Pyruvate kinase (PK) deficiency is a rare, hereditary disease caused by mutations in the PKLR gene that result in chronic hemolytic anemia, ineffective erythropoiesis, and serious complications including iron overload, regardless of age, genotype, or transfusion history.1, 2, 3, 4, 5, 6 Dyserythropoietic features, including key markers associated with iron homeostasis, have been observed in PK deficiency.7 Here, PKLR is linked to pyruvate kinase deficiency of red cells.