Pica in iron deficiency: a case series
- PMID: 20226051
- PMCID: PMC2850349
- DOI: 10.1186/1752-1947-4-86
Pica in iron deficiency: a case series
Abstract
Introduction: Pica is an unusual condition where patients develop cravings for non-nutritive substances that can cause significant health risks. We report three patients with pica, two of them showing evolutionary changes associated with pica and the third demonstrating a peculiar nature of pica, which has yet to be reported.
Case presentation: We describe three patients who presented with symptoms of pica. The first patient is a 36-year-old Caucasian woman who had dysfunctional uterine bleeding associated with daily ingestion of two super-sized cups of ice as iced tea. The second patient is a 62-year-old Caucasian man who presented with bleeding from colonic polyps associated with drinking partially frozen bottled water. Lastly, the third patient, a 37-year-old Hispanic woman, presented with dysfunctional uterine bleeding and habitually chewed rubber bands. All three patients presented with hematological parameters diagnostic for iron deficiency anemia.
Conclusion: Pica has been practiced for centuries without a clear etiology. We have noticed that the younger community of academic and community physicians are not aware of the importance of complaints related to pica. None of our patients we describe here, as well as their primary care physicians, were aware of the importance of their pica related symptoms. Pica symptoms abated in one of our patients upon iron supplementation, while the other two are currently under treatment as of this writing. We believe pica is an important sign of iron deficiency that should never be ignored, and the craving for any unusual substance should compel clinicians to search for occult blood loss with secondary iron deficiency.
Similar articles
-
Sodium chloride pica causing recurrent nephrolithiasis in a patient with iron deficiency anemia: a case report.J Med Case Rep. 2017 Nov 18;11(1):325. doi: 10.1186/s13256-017-1499-5. J Med Case Rep. 2017. PMID: 29149910 Free PMC article.
-
A Different Kind of Craving: Incidence and Treatment of Pica After Laparoscopic Roux-en-Y Gastric Bypass.World J Surg. 2017 Sep;41(9):2324-2328. doi: 10.1007/s00268-017-4048-x. World J Surg. 2017. PMID: 28477159
-
[Rapid regression of prolonged pagophagia after treatment of iron deficiency].Presse Med. 2001 Feb 24;30(7):321-3. Presse Med. 2001. PMID: 11262806 French.
-
[Pica in Germany--amylophagia as the etiology of iron deficiency anemia].Z Gastroenterol. 1998 Aug;36(8):635-40. Z Gastroenterol. 1998. PMID: 9773481 Review. German.
-
Pica: A Common Condition that is Commonly Missed - An Update Review.Curr Pediatr Rev. 2019;15(3):164-169. doi: 10.2174/1573396315666190313163530. Curr Pediatr Rev. 2019. PMID: 30868957 Review.
Cited by
-
Ask about ice, then consider iron.J Am Assoc Nurse Pract. 2016 Feb;28(2):116-20. doi: 10.1002/2327-6924.12268. Epub 2015 May 5. J Am Assoc Nurse Pract. 2016. PMID: 25943566 Free PMC article.
-
Pica/Pagophagia-Associated Hyponatremia: Patient Presenting With Seizure.Cureus. 2020 Jul 21;12(7):e9330. doi: 10.7759/cureus.9330. Cureus. 2020. PMID: 32742885 Free PMC article.
-
Intestinal Obstruction due to Colonic Lithobezoar: A Case Report and a Review of the Literature.Case Rep Pediatr. 2013;2013:854975. doi: 10.1155/2013/854975. Epub 2013 Jan 16. Case Rep Pediatr. 2013. PMID: 23424701 Free PMC article.
-
Diagnosis and management of iron deficiency in children with or without anemia: consensus recommendations of the SPOG Pediatric Hematology Working Group.Eur J Pediatr. 2020 Apr;179(4):527-545. doi: 10.1007/s00431-020-03597-5. Epub 2020 Feb 4. Eur J Pediatr. 2020. PMID: 32020331 Review.
-
Surviving Critical Low Hemoglobin Levels and Pica.Cureus. 2023 May 10;15(5):e38812. doi: 10.7759/cureus.38812. eCollection 2023 May. Cureus. 2023. PMID: 37303454 Free PMC article.
References
-
- Grotegut CA, Dandolu V, Katari S, Whiteman VE, Holtzman OG, Teitelman M. Baking soda pica: a case of hypokalemic metabolic alkalosis and rhabdomyolysis in pregnancy. Obstet Gynecol. 2006;107:484–486. - PubMed
-
- Grivetti LE. Culture, diet and nutrition: selected themes and topics. BioScience. 1978;28(3):171–177. doi: 10.2307/1307345. - DOI
LinkOut - more resources
Full Text Sources