So, apparently (according to my paramedic book) anemic people develop Pika due to their anemia. I know several anemic people and have NEVER heard of them chewing on ice or anything like that. Is this with severe cases or is this just one of those nuggets you read in the book but discard due to it's rare nature?
Anemia
- Thread starter rmena
- Start date
- 2,735
- 1,272
- 113
That's not definitive. It's one of the speculated causes of pica, but it doesn't explain the affinity towards ice chips at all. As you mention, it's certainly not universal amongst anemic patients either.
VFlutter
Flight Nurse
- 3,728
- 1,264
- 113
Pica is a psychological disorder. One theory is that a person with Pica is eating something containing whatever mineral they are deficient in however it rarely works out that way. Many patients with Pica eat material that is entirely non-nutritious, and does not correlate with any deficiency, which is entirely psychological not physiological. But anemia does not cause Pica.
Anecdotally, I see at least 2-3 patients a week that are anemic both chronically and acutely, and I have never seen a patient with Pica.
The association between eating ice chips and iron deficient anemia is something that is taught. But, in 2 years of medical school, Fe deficient anemia (well, anemia in general) is dime-a-dozen and I never encountered any with pica. If I recall, there were some physicians who had encountered this phenomenon (one was an OB/gyn, I think). Part of it could be that we aren't noticing it. Patients eating ice chips is pretty common, so it may not raise any flags to nurses and the docs don't spend enough time with the patient to really observe their activities.
A couple abstracts on the subject that I found:
BMC Blood Disord. 2010 Dec 22;10:9. doi: 10.1186/1471-2326-10-9.
Pica associated with iron deficiency or depletion: clinical and laboratory correlates in 262 non-pregnant adult outpatients.
Barton JC1, Barton JC, Bertoli LF.
BACKGROUND:
There are many descriptions of the association of pica with iron deficiency in adults, but there are few reports in which observations available at diagnosis of iron deficiency were analyzed using multivariable techniques to identify significant predictors of pica. We sought to identify clinical and laboratory correlates of pica in adults with iron deficiency or depletion using univariable and stepwise forward logistic regression analyses.
METHODS:
We reviewed charts of 262 non-pregnant adult outpatients (ages ≥18 y) who required treatment with intravenous iron dextran. We tabulated their sex, age, race/ethnicity, body mass index, symptoms and causes of iron deficiency or depletion, serum iron and complete blood count measures, and other conditions at diagnosis before intravenous iron dextran was administered. We excluded patients with serum creatinine >133 μmol/L or disorders that could affect erythrocyte or iron measures. Iron deficiency was defined as both SF <45 pmol/L and TS <10%. Iron depletion was defined as serum ferritin (SF) <112 pmol/L. We performed univariable comparisons and stepwise forward logistic regression analyses to identify significant correlates of pica.
RESULTS:
There were 230 women (184 white, 46 black; ages 19-91 y) and 32 men (31 white, 1 black; ages 24-81 y). 118 patients (45.0%) reported pica; of these, 87.3% reported ice pica (pagophagia). In univariable analyses, patients with pica had lower mean age, black race/ethnicity, and higher prevalences of cardiopulmonary and epithelial manifestations. The prevalence of iron deficiency, with or without anemia, did not differ significantly between patients with and without pica reports. 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. Thrombocytosis occurred only in women and was more prevalent in those with pica (20.4% vs. 8.3%; p = 0.0050). Mean total iron-binding capacity was higher and mean serum ferritin was lower in patients with pica. Nineteen patients developed a second episode of iron deficiency or depletion; concordance of recurrent pica (or absence of pica) was 95%. 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.
CONCLUSIONS:
In non-pregnant adult patients with iron deficiency or depletion, lower age is a significant predictor of pica. Patients with pica have lower MCV, higher RDW, and higher platelet counts than patients without pica.
J Gen Intern Med. 1989 Nov-Dec;4(6):512-3.
Pica: its frequency and significance in patients with iron-deficiency anemia due to chronic gastrointestinal blood loss.
Rector WG Jr.
PURPOSE:
Pica, particularly ice-eating (pagophagia), is a recognized symptom of iron deficiency. The value of pica as a clue to the etiology of blood loss has never been studied.
PATIENT POPULATION:
Fifty-five unselected patients with iron-deficiency anemia due to gastrointestinal blood loss evaluated by a gastroenterology referral service at a city hospital.
RESULTS:
The patients' mean hematocrit was 26 +/- 15% (SD). Thirty two (58%) had pica, and in 28 (88%) it manifested as pagophagia. Pica was present significantly more often in women (19/32, 68%) than in men (9/23, 39%, p less than 0.05). Pica occurred less frequently in patients with malignancy (2/9 vs. 30/46), but this difference was not significant.
CONCLUSION:
Pica, a frequent symptom in patients with iron-deficiency anemia due to gastrointestinal blood loss, particularly women, is not of value in predicting the cause of bleeding.
A couple abstracts on the subject that I found:
BMC Blood Disord. 2010 Dec 22;10:9. doi: 10.1186/1471-2326-10-9.
Pica associated with iron deficiency or depletion: clinical and laboratory correlates in 262 non-pregnant adult outpatients.
Barton JC1, Barton JC, Bertoli LF.
BACKGROUND:
There are many descriptions of the association of pica with iron deficiency in adults, but there are few reports in which observations available at diagnosis of iron deficiency were analyzed using multivariable techniques to identify significant predictors of pica. We sought to identify clinical and laboratory correlates of pica in adults with iron deficiency or depletion using univariable and stepwise forward logistic regression analyses.
METHODS:
We reviewed charts of 262 non-pregnant adult outpatients (ages ≥18 y) who required treatment with intravenous iron dextran. We tabulated their sex, age, race/ethnicity, body mass index, symptoms and causes of iron deficiency or depletion, serum iron and complete blood count measures, and other conditions at diagnosis before intravenous iron dextran was administered. We excluded patients with serum creatinine >133 μmol/L or disorders that could affect erythrocyte or iron measures. Iron deficiency was defined as both SF <45 pmol/L and TS <10%. Iron depletion was defined as serum ferritin (SF) <112 pmol/L. We performed univariable comparisons and stepwise forward logistic regression analyses to identify significant correlates of pica.
RESULTS:
There were 230 women (184 white, 46 black; ages 19-91 y) and 32 men (31 white, 1 black; ages 24-81 y). 118 patients (45.0%) reported pica; of these, 87.3% reported ice pica (pagophagia). In univariable analyses, patients with pica had lower mean age, black race/ethnicity, and higher prevalences of cardiopulmonary and epithelial manifestations. The prevalence of iron deficiency, with or without anemia, did not differ significantly between patients with and without pica reports. 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. Thrombocytosis occurred only in women and was more prevalent in those with pica (20.4% vs. 8.3%; p = 0.0050). Mean total iron-binding capacity was higher and mean serum ferritin was lower in patients with pica. Nineteen patients developed a second episode of iron deficiency or depletion; concordance of recurrent pica (or absence of pica) was 95%. 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.
CONCLUSIONS:
In non-pregnant adult patients with iron deficiency or depletion, lower age is a significant predictor of pica. Patients with pica have lower MCV, higher RDW, and higher platelet counts than patients without pica.
J Gen Intern Med. 1989 Nov-Dec;4(6):512-3.
Pica: its frequency and significance in patients with iron-deficiency anemia due to chronic gastrointestinal blood loss.
Rector WG Jr.
PURPOSE:
Pica, particularly ice-eating (pagophagia), is a recognized symptom of iron deficiency. The value of pica as a clue to the etiology of blood loss has never been studied.
PATIENT POPULATION:
Fifty-five unselected patients with iron-deficiency anemia due to gastrointestinal blood loss evaluated by a gastroenterology referral service at a city hospital.
RESULTS:
The patients' mean hematocrit was 26 +/- 15% (SD). Thirty two (58%) had pica, and in 28 (88%) it manifested as pagophagia. Pica was present significantly more often in women (19/32, 68%) than in men (9/23, 39%, p less than 0.05). Pica occurred less frequently in patients with malignancy (2/9 vs. 30/46), but this difference was not significant.
CONCLUSION:
Pica, a frequent symptom in patients with iron-deficiency anemia due to gastrointestinal blood loss, particularly women, is not of value in predicting the cause of bleeding.
DesertMedic66
Forum Troll
- 11,273
- 3,452
- 113
According to the blood bank I was anemic and was unable to donate blood. Around that time I was constantly eating ice chips. My aunt pointed it out. So now I have more iron in my diet and I don't eat ice chips nearly as much as I used to.
I work at a mental facility where we have an individual with pica. one of our staff was putting his shoes on and noticed he only had one in his room. when asked where the other went he said, "uh oh" And patted his stomach. the dude at an entire freaking shoe! not all at once of course.
Tii
Forum Probie
- 23
- 0
- 0
I am actually anemic and chew on ice chips all the time. My anemia got so bad I had to go for iron infusions.