hematology and oncology
Sideroblastic Anemias
Diagnosis of Sideroblastic Anemias
Complete blood count (CBC), reticulocyte count, and peripheral blood smear Iron studies (serum iron, serum ferritin, and transferrin saturation) Bone marrow examination Genetic testing for a suspected inherited or acquired mutation Sideroblastic anemia is suspected in patients with microcytic anemia or a high RDW anemia, particularly with increased serum iron, serum ferritin, and transferrin saturation (see Iron Deficiency Anemia ). The Peripheral smear shows RBC dimorphism. RBCs may appear stippled. Bone marrow examination is necessary and reveals erythroid hyperplasia. Iron staining reveals the pathognomonic iron-engorged perinuclear mitochondria in developing RBCs (ringed sideroblasts). Other features of Myelodysplasia and Iron-Transport Deficiency Anemia , such as cytopenias and dysplasia, may be evident. Serum lead is measured if sideroblastic anemia has an unknown cause. 