SIDEROBLASTIC ANAEMIA

[disordered iron metabolism; dyserythropoeisis causes excessive iron loading of red cell precursors; RING SIDEROBLASTS in bone marrow are diagnostic; widespread haemosiderosis may be present]

hereditary [sex-linked benign disorder; much commoner in males; some respond to vitamin B6; low MCV]

acquired [high MCV]:

primary [group of idiopathic anaemias in elderly; 'idiopathic acquired sideroblastic anaemia'; one of the myelodysplastic syndromes; some develop into AML over years]

secondary:

inflammatory disease:

rheumatoid arthritis

systemic lupus erythematosus

chronic infections

disease of bone marrow:

myeloproliferative disorders, eg. PRV

AML, other leukaemias

multiple myeloma

myelodysplastic syndromes

myelosclerosis

other / miscellaneous:

disseminated carcinoma

megaloblastic anaemia, eg. pernicious anaemia

malabsorption syndrome

myxoedema

pregnancy

haemolytic anaemias

drugs and toxins:

pyrazinamide

alcohol

lead

chloramphenicol

isoniazid (pyridoxine (B6) deficiency)

cycloserine

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