Reversible Sideroblastic Anemia Caused by Chloramphenicol

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Abstract
During a 4-year period, abnormal sideroblasts were demonstrated on bone marrow smears obtained from 18 patients concomitantly with or shortly after chloramphenicol therapy. The relation between chloramphenicoltreatment and formation of abnormal sideroblasts is illustrated by 3 case reports. Sideroblastic anemia appeared during chloramphenicol therapy and disappeared upon withdrawal of the drug in these patients. However, abnormal sideroblasts were not demonstrable in every instance of reversible bone marrow depression by chloramphenicol. The following additional findings may be associated with the development of sideroblastic anemia caused by chloramphenicol: thrombocytopenia or reversible pancytopenia; decreasing reticulocyte counts; increased serum iron levels; increase in erythrocyte protoporphyrin and in the excretion of coproporphyrin in the urine. Irreversible bone marrow suppression by chloramphenicol was not observed during the period of the study.