The sideroblastic anaemias comprise a group of refractory anaemias (Table 3.8), in which there are variable numbers of hypochromic cells in the peripheral blood, with an excess of iron in the bone marrow, many of the developing erythroblasts containing iron granules arranged in a ring around the nucleus (Figure 3.6). These ring sideroblasts (more than four perinu-clear granules per cell and covering one-third or more of the nuclear circumference) are the diagnostic feature of the anaemia and, although they may form a small percentage of the erythro-blasts in a wide variety of clinical disorders, they are present in large numbers (> 15% erythroblasts) in primary sideroblastic anaemias. The various types of sideroblast that may be seen in the marrow are classified in Table 3.9.
Figure 3.6 Sideroblastic anaemia. Erythroblasts showing perinuclear rings of iron (Perls' stain).
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