In sideroblastic anemia, what happens to the serum iron and ferritin levels?

In sideroblastic anemia, there is a defect in the incorporation of iron into heme, leading to an accumulation of iron in the erythrocyte precursors. This is a result of impaired hemoglobin synthesis, despite the presence of adequate or even elevated iron stores.

Due to the body's inability to utilize iron effectively for hemoglobin production, serum iron levels are typically increased as the iron remains in circulation rather than being utilized for erythropoiesis. Additionally, ferritin levels, which reflect the body's iron stores, are also elevated because the body is essentially "storing" excess iron that cannot be used due to the defect in hemoglobin synthesis.

Thus, both serum iron and ferritin levels are increased in sideroblastic anemia, reflecting the accumulation of iron in the body alongside the iron utilization defect. This understanding is crucial for correctly diagnosing and managing patients with sideroblastic anemia, which can be associated with other conditions such as alcohol use, certain medications, and lead exposure.