Late Onset Psychosis and Beta-thalassemia: is There a Connection?

Abstract

Beta-thalassemia is a monogenic disease caused by mutations in the beta chain of the haemoglobin molecule. It is widespread in many areas of the world and has a large prevalence among Mediterranean populations[1-2]. Furthermore, many studies recently suggested that a gene situated on chromosome 11, proximal to the genes involved in beta-thalassemia, could induce psychosis in predisposed individuals [3]. Several studies have revealed, through the sequencing of chromosome 11, that a possible genetic susceptibility for schizophrenia could be located on the short arm of this chromosome near the gene involved in beta-thalassemia [4-5-6]. In our case report, we describe a late onset of psychosis disorder in a man suffering from beta-thalassemia. Mr. A. is a 35 years old man with a history of major beta-thalassemia treated with transfusion therapy, he is HCV positive. No family history of psychiatric disorders. He has never suffered from any psychiatric disorder until January 2014, when he revealed a psychotic episode characterized by persecution delusions, religious hallucinations, remarkable aggressiveness and absent insight. He was so administrered with Paliperidone Palmitate 100 mg 1 fl 1.m./month, obtaining clinical remission after 5 months. Several studies have assessed the prevalence of depression and axiety in patients with beta thalassemia. Rather few studies have been conducted to assess the comorbidity of psychosis among beta-thalassemia. We have described one rare case in literature that highlights this possible genetic link between these two pathologies. Further studies are needed to better clarify this association.