Presentation
The ultrastructural findings of the bone marrow cells from 15 patients with acquired sideroblastic anemia are presented. [ncbi.nlm.nih.gov]
Patients can present at any age with symptoms of anemia or iron overload. 4, 11 Physical examination is unremarkable although mild hepatosplenomegaly may be present. [clinicalgate.com]
Entire Body System
- Hypothermia
Hypothermia. Lead poisoning. Zinc overdose. Haemodialysis. [ 5 ] Pregnancy. Presentation Clinical features are those related to anaemia in general. Symptoms reflect the cytopenias, ie anaemia, infection, bruising and haemorrhage. [patient.info]
Recurrent thrombocytopenia, erythroid hypoplasia and sideroblastic anaemia associated with hypothermia. Br J Haematol. 1982 Jul. 51(3):451-6. [Medline]. Guernsey DL, Jiang H, Campagna DR, Evans SC, Ferguson M, Kellogg MD, et al. [emedicine.medscape.com]
[…] anemia have been documented in other genetic disorders, notably: Erythropoietic porphyria, in which significant anemia can occur Pearson syndrome, Zinc overload or copper deficiency Thiamine responsive megaloblastic anemia For unknown reasons, profound hypothermia [psychiatryadvisor.com]
Hypothermia - as low temperature may influence mitochondrial functions. Refractory The next big group in terms of prevalence after reversible. [clinicaladvisor.com]
O'Brien H, Amess JA, Mollin DL. 1982 Recurrent thrombocytopenia, erythroid hypoplasia and sideroblastic anemia associated with hypothermia. Br J Hemeatol 51:451-456. [sickle.bwh.harvard.edu]
- Splenectomy
Blood films of patient III.3 and patient III.2 showed Pappenheimer bodies—these were particularly prominent in patient III.2 as a result of his previous splenectomy (fig 3 ); the splenectomy causes a higher mean corpuscular volume than otherwise would [jnnp.bmj.com]
Splenectomy is not recommended because this has led to thrombotic complications. 4 At least 120 cases from 70–80 families are reported (January 2011). [clinicalgate.com]
Interesting sequence of splenectomy. Am J Med Sci 1945;209:561-2. 4. Fleming MD. The genetics of inherited sideroblastic anemias. Semin Hematol 2002;39:270-81. 5. Bottomley SS, Wise PD, Wasson EG. [ijpmonline.org]
Splenectomy is contraindicated as treatment because there have been reports of adverse outcomes. A. Immediate management. No immediate management unless life-threatening anemia. C. [clinicaladvisor.com]
- HELLP Syndrome
(see Kasabach-Merritt Syndrome, [[Kasabach-Merritt Syndrome]]) Abnormal vessel wall -> damage to RBC Mild thrombocytopenia HELLP Syndrome (see HELLP Syndrome, [[HELLP Syndrome]]) Hemolytic-Uremic Syndrome (see Hemolytic-Uremic Syndrome, [[Hemolytic-Uremic [mdnxs.com]
- Weight Loss
He complains of weight loss and has not been eating. You note pallor of his conjuctiva and skin. His Hct = .22L/L; Hgb = 72g/L; MCV = 105 fL. The PBS shows a basophilic stippling and hypochromia. The bone marrow aspirate Fe stains is at right. [med-ed.virginia.edu]
Cardiovascular
- Chest Pain
Other symptoms of SA include: Pale skin color Rapid heart rate, or tachycardia Headaches Heart palpitations Weakness and fatigue Chest pain Types of SA There are two main types of sideroblastic anemia: inherited and acquired. [webmd.com]
Pain (see Chest Pain, [[Chest Pain]]) xxxx Dermatologic Manifestations Pallor xxxx Pulmonary Manifestations Dyspnea (see Dyspnea, [[Dyspnea]]) xxxx Other Manifestations xxxx Treatment Iron Agents Ferrous Sulfate (see Ferrous Sulfate, [[Ferrous Sulfate [mdnxs.com]
PHYSICAL FINDINGS & CLINICAL PRESENTATION The symptoms for sideroblastic anemia are the same for any anemia: • Symptoms include fatigue, weakness, palpitations, shortness of breath, headaches, irritability, and chest pain. • Physical findings may include [encyclopedia.lubopitko-bg.com]
Exertion may cause chest pains similar to angina. The mucous membranes and skin of hands and arms may be pale, possibly with a lemon-yellow cast. Subcutaneous bleeding may occur, causing a brownish-red effect. [encyclopedia.com]
- Vascular Disease
Hunt KE, Salama ME, Sever CE, Foucar K (2013) Bone marrow examination for unexplained cytopenias reveals nonspecific findings in patients with collagen vascular disease. Arch Pathol Lab Med 137: 948-954. [omicsonline.org]
Musculoskeletal
- Muscle Cramp
cramps Possibly tachycardia Bounding pulses ;, palpitations, pulsatile sound in the ear Worsening of angina pectoris Features of extramedullary hematopoiesis in certain severe chronic anemias (e.g., thalassemia, myelofibrosis ) Subtypes and variants [amboss.com]
Neurologic
- Headache
You may be short of breath or have a headache. Your doctor will diagnose anemia with a physical exam and blood tests. Treatment depends on the kind of anemia you have. [icdlist.com]
Headache. Irritability and other mood disturbances. Mental confusion. Loss of sexual drive. Shortness of breath on exertion. [doctor-clinic.org]
Other symptoms of SA include: Pale skin color Rapid heart rate, or tachycardia Headaches Heart palpitations Weakness and fatigue Chest pain Types of SA There are two main types of sideroblastic anemia: inherited and acquired. [webmd.com]
PHYSICAL FINDINGS & CLINICAL PRESENTATION The symptoms for sideroblastic anemia are the same for any anemia: • Symptoms include fatigue, weakness, palpitations, shortness of breath, headaches, irritability, and chest pain. • Physical findings may include [encyclopedia.lubopitko-bg.com]
The symptoms and signs of congenital sideroblastic anemia (CSA) in children are primarily related to the anemia and its severity: Fatigue, weakness Irritability Exercise/feeding intolerance Exertional dyspnea Headache, vertigo Pale or yellow skin Some [danafarberbostonchildrens.org]
- Irritability
[…] iron, folic acid or vitamin B12 Blood disorders such as sickle cell anemia and thalassemia, or cancer Aplastic anemia, a condition that can be inherited or acquired G6PD deficiency, a metabolic disorder Anemia can make you feel tired, cold, dizzy, and irritable [icdlist.com]
Irritability and other mood disturbances. Mental confusion. Loss of sexual drive. Shortness of breath on exertion. [doctor-clinic.org]
You might feel tired, irritable, and find it difficult to breathe. [webmd.com]
PHYSICAL FINDINGS & CLINICAL PRESENTATION The symptoms for sideroblastic anemia are the same for any anemia: • Symptoms include fatigue, weakness, palpitations, shortness of breath, headaches, irritability, and chest pain. • Physical findings may include [encyclopedia.lubopitko-bg.com]
The symptoms and signs of congenital sideroblastic anemia (CSA) in children are primarily related to the anemia and its severity: Fatigue, weakness Irritability Exercise/feeding intolerance Exertional dyspnea Headache, vertigo Pale or yellow skin Some [danafarberbostonchildrens.org]
- Tremor
Some of the affected members had delayed motor milestones as in our family, with tremor described at a young age. [jnnp.bmj.com]
Dysmetria, finger-nose and heel-shin ataxia, dysarthria, intention tremor and diminished deep tendon reflexes are usually present to varying degrees. Nystagmus, strabismus and abnormal plantar responses may or may not be present. [clinicalgate.com]
Workup
Anemia is often an incidental finding made on CBC that requires further workup to determine the cause. [amboss.com]
WORKUP The diagnostic workup of suspected sideroblastic anemia includes laboratory evaluation and bone marrow aspiration and biopsy. [encyclopedia.lubopitko-bg.com]
Workup may include a complete blood count (CBC), peripheral smear, iron studies (eg, ferritin and total iron-binding capacity [TIBC]), bone marrow aspiration and biopsy, and other studies as appropriate. [emedicine.medscape.com]
Biopsy
- Bone Marrow with Ringed Sideroblasts
and linezolid. [14] Diagnosis [ edit ] Bone marrow aspirate: ring sideroblasts Ringed sideroblasts are seen in the bone marrow. [en.wikipedia.org]
• Bone marrow shows the classic ringed sideroblasts not seen in normal bone marrow tissue.The ringed sideroblasts represent iron storage in the mitochondria of normoblasts. TREATMENT The underlying cause determines the course of treatment. [encyclopedia.lubopitko-bg.com]
Treatment
Practical, bulleted, highly templated text with easy-to-use features including flow charts and treatment boxes. [books.google.com]
Treatment The underlying cause determines the course of treatment. Hereditary sideroblastic anemia usually responds to several weeks of treatment with high doses of pyridoxine. [doctor-clinic.org]
TREATMENT The underlying cause determines the course of treatment. Hereditary sideroblastic anemia usually responds to several weeks of treatment with high doses of pyridoxine. [encyclopedia.lubopitko-bg.com]
After all tests are completed, the hematologist will be able to outline the best treatment options. How is congenital sideroblastic anemia treated? Treatment for CSA depends on the exact type and severity of the disorder. [danafarberbostonchildrens.org]
MCV < 80 fL = microcytic anemia MCV 80–100 fL = normocytic anemia MCV > 100 fL = macrocytic anemia Bone marrow biopsy References: [2] [1] [14] [15] Treatment [amboss.com]
Prognosis
The fact that two of these patients had preleukemia and the third had overt acute leukemia may imply that patients with IASA and X chromosome abnormalities have a poor prognosis. [ncbi.nlm.nih.gov]
A normal karyotype carries the most favorable prognosis. Monosomy 7 or deletions of the long arms of chromosome 7 are associated with a worse prognosis. “What if” scenarios. [psychiatryadvisor.com]
Generally, the prognosis depends on the severity of anemia and its response to treatment Proper care should be taken to treat and control complications from MDS. [dovemed.com]
Few patients are eligible for transplant. [ 1 ] Prognosis [ 9 ] The prognosis is very variable. Reversible causes (eg, alcohol or drugs) appear to have no long-term effects if the underlying cause is successfully treated or removed. [patient.info]
For those responding to steroid therapy the prognosis is good. [medical-dictionary.thefreedictionary.com]
Etiology
Thrombotic Thrombocytopenic Purpura (TTP)/Hemolytic Uremic Syndrome (HUS) Mechanical RBC Damage Target Cells Etiology Liver Disease (see xxxx, [[xxxx]]): especially extrahepatic biliary obstruction Thalassemia (see xxxx, [[xxxx]]) Spur Cells Etiology [mdnxs.com]
Etiology Congenital Diamond-Blackfan anemia (DBA) is a congenital pure red blood cell aplasia that presents in infancy with the following features: Macrocytic ( non-megaloblastic ) anemia in infancy or early childhood (usually diagnosed before one year [amboss.com]
(Etiology) Refractory Anemia with Ringed Sideroblasts is caused by genetic mutations. [dovemed.com]
ETIOLOGY • Primary hereditary sideroblastic anemia is usually inherited as a sex-linked recessive disease. • Primary acquired sideroblastic anemia is idiopathic. • Secondary acquired sideroblastic anemia can be caused by alcohol, isoniazid, pyrazinamide [encyclopedia.lubopitko-bg.com]
Sideroblastic anemias: etiologic classification. DIDMOAD = diabetes insipidus, diabetes mellitus, optic atrophy, deafness. [emedicine.medscape.com]
Epidemiology
Infections in Compromised Hosts 593 Clinical Considerations 601 Approach to Patients With Systemic Infection 612 Epidemiology and Infection Control 621 PULIMONARY AND CRITICAL CARE 629 Respiratory Therapy Techniques and Mechanical 636 Management of Acute [books.google.com]
[…] than usual Weakness or feeling tired Diagnostic Exams FISH (flourescence in situ hybridzation) Flow cytometry Immunocytochemistry Immunophenotyping Peripheral blood smear Progression and Transformation ~1-2% of case s evolve to acute myeloid leukemia Epidemiology [seer.cancer.gov]
Epidemiology There are few data on the epidemiology of RARS, which may account for 5-15% of all MDS cases. MDS is predominantly diagnosed in the elderly population. [atlasgeneticsoncology.org]
Young NS, Kaufman DW (2008) The epidemiology of acquired aplastic anemia. [omicsonline.org]
Epidemiology Refractory anaemia with ringed sideroblasts (RARS) may account for 5-15% of all MDS cases. [ 4 ] Aetiology Congenital The most common inherited sideroblastic anaemia is X-linked sideroblastic anaemia (XLSA) caused by mutations of the erythroid-specific [patient.info]
Pathophysiology
[This chapter provides both an in depth review of the pathophysiology of sideroblastic anemias and a short, readable summary of clinical evaluation, management, and treatment of these anemias.] [psychiatryadvisor.com]
[…] hypertelorism, flat nasal bridge, micrognathia, short stature, webbed neck, cleft palate, and triphalangeal thumbs Electrophoresis reveals elevated fetal Hb levels Acquired : most often idiopathic, but can be associated with a number of conditions, such as: Pathophysiology [amboss.com]
Harigae H, Furuyama K ; Hereditary sideroblastic anemia: pathophysiology and gene mutations. Int J Hematol. 2010 Oct92(3):425-31. Epub 2010 Sep 17. Rigoli L, Di Bella C ; Wolfram syndrome 1 and Wolfram syndrome 2. [patient.info]
"Hereditary sideroblastic anemia: pathophysiology and gene mutations". International Journal of Hematology. vol. 92. 2010. pp. 425-431. Cazzola, M, Invernizzi, R. "Ring sideroblasts and sideroblastic anemias". [clinicaladvisor.com]
The etiology, epidemiology, pathophysiology and treatment of these conditions differ vastly. The mitochondrion is the nexus of sideroblastic anemia, however. [sickle.bwh.harvard.edu]
Prevention
Rapidly find the answers you need with separate sections on diseases and disorders, differential diagnosis, clinical algorithms, laboratory results, and clinical preventive services, plus an at-a-glance format that uses cross-references, outlines, bullets [books.google.com]
Advanced Hematologic Cancer, Metastatic Breast Cancer, or Kidney Cancer Completed NCT00365287 Phase 1, Phase 2 anti-thymocyte globulin;cyclophosphamide;cyclosporine;fludarabine phosphate;mycophenolate mofetil 40 Tacrolimus and Mycophenolate Mofetil in Preventing [malacards.org]
Some patients with sideroblastic anemias may benefit from phlebotomy to prevent hemochromatosis. Phlebotomy increases the rate of erythropoiesis and uses up excess iron stores; thus, it reduces serum and total-body iron levels. [doctor-clinic.org]