ascorbic-acid and Anemia--Sideroblastic

The unusual occurrence of microcytic anemia with hypochromia, high iron blood levels and excess of sideroblasts in the bone marrow, observed during the treatment of tuberculosis with isoniazid and rifampicine is reported. Three particularities were noted. First, in our experience, the occurrence of this type of anemia has never been noted previously as a result of these two drugs. Secondly, the improvement of the blood abnormalities was obtained by the combined use of vitamin B6 and vitamin C. Thirdly, the anemia was associated with neuropathy, characterized by areflexia and dysesthesia, which improved with vitamin B6 therapy (but not with vitamin C). Some mechanisms are discussed as being possibly the origin of this kind of anemia, particularly a lack of vitamin B6 resulting from a massive urinary loss of pyridoxal induced by isoniazid as well as both a tissue depletion and an overconsumption of this vitamin. The anemia may be the consequence of a deficiency of hemoglobin synthesis involving probably the first step of the biosynthesis of heme.

Topics: Aged; Anemia, Sideroblastic; Antitubercular Agents; Ascorbic Acid; Female; Humans; Isoniazid; Pyridoxine; Rifampin; Tuberculosis, Pulmonary

Topics: Anemia, Sideroblastic; Animals; Ascorbic Acid; Chelating Agents; Deferoxamine; Hemosiderosis; Humans; Iron; Metabolic Diseases; Thalassemia

The effect of 12 and 24 h continuous subcutaneous infusion of desferrioxamine (D.F.) on urinary iron excretion was compared in 13 patients with beta-thalassaemia major and 1 with congenital sideroblastic anaemia, all of whom were receiving regular blood-transfusions. 750 mg D.F. given over a 12 h period, gave a mean total (30 h) iron excretion of 17-5 mg, which was not statistically different from the mean iron excretion of 21-5 mg when the same dose was delivered over 24 h. 1500 mg D.F. gave a mean urinary iron excretion of 28-1 mg with a 12 h infusion, which was significantly less than the mean iron excretion of 39-6 mg with 24 h infusion. The 1500 mg dose gave a significant increase in iron excretion compared with the 750 mg dose when given by either 12 h or 24 h infusion. 7 of 8 patients, given D.F. over a 12 h period, had increased iron excretion when the dose was increased from 750 to 2000 mg. When the dose was increased to 4000 mg, however, the effect on iron excretion was variable. On the other hand, ascorbic-acid therapy was invariably associated with increased iron excretion after subcutaneous D.F. In twelve studies at different dose levels of D.F., ascorbate therapy was associated with increased iron excretion ranging from 24 to 245%. It is concluded that in most patients with transfusional iron overload subcutaneous D.F over a 12 h period, at a dose ranging from 2 to 4 g daily with ascorbic-acid saturation, is at present the most satisfactory method of removing excess iron.

Topics: Administration, Oral; Adolescent; Adult; Anemia, Sideroblastic; Ascorbic Acid; Child; Deferoxamine; Dose-Response Relationship, Drug; Drug Synergism; Drug Therapy, Combination; Female; Hemosiderosis; Humans; Infusions, Parenteral; Iron; Male; Skin; Thalassemia; Transfusion Reaction

Absorption of 59Fe ferrous sulphate was measured in patients with a variety of iron-loading anaemias both before and during subcutaneous infusions of desferrioxamine. The infusions were associated with a reduction in absorption (P less than 0-025). This effect was not altered by saturation with ascorbic acid.

Topics: Administration, Oral; Adolescent; Adult; Anemia, Aplastic; Anemia, Sideroblastic; Ascorbic Acid; Binding Sites; Blood Transfusion; Deferoxamine; Drug Synergism; Erythrocytes; Female; Ferritins; Ferrous Compounds; Humans; Infusions, Parenteral; Intestinal Absorption; Iron; Iron Radioisotopes; Isotope Labeling; Male; Thalassemia

Topics: Adult; Anemia, Sideroblastic; Ascorbic Acid; Deferoxamine; Drug Administration Schedule; Female; Hemosiderosis; Humans; Injections, Intravenous; Injections, Subcutaneous; Iron; Male; Middle Aged; Primary Myelofibrosis; Thalassemia; Transfusion Reaction

Topics: Anemia; Anemia, Hypochromic; Anemia, Sickle Cell; Anemia, Sideroblastic; Ascorbic Acid; Black People; Blood Proteins; Child Nutritional Physiological Phenomena; Child, Preschool; Diet; Diet Surveys; Dietary Proteins; Erythrocytes; Hematocrit; Hemoglobins; Humans; Iron; Mass Screening; Mississippi; Protein Binding; Transferrin

Topics: Adult; Anemia, Sideroblastic; Ascorbic Acid; Chloramphenicol; Female; Folic Acid; Humans; Male; Pyridoxine; Typhoid Fever; Zambia

A 72-year-old woman with primary sideroblastic anaemia showed no response to treatment with pyridoxine. When she was given pyridoxal-5-phosphate there was a prompt reticulocyte response and sustained symptomatic improvement with satisfactory control of the anaemia.

Topics: Aged; Anemia, Sideroblastic; Ascorbic Acid; Female; Folic Acid; Hemoglobinometry; Humans; Pyridoxal Phosphate; Pyridoxine; Reticulocytes; Tryptophan

Topics: Aged; Anemia, Sideroblastic; Ascorbic Acid; Autopsy; Blood Cell Count; Blood Transfusion; Bone Marrow; Bone Marrow Cells; Bone Marrow Examination; Erythrocytes; Erythropoiesis; Folic Acid; Follow-Up Studies; Humans; Hyperplasia; Iron; Leukemia, Myeloid; Male; Middle Aged; Monocytes; Muramidase; Precancerous Conditions; Pyridoxine; Vitamin B 12

Topics: Adolescent; Adult; Anemia, Sideroblastic; Ascorbic Acid; Female; Humans; Iron; Male; Middle Aged

Topics: Anemia, Sideroblastic; Animals; Ascorbic Acid; Cobalt; Erythropoiesis; Erythropoietin; Humans; Lead Poisoning; Porphyrias; Porphyrins; Rats

Topics: Anemia; Anemia, Macrocytic; Anemia, Sideroblastic; Ascorbic Acid; Child; Folic Acid; Humans; Vitamin B 12

Topics: Anemia; Anemia, Hypochromic; Anemia, Sideroblastic; Ascorbic Acid; Genetic Diseases, X-Linked; Humans; Iron; Pyridoxine

Topics: Anemia; Anemia, Sideroblastic; Ascorbic Acid; Hemochromatosis; Humans; Pyridoxine; Vitamin B 6; Vitamins