Iron studies for sideroblastic anemia (vs hemochromatosis)

[ChessMaster3000]

Is there any way to distinguish sideroblastic anemia from hemochromatosis on iron studies alone? I think in sideroblastic, TIBC could be normal at first but as iron starts to build up it will go down. That might be the only difference (with TIBC down in hemochromatosis at the time of presentation)

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[acciddropping]

Is there any way to distinguish sideroblastic anemia from hemochromatosis on iron studies alone? I think in sideroblastic, TIBC could be normal at first but as iron starts to build up it will go down. That might be the only difference (with TIBC down in hemochromatosis at the time of presentation)

In hemochromatosis, the driving force is an increased serum Fe. In sideroblastic anemia, the driving force may be from an increased Ferratin (as Fe+ overloaded mitochondria will be lysed and release Fe to be stored in bone marrow macrophages; increase in iron store will need less transferrin, low TIBC). So, I can see TIBC being normal at the beginning while mitochordia sucking up all the Fe.