pica and Hemoglobin-SC-Disease

We report three cases of pica for foam rubber among sickle cell disease patients. All three were African-American males, and at the times of initial presentation for the pica, two of them were 11 years of age and one was 15 years of age. In all cases, the pica reportedly had been occurring for at least several years. The foam rubber was most often obtained from furniture and mattresses, as well as from ironing-board pads, stereo speakers, and padded hair rollers. Reports from other researchers also suggest that this is not an uncommon type of pica. We discuss this problem from biologic, psychologic, and social perspectives.

Topics: Adolescent; Anemia, Sickle Cell; Child; Hemoglobin SC Disease; Humans; Interior Design and Furnishings; Male; Pica; Rubber

To determine the prevalence of pica and its characteristics among children with sickle cell disease.. Retrospective, observational study.. An urban, ambulatory care, interdisciplinary center.. The medical records of all 480 patients who visited the center from March 1, 1998, to June 30, 1999, were reviewed. Patients were excluded for history of stroke, long-term transfusions, pregnancy, acute illness, or age younger than 3 years.. Sex, age, weight, height, Tanner stage, complete blood cell count, sickle cell genotype, pica history, and levels of iron, zinc, lead, and fetal hemoglobin (Hb).. Of 395 study patients, 134 (33.9%) reported pica. Ingested items included paper, foam, and powders. There was a significantly higher prevalence of pica among patients homozygous for Hb S (Hb SS, sickle cell anemia) compared with the combined group of double heterozygous patients with Hb SC, Hb SD, and Hb Sbeta thallasemia (Sbeta(+)or Sbeta(0)) (35.6% vs 25.5%; P =.03). Within genotype, mean Hb levels were significantly lower and reticulocyte counts were significantly higher in the patients with pica. Overall, the mean age of patients with pica was significantly lower; however, the prevalence was 23.3% (27/116) among those aged 10.0 to 14.9 years and 14.8% (8/54) among those aged 15.0 to 19.0 years. Within age groups, patients with pica weighed significantly less.. Pica appeared to have an unusually high prevalence in patients with sickle cell disease and a correlation with lower Hb levels. It is unclear whether pica is a specific marker of disease severity, because our review did not show a relationship to increased number and duration of hospitalizations. The association between pica and low body weight suggests a nutritional effect on its prevalence.

Topics: Adolescent; Adult; Child; Child, Preschool; Comorbidity; Female; Hemoglobin SC Disease; Hemoglobins; Humans; Male; Pica; Prevalence; Retrospective Studies

Topics: Ascariasis; Child, Preschool; Diagnosis, Differential; Hemoglobin SC Disease; Humans; Lead Poisoning; Male; Pica; Toxocariasis