Clozapine Induced Normocytic Anemia: A Rare Case Report

Abstract

Anemia, characterized by a shortage of red blood cells (RBCs) or reduced hemoglobin levels, can result from various factors including deficiencies, chronic diseases, and medication side effects. This case report presents a 40-year-old male with a 5-year history of anxiety and schizophrenia who developed normocytic anemia while on clozapine, an atypical antipsychotic known for its association with agranulocytosis. The patient, referred for anemia workup, exhibited fatigue and exertional dyspnea, with an initial complete blood count revealing normocytic anemia and low reticulocyte count. Investigations ruled out common causes of anemia, including iron and vitamin deficiencies, and a bone marrow biopsy was not performed at the patient's request. Given the suspected link between clozapine and bone marrow suppression, clozapine was discontinued and replaced with quetiapine. Hemoglobin levels normalized within four weeks, confirming clozapine-induced normocytic anemia. This case highlights a rare hematologic side effect of clozapine and underscores the need for further research into its idiosyncratic effects.