![]() ![]() These observations suggest that heritable traits could contribute to pica susceptibility in adults with iron deficiency. ![]() Among iron-deficient adults of the same race/ethnicity, some develop pica and others do not. Significant race/ethnicity differences in the prevalence of pica have also been reported in other iron deficiency case series. In a case-control study from France, a logistic regression model demonstrated that iron deficiency and being non-European were significant independent predictors of pica. There are few reports in which observations available at diagnosis of iron deficiency were evaluated using multivariable analyses to identify possible significant differences between persons who did and did not develop pica. Many reports describe substances that patients with iron deficiency consumed in a compulsive manner, and effects of treatment of iron deficiency on pica. Pica items are diverse, and vary according to race/ethnicity, culture, and geographic location. ![]() Individual adults with pica associated with iron deficiency or depletion typically ingest only one or a few substances in a compulsive manner. Physicians of the 19 th C reported that persons with chlorosis (predominantly women) had "various forms of pica or morbid appetite, as for pickles, magnesia, cinders, &c", or "capricious appetite". In the early 15 th C, de Cervantes reported a history in which "women that by caprice eat soil, plaster, coal and other disgusting substances". Hippocrates wrote that "a craving to eat earth" was associated with "corruption of the blood". Pica is a distinctive but poorly understood accompaniment of iron deficiency or depletion in some adults, although most pica items contain little or no iron. Pica is the daily compulsive eating of food or non-food items not part of one's habitual diet or preferences. Predictors of pica in logistic regression analyses were age and MCV (negative associations p = 0.0250 and 0.0018, respectively) and RDW and platelet count (positive associations p = 0.0009 and 0.02215, respectively) the odds ratios of these predictors were low. Nineteen patients developed a second episode of iron deficiency or depletion concordance of recurrent pica (or absence of pica) was 95%. Mean total iron-binding capacity was higher and mean serum ferritin was lower in patients with pica. Thrombocytosis occurred only in women and was more prevalent in those with pica (20.4% vs. Mean hemoglobin and mean corpuscular volume (MCV) were lower and mean red blood cell distribution width (RDW) and platelet count were higher in patients with pica. The prevalence of iron deficiency, with or without anemia, did not differ significantly between patients with and without pica reports. In univariable analyses, patients with pica had lower mean age, black race/ethnicity, and higher prevalences of cardiopulmonary and epithelial manifestations. 118 patients (45.0%) reported pica of these, 87.3% reported ice pica (pagophagia). There were 230 women (184 white, 46 black ages 19-91 y) and 32 men (31 white, 1 black ages 24-81 y). ![]()
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