Striking dysplastic changes in erythroblasts included aberrant erythroblasts in bone marrow and destruction of RBCs in the peripheral circulation.5,12 CDA types I, II, and III were originally defined according to distinctive morphologic features of erythroblasts in bone marrow in the 1960s,13 although the three types of CDA present with a common process of ineffective erythropoiesis and peripheral hemolysis simultaneously. This evidence concerns the gene CDA and congenital dyserythropoietic anemia.