Pristinamycin-induced sideroblastic anaemia.

This case illustrates pristinamycin as a potential cause of sideroblastic anaemia and should be considered in patients experiencing unexplained anaemia prescribed pristinamycin. Applying the Naranjo adverse drug reaction probability score, a diagnosis of pristinamycin-induced sideroblastic anaemia is probable in the case illustrated.[10] This is supported by resolution of transfusion-dependency anaemia following cessation of pristinamycin and anaemia reoccurring during a subsequent rechallenge. Pristinamycin is an antibiotic composed of two streptogramin molecules used primarily in the treatment of Gram-positive bacterial infection.[1],[2] Synergistic binding of these molecules to bacterial ribosomes inhibits protein synthesis, leading to bactericidal activity.[3] Though generally well tolerated, gastrointestinal disturbance can occur and less commonly, severe reactions such as anaphylaxis, cutaneous drug eruptions or drug-induced haemolytic anaemia.[[4], [6]] Sideroblastic anaemia, caused by pathological accumulation of iron leading to impaired haem biosynthesis from pristinamycin has not been previously documented. [Extracted from the article]