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Case Reports
. 2011 Jan 13;3(1):e2.
doi: 10.4081/hr.2011.e2. Epub 2011 Jan 21.

Severe isoniazid related sideroblastic anemia

Rein Jan Piso  1 , Kveti Kriz, Marie-Claire Desax
Affiliations
Case Reports

Severe isoniazid related sideroblastic anemia

Rein Jan Piso et al. Hematol Rep. .

Abstract

Isoniazid induced sideroblastic anemia is a rare event. We report case of a 45 year old Caucasian women with development of severe anaemia 4 month after introduction of Isoniazid as part of Tuberculosis treatment. While haemoglobin fell to 47 g/L and erythrocyte count to 1.5 G/L, reticulocytes were very low (reticulocyte production index of 0.48), but bone marrow aspirate showed an accelerated erythropoiesis with ringsideroblasts. Anaemia rapidly resolved after cessation of Isoniazid. We postulate an Isoniazid induced inhibition of the δ-Amino-levulinat-synthase resulting in marked depletion of heam synthesis.

Keywords: isoniazid; sideroblastic anaemia; tuberculosis..

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Figures

Figure 1
Figure 1
Blood values and treatment duration. RIF, rifampin; INH, isoniazid; PZA, pyrazinamide; ETB, ethambutol; MOF, moxifloxacin; RPI, reticulocyte production index.
Figure 2
Figure 2
Hypercellular bone marrow aspirate with dysplastic erythropoiesis.
Figure 3
Figure 3
Ringsideroblasts.
See this image and copyright information in PMC

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