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Acquired Sideroblastic Anemia


Presentation

  • The ultrastructural findings of the bone marrow cells from 15 patients with acquired sideroblastic anemia are presented.[ncbi.nlm.nih.gov]
  • We report a patient who initially presented with slight anemia and a raised platelet count. Further investigations suggested a diagnosis of primary acquired sideroblastic anemia. Cytogenetic examination revealed a clone with trisomy 8.[ncbi.nlm.nih.gov]
  • We describe a 63-year-old man who presented with idiopathic acquired sideroblastic anemia and subsequently developed acute myelofibrosis.[ncbi.nlm.nih.gov]
  • The underlying mechanism is not understood, but, taken separately, these two anomalies commonly present heme metabolic anomalies in the mitochondria.[ncbi.nlm.nih.gov]
  • The common Xq13 chromosome breakpoint and clinical presentation (IASA) among these three patients and the occurrence of an X-linked type of sideroblastic anemia may suggest that an association exists between X chromosome abnormalities and IASA.[ncbi.nlm.nih.gov]
Atrial Septal Defect
  • Other variable clinical signs include: retinal dystrophy, optic nerve atrophy, short stature, cardiovascular abnormalities including congenital heart defects such as ventricular and/or atrial septal defects and conduction abnormalities / arrhythmias,[bloodgenetics.com]
Aspiration
  • Aspirate Bone marrow aspirate showing erythroid hyperplasia Iron Stain The iron stain shows ringed sideroblasts. Bone Marrow Core Biopsy Bone marrow core biopsy showing hypercellular marrow with erythroid hyperplasia[imagebank.hematology.org]
  • Figure 1 Bone marrow aspirate iron stain with a diffuse pattern. Original magnification 10, top; 25 bottom. Figure 2 Bone marrow aspirate iron stain with a punctate pattern. Original magnification 10, top; 25 bottom.[nature.com]
  • When do you need to get more aggressive tests: Bone marrow aspiration biopsy should be considered when all other possibilities for a hypoproliferative anemia with a dimorphic blood picture have been ruled out.[psychiatryadvisor.com]
  • WORKUP The diagnostic workup of suspected sideroblastic anemia includes laboratory evaluation and bone marrow aspiration and biopsy.[encyclopedia.lubopitko-bg.com]
  • A bone marrow aspirate seven weeks later showed only occasional ring sideroblasts. Pyridoxine was again discontinued.[nejm.org]
Hemoptysis
  • 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 Respiratory Failure 647 Approach to the Patient With Hemoptysis[books.google.com]
Respiratory Insufficiency
  • This disorder shows a marked phenotypic variability: some patients have a severe multi-systemic disorder since infancy, including cardiomyopathy and respiratory insufficiency that causes early death, while others present in the second or third decade[bloodgenetics.com]
Osteoporosis
  • Infection 823 Demyelinating Diseases 832 Chronic Dementing Conditions 835 Central Nervous System Poisoning 841 Disorders of the Peripheral Nervous System 847 Mononeuropathies Caused by Entrapment 854 APPROACH TO THE DIAGNOSIS 860 DISEASES COMMON IN 874 Osteoporosis[books.google.com]
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]
  • Clinical manifestations of megaloblastic anemia may include hyporexia, lethargy, headache, pallor, diarrhea, and paresthesia in the hands and feet.[bloodgenetics.com]
  • 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]
Mononeuropathy
  • […] a Sleep 806 Approach to the Patient With Visual 815 Approach to the Patient With Suspected Infection 823 Demyelinating Diseases 832 Chronic Dementing Conditions 835 Central Nervous System Poisoning 841 Disorders of the Peripheral Nervous System 847 Mononeuropathies[books.google.com]
Convulsions
  • The disease occurs in infancy with recurrent febrile episodes, gastrointestinal disorders, developmental delay, convulsions, ataxia and sensorineural deafness.[bloodgenetics.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]
Glycosuria
  • We found higher glycosuria (21:43 /- 42.58 vs 0.0 /- 0.0 mg/dl), total aminoaciduria (6280 /- 3943 vs 4138 /- 2269 microMol/g creatinine, p 0.19) and lower maximum capacity for phosphate reabsorption by the renal tube (TmPO4) (2.11 /- 0.38 vs 2.9 /- 0.73[ncbi.nlm.nih.gov]
Bone Marrow with Ringed Sideroblasts
  • 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

  • Features sweeping content updates throughout , including basic science research which serves as a foundation for modern hematology, recent advances in stem cell transplantation, clinical advances in the treatment of each of the hematologic malignancies[books.google.com]
  • The Hematology: Diagnosis and Treatment eBook is the ideal mobile resource in hematology ! It distills the most essential, practical information from Hematology: Basic Principles and Practice, 6th Edition - the comprehensive masterwork by Drs.[books.google.com]
  • These patients may respond to treatment with vitamin B6 (pyridoxine) and folic acid. In some cases of severe anemia without response to treatment support measures such as blood transfusions are necessary.[bloodgenetics.com]
  • January 09, 1987 Published online: February 25, 2009 Number of Print Pages: 2 Number of Figures: 0 Number of Tables: 0 ISSN: 0001-5792 (Print) eISSN: 1421-9662 (Online) For additional information: Abstract Danazol, a synthetic androgen, was used in the treatment[karger.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]

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]
  • Other known etiologies include mutations in the genes for SLC19A2, GLRX5, PUS1, ABCB7, YARS2, and mitochondrial DNA deletions [ 5 , 7 – 13 ].[jhoonline.biomedcentral.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]
Sex distribution
Age distribution

Pathophysiology

  • Pathophysiology N/A What other clinical manifestations may help me to diagnose sideroblastic anemia? N/A What other additional laboratory studies may be ordered? N/A Hoffman, R, Benz, E, Shattil, S. "Hematology Basic Principles and Practice".[psychiatryadvisor.com]
  • , 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]
  • Bejar R, Levine R, Ebert BL (2011) Unraveling the molecular pathophysiology of myelodysplastic syndromes. J ClinOncol 29: 504-515.[omicsonline.org]

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]

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