Dyserythropoiesis in iron‐deficiency anemia: Ultrastructural reassessment

Iron deficiency is usually included among the causes of acquired dyserythropoiesis. This concept was derived mainly from light microscopic studies. To reassess such a notion at ultrastructural level, a transmission electron microscopic evaluation of bone marrow was performed in seven patients with iron‐deficiency anemia. In contrast to the widely accepted concept, derived from light microscopic studies, only a small proportion (2–4%, not different from controls) of erythroblasts displayed some of the features of nuclear dyserythropoiesis. On the contrary, when examining the cytoplasm, we found a significantly increased number of void ropheocytotic vesicles in the majority of late erythroblasts as compared to controls (P < 0.001). This feature may be considered as an ultrastructural marker of iron deficiency and is consistent with the present knowledge on transferrin‐mediated delivery of iron to the cell. © 1992 Wiley‐Liss, Inc.