The response of free erythrocyte protoporphyrin to pyridoxine therapy in a patient with sideroachrestic (sideroblastic) anemia.

By G. R. LEE, G. E. CARTWRIGHT AND M. M. \VINTROBE F’ EILMEYER has applied the term “sideroachrestic anemia” to conditions characterized by the association of hypochromic anemia with excessive iron storage.’ In referring to the same syndrome, Mollin and others2 prefer the designation “sideroblastic anemia,” a term which emphasizes the importance of abnormal iron accumulation in erythrohlasts. Classifications of the reported cases have been proposed.1’2 The patients in whom “sideroachrcstic anemia” has been detected differ from one another in several important respects, including the response to pyridoxine therapy,3’4 the association with underlying disease,5 and the cvidence of familial transmission of the disorder.#{176} It has been suggested”7 that these varied disorders have in common the presence of a metabolic lesion in the hemoglobin synthetic pathways. We have studied a patient with acquired sideroachrcstic ( sideroblastic) anemia and carcinoma of the prostate in whom a remarkable amount of protoporphyrin accumulated within his erythrocytes during pyridoxine therapy. Since this observation contributed to the understanding of the biochemical defects present in this patient, the case report is presented. A preliminary report was published elsewhere.8