/neoplastic

§  Myelodysplastic syndrome (MDS) with ring sideroblasts, single or multilineage

§  MDS/MPN with ring sideroblasts and thrombocytosis (MDS/MPN-RS-T)

o   Metabolic/reversible

§  Copper deficiency (zinc toxicity)

§  Drugs (eg, isoniazid, chloramphenicol, linezolid)

§  Excess alcohol use

§  Hypothermia

§  Lead poisoning

§  Transient sideroblastic anemia during pregnancy

Pathogenesis

Laboratory findings

  • Reduced: Hb, MVC, MCHC
  • Elevated: Serum iron, serum ferritin, transferrin saturation
  • TIBC might be normal
  • Marrow findings

o   Ring sideroblasts: iron deposit forming a ring around the nucleus by iron stain

Diagnosis

  • > 15% of ring sideroblasts in bone marrow

Management

  • Removal of toxic agents
  • Transfusion
  • Marrow or liver transplantation, etc

 

 

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Anemia

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Practice questions Anemia I

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Practice questions Anemia I © Jun Wang, MD, PhD   Abbreviations: Hb: hemoglobin HCT: hematocrit MCV: Mean Corpuscular Volume MCHC: Mean Corpuscular Hemoglobin RDW: Red Cell Distribution Width TIBC: total iron binding capacity   1. Use this case for the next three questions . A 25-year-old woman is brought to the emergency department 2 hours after being involved in a motor vehicle accident. She is conscious but feels dizziness and weakness.   Her blood pressure is 90/60 mmHg, and her heart rate is 120 beats per minute. Physical examination reveals pale skin and mucosa and a 15 cm laceration on her left thigh with significant bleeding. What are most likely the CBC and TIBC results? A. Low Hb, low HCT, high MCV, high RDW, high TIBC B. Low Hb, low HCT, slightly low MCV, normal RDW, normal TIBC C. Low Hb, low HCT, slightly high MCV, normal RDW, normal TIBC D. Normal Hb, normal HCT, normal MCV, normal
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