Febrile pancytopenia and psychosis revealing pernicious anemia.

The rare case of a 42-year-old woman of African origin presenting with persecution mania leading to admission to a psychiatric hospital is reported. The outcome was rapidly marked by febrile pancytopenia and ataxia leading to the diagnosis of pernicious anemia. Although the hematologic abnormalities and mania were corrected within 2 weeks under vitamin therapy, neural improvement was slower as observed classically. The literature regarding pancytopenia and psychiatric presentations is briefly reviewed, suggesting that vitamin B(12) deficiency may induce paranoid delusion.