Sideroblastic Anemia

Aka: Sideroblastic Anemia, Pearson Syndrome

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II. Pathophysiology

  1. Defective heme metabolism

III. Causes

  1. Toxin Exposure
    1. Alcohol Abuse
    2. Lead exposure
    3. Isoniazid
    4. Chloramphenicol
  2. Neoplasm or inflammatory disease
    1. Carcinoma
    2. Leukemia
    3. Lymphoma
    4. Rheumatoid Arthritis
  3. X-Linked recessive Sideroblastic Anemia
  4. Pearson Syndrome
    1. Vacuolation of marrow precursor cells
    2. Exocrine pancreatic dysfunction

IV. Labs

  1. Complete Blood Count
    1. See Hemoglobin Cutoffs for Anemia
    2. See Hematocrit Cutoffs for Anemia
    3. Mean Corpuscular Volume (MCV) <80 fl
      1. See MCV Cutoffs for Microcytic Anemia
      2. MCV cutoff varies by age and per reference
  2. Serum Iron increased
  3. Peripheral Smear
    1. Hypochromic Microcytic Anemia
  4. Bone Marrow Aspirate
    1. Ringed Sideroblasts

V. Management

  1. Remove offending exposure
  2. Pyridoxine (variable efficacy)

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