Sideroblastic anemia was recognized as a distinct entity 20 years ago. A satisfactory working classification into hereditary, idiopathic (primary) acquired, and secondary forms soon followed the initial descriptions of this uncommon disorder, and it seemed then that useful information about the etiology and treatment would soon be available. Therefore, it is sad to report, in 1980, that the etiology remains obscure and that repeated blood transfusion is still the fate awaiting most patients with the idiopathic form of the disease. There are a number of reasons for this sorry state of affairs. First, diagnostic confusion has occurred; second, there are probably a large number of different causes of the same hematologic findings; and third, the disorder itself is rare.
The diagnosis of sideroblastic anemia can only be made when an anemic patient has the following triad of hematologic abnormalities: a dimorphic population of RBCs in the blood, an erythroid hyperplasia