6 One must be vigilant to rule out relatively less common causes of this presentation, such as sideroblastic anemia
, chronic disorder, lead poisoning, and others.
A histogram distribution that is bimodal can be seen in various situations, are usually associated with therapeutic transfusion and/or hematinic agent response to microcytic and macrocytic anemia, but they may also indicate other hematological disorders like cold agglutinin disease, in the presence of erythrocyte fragments, in IDA (microcytic) with recent blood transfusion, in sideroblastic anemia
especially in acquired forms, and megaloblastic anemia (macrocytic anemia) with recent blood transfusion.
A new syndrome of refractory sideroblastic anemia
with vacuolization of marrow precursors and exocrine pancreatic dysfunction.
1 sideroblastic anemia
due recessive to GLRX5 mutation XJinked sideroblastic 301310 X- linked anemia with ataxia recessive Xql3.
Iron deficiency may result from several other less commonly occurring conditions, including a disorder of iron utilization, sideroblastic anemia
, selected hemoglobinopathies, anemia related to chronic disorders, chronic inflammation, parasitic infections such as hookworm, and a deficiency of the plasma iron transporting protein, transferrin.
Disorders of iron metabolism and sideroblastic anemia
in Nathan and Oski's Hematology of infancy and childhood.
Iron deficiency anemia, thalassemia, and sideroblastic anemia
present with microcytic, hemochromic cells (Mansen & McCance, 2006; Uphold & Graham, 2003).
13) Furthermore, if a sideroblastic anemia
is unresponsive to pyridoxine, supplementation with pyridoxal-5'-phosphate may be effective, as the anemia may be due to defective phosphorylation of pyridoxine to its active form.