PICA AND THE IRON DEFICIENCY ANAEMIA: A CASE SERIES

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, which presented with three different clinical presentations and were found to have iron deficiency anaemia with underlying cause as pica. Case Presentation: We describe three patients who presented with symptoms of pica. The first patient is a 25-year-old man who had obsessive compulsive symptoms associated with daily ingestion of dust,sand and ice. The second patient is a 9-year-old girl who presented with abdominal pain associated with consuming brick remains. Lastly, the third patient, a 19-year-old with mild intellectual disability presented with behavior abnormality and eating cracked cement from walls. All three patients presented with hematological parameters diagnostic for iron deficiency anaemia. Conclusion: Pica has been practiced for centuries without a clear etiology. Clinicians in their practice 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 resolved gradually in these patients upon iron supplementation. 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 consider pica as a differential diagnosis of iron deficiency.