Megaloblastic anemia is a condition in which the bone marrow produces unusually large, structurally abnormal, immature red blood cells (megalo-blasts). Pernicious anemia is a rare blood disorder characterized by the inability of the body to properly utilize vitamin B12, which is essential for the development of red blood cells. Most cases result from the lack of the gastric protein known as intrinsic factor, without which vitamin B12 cannot be absorbed. The sideroblastic anemias are a group of blood disorders in which the body has enough iron but is unable to use it to make hemoglobin, which carries oxygen in the blood. As a result, iron accumulates in the mitochondria of red blood cells, giving a ringed appearance to the nucleus (ringed sideroblast). There are three categories of sideroblastic anemias: inherited, acquired, and idiopathic (of unknown origin). The signs and symptoms can range from mild to severe, and include fatigue, breathing difficulties, and weakness. Enlargement of the liver or spleen may also occur. In severe cases, the increased levels of iron in the blood may lead to heart disease, liver damage, and kidney failure.

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