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● Diagnostic approach
The multisystemic lens provides a systematic approach to considering a multisystemic medical condition as the underlying cause of psychosis (without delirium) when abnormalities involving more than one non-CNS organ system are identified. In this case, there are findings pointing towards gastrointestinal and haematologic involvement. Consideration of conditions that can present with this combination of organ-system involvement leads towards the correct diagnosis. And in addition to this methodical approach, the combination of a smooth, inflamed tongue, macrocytic anaemia and sensory abnormalities provides a recognizable clinical pattern.
● Explore the relevant diagnostic clues
The combination of gastrointestinal and hematologic involvement ➚
Scroll further down to see the answer to today's diagnostic challenge.
● Today's answer
Vitamin B12 deficiency
Vitamin B12 deficiency can cause haematological, gastrointestinal and neurological manifestations and may be associated with psychosis. Features include macrocytic anaemia, glossitis and peripheral sensory disturbances.