Study of sideroblasts and iron stores in bone marrow aspirates using Perls′ stain

Abstract

Introduction: A bone marrow examination is a critical part of the evaluation of patients with a variety of hematopoietic and nonhematopoietic diseases. A Perls′ or Prussian blue stain demonstrates hemosiderin in bone marrow macrophages and iron within sideroblasts. Examination of iron stain allows detection not only of an increased or decreased proportion of sideroblasts but also of abnormal sideroblasts. We undertook this study to evaluate the iron stores in bone marrow as judged by Perls′ stain. Materials and Methods: A Prospective analysis of 55 bone marrow aspirates in a tertiary care center. Results: Sideroblasts were present in all the cases. They were decreased in iron deficiency anemia (IDA), and few other chronic diseases whereas normal to increase in megaloblastic anemia. According to Gale′s method, cases of IDA had absent or decreased iron stores while those of megaloblastic anemia or normoblastic marrows showed normal to increased stores. Grading by the recent intensive method showed combined functional and iron stores deficiency. Conclusion: Perls′ stain on bone marrow aspirates is an important tool not only for assessing the iron stores, increased or decreased but also to study abnormal sideroblasts.

Keywords

• Bone marrow aspirates
• iron store
• Perls′ stain
• sideroblasts