Severe isoniazid related sideroblastic anemia

Severe isoniazid related sideroblastic anemia

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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 belle de grasse 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 fr5457 postulate an Isoniazid induced inhibition of the δ-Amino-levulinat-synthase resulting in marked depletion of heam synthesis.