pica and Polycythemia-Vera

In order to examine whether symptoms of iron deficiency anemia are due to the iron deficiency itself or the associated anemia, 34 patients with polycytemia vera (PV) treated with venesectio, who had iron deficiency but normal hemoglobin (Hb) levels, were given a questionnaire covering symptoms of iron deficiency including the international RLS-scale and the Fact-fatigue quality of life scale (QoL). We found a prevalence of pica of 11.7%, mouth paresthesias of 5.8% and rest-less legs 29.6% (RLS "normal" prevalence 10%). Thus, the prevalence of RLS is significantly higher in our population. We also saw a significant difference in QoL between patients with and without RLS (P = 0.015) and QoL correlated with the severity of RLS (R = 0.85). In conclusion, RLS seems to be a frequent and serious problem for PV patients treated with venesectio according to standard guidelines.

Topics: Anemia, Iron-Deficiency; Health Surveys; Humans; Iron Deficiencies; Mouth; Paresthesia; Phlebotomy; Pica; Polycythemia Vera; Prevalence; Quality of Life; Restless Legs Syndrome; Surveys and Questionnaires

Generalized or localized itch without primary skin manifestations may be the presenting symptom of serious internal diseases. Five characteristic cases of pruritus are discussed: Hodgkin's disease, primary sclerosing cholangitis, polycythemia vera, iron deficiency (with pica), and uremia. Other important causes must be considered; all forms of cholestasis, including primary biliary cirrhosis, drug-induced, pregnancy-related, and extrahepatic cholestasis; other hematologic and malignant disorders such as non-Hodgkin's lymphoma, leukemia, multiple myeloma, solid tumors, and myelodysplastic syndromes; metabolic and endocrine diseases, most notably diabetes mellitus, hyperthyroidism, hypothyroidism, and carcinoid syndrome; focal neurologic diseases such as brain tumors, cerebral infarctions and multiple sclerosis; adverse drug reactions without rash; infectious diseases, especially parasitic and HIV infections. A diagnostic laboratory screening for pruritus of undetermined origin is suggested.

Topics: Adult; Aged; Anemia, Iron-Deficiency; Cholangitis, Sclerosing; Diagnosis, Differential; Female; Hematologic Diseases; Hodgkin Disease; Humans; Liver Diseases; Male; Metabolic Diseases; Middle Aged; Pica; Polycythemia Vera; Pruritus; Uremia

Topics: Aged; Anemia, Hypochromic; Animals; Bloodletting; Child; Deglutition Disorders; Exercise Test; Female; Heart; Hematocrit; Humans; Male; Middle Aged; Neuromuscular Diseases; Pica; Platelet Count; Polycythemia Vera; Pruritus; Rats