Sideroblastic Anemia

Sideroblastic Anemia

• Disorder in the synthesis of hemoglobin characterized by trapped iron in the mitochondria of nucleated RBCs.
  • Hereditary form: defect in aminolaevulinic acid synthase or an abnormality in vitamin B6 metabolism.
  • The acquired form: drugs such as chloramphenicol, isoniazid, or alcohol.Z
• No specific finding that will be sufficiently suggestive of sideroblastic anemia.

Elevated Serum Ferritin

• Elevated serum ferritin
• Very high transferrin saturation, and very low TIBC
• High serum iron (the only microcytic anemia with elevated iron)
• Prussian blue stain (most specific test) of RBCs in the marrow will reveal the ringed sideroblasts.
• Treatment: Remove the offending drug. Consider transfusion for serious cases.

Ring sideroblastZOSPE

Fe Panel

• Serum Iron

  • Iron Deficiency Anemia: Decreased
  • Anemia of Chronic Disease: Decreased
  • Sideroblastic Anemia: Increased
  • Thalassemia Minor: Normal

• Serum Ferritin

  • Iron Deficiency Anemia: Decreased or Normal (early)
  • Anemia of Chronic Disease: Increased
  • Sideroblastic Anemia: Increased
  • Thalassemia Minor: Normal

• Transferrin/ TIBC

  • Iron Deficiency Anemia: Increased
  • Anemia of Chronic Disease: Decreased
  • Sideroblastic Anemia: Normal
  • Thalassemia Minor: Normal

• % Saturation

  • Iron Deficiency Anemia: Decreased
  • Anemia of Chronic Disease: N/Decreased
  • Sideroblastic Anemia: Increased
  • Thalassemia Minor: Normal