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.