Causes
By far the most common cause of sideroblastic anemia is excessive alcohol use. In this and other cases, the primary pathophysiology of sideroblastic anemia is failure to completely form heme molecules, whose biosynthesis takes place partly in the mitochondrion. This leads to deposits of iron in the mitochondria that form a ring around the nucleus of the developing red blood cell. Sometimes the disorder represents a stage in evolution of a generalized bone marrow disorder that may ultimately terminate in acute leukemia.
- Toxins: lead, copper, or zinc poisoning
- Drug-induced: ethanol, isoniazid, chloramphenicol, cycloserine, Linezolid, oral contraceptives
- Nutritional: pyridoxine (Vitamin B6) or copper deficiency
- Diseases: Rheumatoid arthritis or multiple myeloma
- Genetic: ALA synthase deficiency (X-linked, associated with ALAS2)
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