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 icon track bar f250 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 here 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.