Sideroblastic anemia is a term used to describe a group of rare blood disorders characterized by the bone marrow’s inability to manufacture normal red blood cells. Although some sideroblastic anemias are hereditary, most are acquired and are associated with drugs (alcohol, isoniazid, chloramphenicol, cytotoxic agents, and other Vit B6 antagonists), heavy metals (lead), and various hematologic, neoplastic and inflammatory diseases. Ethanol abuse is the most common cause, but the cause cannot always be identified.
Sideroblastic anemia is one of the principal types of iron-utilization anemias. Abnormal, iron-saturated red cells are present in the blood of people who have this disease. Although the iron circulates normally from the plasma to the bone marrow, where new red blood cells are created, it is not properly incorporated into new red blood cells.
Hereditary Sideroblastic Anemia
The hereditary form is an X-linked recessive trait with variable expression. Hereditary sideroblastic anemias are usually small (microcytic) and of poor color (hypochromic) and thus must be distinguished from iron deficiency and thalassemia.
Acquired Sideroblastic Anemia
Acquired sideroblastic anemia may be cured when the condition that causes it is treated or removed. If the cause of a patient’s anemia cannot be determined, blood transfusions may be necessary. Medications are prescribed to stimulate excretion or excess iron that accumulates as a result of these transfusions.
Recommendations for Anemia, Sideroblastic
Vitamin B6 (Pyridoxine)
Treatment with oral pyridoxine usually benefits patients whose sideroblastic anemia was present at birth. This treatment improves the condition of some patients but does not cure the anemia.
Key
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Glossary
Anemia
A condition resulting from an unusually low number of red blood cells or too little hemoglobin in the red blood cells. The most common type is iron-deficiency anemia in which the red blood cells are reduced in size and number, and hemoglobin levels are low. Clinical symptoms include shortness of breath, lethargy and heart palpitations.
Red Blood Cell
Any of the hemoglobin-containing cells that carry oxygen to the tissues and are responsible for the red color of blood.
Cytotoxic
A compound that produces a toxic effect on cells.
Vitamin B6
Influences many body functions including regulating blood glucose levels, manufacturing hemoglobin and aiding the utilization of protein, carbohydrates and fats. It also aids in the function of the nervous system.
Iron
An essential mineral. Prevents anemia: as a constituent of hemoglobin, transports oxygen throughout the body. Virtually all of the oxygen used by cells in the life process are brought to the cells by the hemoglobin of red blood cells. Iron is a small but most vital, component of the hemoglobin in 20,000 billion red blood cells, of which 115 million are formed every minute. Heme iron (from meat) is absorbed 10 times more readily than the ferrous or ferric form.
Thalassemia
The thalassemias are a diverse group of genetic blood diseases characterized by absent or decreased production of normal hemoglobin, resulting in a microcytic anemia of varying degree. The thalassemias have a distribution concomitant with areas where P. falciparum malaria is common.