Sideroblastic Anemia: Does Alcohol Cause It And How To Treat It?

Blood comprises of red blood cells, which carry oxygen from the lungs to different cells and help in the elimination of carbon dioxide, which is produced as a waste by product of metabolic activities. The red blood cells are usually discoid in shape. This unique structure of red blood cells, allows them to navigate easily through the capillaries and provide oxygen to the furthest cell in the body.

Reduced number of red blood cells or abnormal red blood cells can lead to anemia, which is a condition associated with reduced level of hemoglobin in the blood. Lower levels of hemoglobin in the blood can interfere with the effective transport of oxygen to cells.

Sideroblastic anemia is a form of anemia which is associated with abnormal and atypical structure of erythroblasts (precursors of the red blood cells). This reduces the hemoglobin content of the blood and reduces the oxygen carrying capacity of blood. As per the World Health Organization, three types of sideroblasts have been identified,

  • Type 1: Presence of fewer than 5 siderotic granules (iron containing granules) in the cytoplasm.
  • Type 2: Presence of five or more siderotic granules, but without a perinuclear distribution
  • Type 3: Presence of five or more siderotic granules with perinuclear distribution, encompassing at least one third of the nuclear circumference.

How Does Alcohol Cause Sideroblastic Anemia?

Excessive consumption of alcohol is the primary factor that leads to the development of this condition. Excessive alcohol consumption interferes with the ability of the mitochondria to synthesize the heme molecule. This result in deposition of the heme molecule in the form of iron around the mitochondria, giving a typical ring shaped appearance. Some of the other less frequently observed causes include,

  • Lead, zinc or copper poisoning.
  • Nutritional deficiencies namely of Vitamin B6 or copper.
  • Rheumatoid arthritis or myeloma is associated with this condition.
  • In some cases drugs like ethanol, chloramphenicol, isoniazid and oral contraceptives can lead to the development of the condition.
  • The condition may also have a genetic origin in cases of ALA synthase deficiency.

Complications: The condition is associated with complications which are primarily attributed to accumulation of iron in the different organs of the body. The complications include liver damage, kidney failure and heart disease along with symptoms like paleness, dizziness, enlargement of liver and spleen and fatigue.

How To Treat Sideroblastic Anemia?

The treatment regimen usually depends upon the severity of the condition. Here are some contemporary treatment options,

  • High to medium doses of Vitamin B6 are recommended to improve the heme level and reverse anemia. However this can be done in mild to moderately severe conditions.
  • In relatively more severe conditions, blood transfusion is required.
  • Bone marrow transplant is recommended in the most severe cases; however there is significant ambiguity over the success rate of this procedure.
  • A healthy and balanced diet might prove helpful but there is no clinical evidence to support this.

The prognosis of the condition depends upon the causative factor associated with the ailment. In sideroblastic anemia caused due to heredity or secondary acquired factors, the responsiveness to the treatment is high.

In cases of primary acquired factors, the prognosis is relatively poor with responsive rate as low as 40%. Severe sideroblastic anemia is associated with significant reduction in life expectancy.

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