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Severe isoniazid related sideroblastic anemia
Rein Jan Piso1, Kveti Kriz, Marie-Claire Desax
1Department of Medicine, Infectiology, Kantonsspital, Olten, Switzerland.
Hematology Reports
|December 21, 2011
Summary
Isoniazid, a tuberculosis drug, can rarely cause severe anemia. This case shows anemia rapidly resolved after stopping Isoniazid, suggesting a drug-induced mechanism.
Area of Science:
- Hematology
- Pharmacology
- Internal Medicine
Background:
- Isoniazid is a primary drug for tuberculosis treatment.
- Sideroblastic anemia is a rare complication of Isoniazid therapy.
- This report details a specific case to illustrate the condition.
Observation:
- A 45-year-old female developed severe anemia four months after starting Isoniazid.
- Hemoglobin levels dropped significantly, with low reticulocyte counts.
- Bone marrow examination revealed ring sideroblasts, indicative of impaired heme synthesis.
Findings:
- The patient presented with severe anemia (hemoglobin 4.7 g/dL) and erythrocyte count (1.5 G/L).
- Bone marrow aspirate showed accelerated erythropoiesis with ring sideroblasts.
- Discontinuation of Isoniazid led to rapid resolution of anemia.
Implications:
- Isoniazid can induce sideroblastic anemia by inhibiting delta-aminolevulinate synthase.
- This mechanism leads to a marked depletion of heme synthesis.
- Awareness of this rare side effect is crucial for clinicians managing tuberculosis.
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