Hereditary Hemochromatosis and Exacerbation of Psychiatric Manifestations Following Therapeutic Phlebotomy Sessions: A Case Report

Abstract

Hereditary hemochromatosis, characterized by iron overload, is well known for its
systemic effects; however, psychiatric clinical
manifestations are underreported. Previous research
articles discussed the link between excessive iron
accumulation and mood disorders that were resolved
following therapeutic phlebotomy treatment. In this
case study, we presented a unique case that revealed
the emergence of mood disorders following phlebotomy
sessions. Our aim is to explore the relationship between
them.
This case report describes a 24-year-old Caucasian
male who was admitted to the hospital with severe
depression and suicidal ideations along with poor insight
and tangential thought process following a financial
trauma. He was diagnosed with a Major Depressive
Disorder based on the Diagnostic and Statistical Manual
of Mental Disorders, 5th Edition (DSM-V). The patient
reported a diagnosis of hereditary hemochromatosis in
2023 and has received two phlebotomy treatments
since then. After the second phlebotomy session, he
experienced worsening depressive symptoms (passive
suicidal ideations); his blood tests revealed normal iron
and ferritin levels on the 5th day of admission. He had
been taking Escitalopram and Lamotrigine over the past
six months