Sideroblastic anaemia

Hypochromic and microcytic cells Iron deficiency Sideroblastic anaemia Thalassaemia and haemoglobinopathy... 

Sideroblastic defect (abnormal production of red blood cells), for example hereditary sideroblastic anaemia, acquired sideroblastic anaemia, including lead poisoning, and reversible sideroblastic anaemia. 

Characterised by sideroblastic anaemia and exocrine pancreas dysfunction. Usually fatal in infancy. The few patients who survive into adulthood often develop symptoms of Kearns-Sayre syndrome. It is very rare less than 100 cases have been reported. 

Adverse effects include hyperuricaemia and arthralgia, which is relatively frequent with daily but less so with intermittent dosing and, unlike gout, affects both large and small joints. Pyrazinoic acid, the principal metabolite of pyrazinamide, inhibits renal tubular secretion of urate. Symptomatic treatment with an NSAID is usually sufficient and it is rarely necessary to discontinue pyrazinamide because of arthralgia. Hepatitis, which was particularly associated with high doses, is not a problem with modern short-course schedules. Sideroblastic anaemia and urticaria also occur. 

Sharp RA, Lowe JG, Johnston RN. Anti-tuberculous drugs and sideroblastic anaemia. Br J Clin Pract 1990 44(12) 706-7. 

Ramselaar AC, Dekker AW, Huber-Bruning O, Bijlsma JW. Acquired sideroblastic anaemia after aplastic anaemia caused by D-penicillamine therapy for rheumatoid arthritis. Ann Rheum Dis 1987 46(2) 156-8. 

Kandola L, Swannell AJ, Hnnter A. Acquired sideroblastic anaemia associated with penicillamine therapy for rhenmatoid arthritis. Ann Rheum Dis 1995 54(6) 529-30. 

Condamine L, Hermine O, Alvin P, Levine M, Rey C, Courtecuisse V. Acquired sideroblastic anaemia during treatment of Wikon s dkease with triethylene tetramine dihydrochloride. Br J Haematol 1993 83(l) 166-8. 

Demiroglu, H., Dundar, S. (1997 Jan-Feb). Vitamin B6 responsive sideroblastic anaemia in a patient with tuberculosis. The British Journal of Clinical Practice, 57(1), 51—52. 

In conditions where there is dyserythropoiesis, with or without hyperplasia, the ELP is greatly increased as has been demonstrated using either N or C-labelled glycine. Examples include peinicous anaemia [386,387], thalas-saemia [387,388], shunt hyperbilirubinaemia [389], sideroblastic anaemia [387,390] and anaemia of rheumatoid arthritis [391]. 

Brodsky RA, Hasegawa S, Fibach E, Dunbar CE, Young NS, Rodgers GP. Acquired sideroblastic anaemia following progesterone therapy. Br J Haematol 1994 87 859-62. 

Bencaiova G, Breymann C. Acquired sideroblastic anaemia following progesterone treatment in pregnancy. Aust N Z J Obstet Gynecol 2009 49 235-6. 

Genetic conditions of vitamin Bg dependency which respond to high dose PN supplementation include certain idiopathic sideroblastic anaemias (30) and disturbed amino acid metabolism, e.g., cystathionine P-synthase deficiency (31). 

LR Solomon, RS Hillman. Vitamin B metabolism in idiopathic sideroblastic anaemia and related disorders. Br J Haematol 42 239-253, 1979. 

Haematology - Sideroblastic anaemia is a known side effect of both INH and PZA as they inhibit the enzyme 5-aminolevulinic acid synthase-2, catalysing the first step of haeme biosynthesis [63, 64 ]. 

Chu NH, Wang J, Wang QF. Pyrazinamide-induced sideroblastic anaemia. Int J Tuberc Lung Dis 2012 16(8) 1133-4. 

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