ACQUIRED SIDEROBLASTIC ANEMIA FOLLOWING PROGESTERONE THERAPY

We report a case of acquired sideroblastic anaemia precipitated by pro gesterone. On two separate occasions, over 15 years apart, the patient developed sideroblastic anaemia with iron overload shortly after the administration of progesterone. No other cause for sideroblastic anaem ia was found, and treatment with folic acid, pyridoxine or androgens c orrected the anaemia. In both instances removal of the progestational agent led to prompt disappearance of the anaemia as well as the ringed sideroblasts. Using a two-phase liquid culture procedure in which hum an peripheral blood-derived progenitor cells undergo erythroid prolife ration and differentiation, we demonstrated enhanced sensitivity of th e patient's erythroid progenitors to progesterone. We conclude that pr ogesterone should be added to the list of medications known to be asso ciated with acquired sideroblastic anaemia.