ACQUIRED SIDEROBLASTIC ANEMIA INDUCED BY A COPPER-CHELATING AGENT

Acquired sideroblastic anaemia may be related to drugs and other chemi cals that inhibit the activity of mitochondrial enzymes involved in ha em synthesis, We report a case of secondary acquired sideroblastic ana emia following administration of triethylene tetramine dihydrochloride (trientine), a second-line copper-chelating agent used in the treatme nt of Wilson's disease. The anaemia improved after dose reduction of t rientine. The mechanism of induction of sideroblastic anaemia in this case is unclear, but trientine does not appear to alter the function o f two key mitochondrial haem enzymes, and may instead act directly on mitochondrial iron metabolism.