Low plasma zinc and iron in pica

Singhi, Sunit; Ravishanker, R.; Singhi, Pratibha; Nath, R.

doi:10.1007/bf02723740

Cited by 42 publications

(23 citation statements)

References 27 publications

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“…The elimination of symptoms and signs of pica in our patient after IDA treatment emphasizes the strong relation between pica and IDA, and more specifically confirms the causative role of IDA in pica development [8,9].…”

Section: Sirsupporting

confidence: 75%

“…[6]. Usually, radiologic tests can provide accurate diagnosis preoperatively; however, in our case radiologic examination failed to set the diagnosis [7].The elimination of symptoms and signs of pica in our patient after IDA treatment emphasizes the strong relation between pica and IDA, and more specifically confirms the causative role of IDA in pica development [8,9]. References 1.…”

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confidence: 78%

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Pica: An Uncommon Cause of Acute Abdominal Pain in Children

et al. 2011

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Sir,We read with considerable interest the excellent review article by Yadav and Chandra [1], which refers to the effects of iron deficiency on tissues, organs and systems. As authors mention, pica represents one of the well-defined clinical manifestations of iron deficiency anemia (IDA). Their relation is widely recognized and most studies suggest that pica is a reversible manifestation of iron deficiency state [1,2]. We would like to enhance the knowledge of pica by presenting a relative rare case report.A 14-year-old girl was admitted to our department suffering from acute abdominal pain, mimicking acute appendicitis. Laboratory tests showed polymorphonuclear leucocytosis and anemia (Hb 7.4 g/dl). The other erythrocyte markers were also indicative of iron deficiency anemia and serum iron level was low (15 μg/dl). Imaging tests of the abdomen were unremarkable.Based on her clinical presentation, the patient was transferred to the operating room. Through McBurney incision, the right lower quadrant of the abdomen was accessed and the appendix was found with no signs of inflammation. Ovaries and fallopian tubes were unremarkable. Exploration of the ileum revealed the presence of multiple, soft and pliable masses into its lumen. With kind manipulation, these masses easily passed through the ileocecal valve to the cecum. The diagnosis of bezoar was suspected and the operation was completed with appendicectomy.A thorough past medical history, obtained postoperatively, revealed patient's abnormal eating habit of consuming clay, ice and wall dust. This finding in association with IDA set the diagnosis of pica. Post-operative course was uneventful and the patient was discharged from the hospital receiving ferrum supplementation therapy. Six months after the operation, the levels of Hb and serum iron were normalized and the patient did not experience any pica symptoms.Pica has been observed in men and women of all ages and ethnicity. Interestingly, it represents a quite common manifestation of IDA, occurring in up to 58% of these patients [2,3]. Patients with pica may present with a variety of clinical manifestations, associated with the specific nature of the ingested substances and the subsequent medical consequences [4,5].Though acute abdomen due to pica is not uncommon in mentally-disabled patients, its incidence in mentally-healthy individuals, like our patient, is quite rare. [6]. Usually, radiologic tests can provide accurate diagnosis preoperatively; however, in our case radiologic examination failed to set the diagnosis [7].The elimination of symptoms and signs of pica in our patient after IDA treatment emphasizes the strong relation between pica and IDA, and more specifically confirms the causative role of IDA in pica development [8,9]. References 1. Yadav D, Chandra J. Iron deficiency: beyond anemia. Indian J Pediatr. 2011;78:65-72. 2. Mark AM. "Tomatophagia" and iron-deficiency anemia. NEJM.

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confidence: 75%

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confidence: 78%

Pica: An Uncommon Cause of Acute Abdominal Pain in Children

et al. 2011

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“…Zinc (Zn) deficiency in humans has been found in infants, preschool children, and schoolchildren [11]. Zinc deficiency associates with Fe deficiency anemia in areas where Fe deficiency is a problem [12].…”

Section: Introductionmentioning

confidence: 99%

Evaluation of Status of Trace and Toxic Metals in Biological Samples (Scalp Hair, Blood, and Urine) of Normal and Anemic Children of Two Age Groups

Shah

Kazi

Afridi

et al. 2010

Biol Trace Elem Res

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Anemia affects a substantial portion of the world's population, provoking severe health problems as well as important economic losses to the region in which this condition is found. This study was designed to compare the levels of essential trace and toxic elements in scalp hair, blood, and urine samples of anemic children (n = 132) with age range 1-5 and 6-10 years of both genders. For a comparative study, 134 non-anemic age- and sex-matched children as control subjects, residing in the same city, were selected. The metals in the biological samples were measured by flame atomic absorption spectrophotometry/electrothermal atomic absorption spectrometry prior to microwave-assisted acid digestion. The proposed method was validated using certified reference samples of hair, blood, and urine. The results indicated significantly lower levels of iron, copper, and zinc in the biological samples as compared to the control children of both genders (p = 0.01-0.008). The mean values of lead and cadmium were significantly high in all three biological samples of anemic children as compared to non-anemic children of both age groups (p = 0.005-0.001). The ratios of essential metal to toxic metals in the biological samples of anemic children of both age groups were significantly lower than that of controls. Deficiency of essential trace metals and high level of toxic metals may play a role in the development of anemia in the subjects under study.

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“…The association of pica with iron deficiency is well documented in literature [24,25]. Singhi et al studied 50 children with iron deficiency anemia with pica and found that the plasma iron level (mean ± SD) in children with pica (42.7 ± 9.2 mg/dl) was about 20% lower than that in controls (51.5 ± 10.0 mg/dl, P value \ 0.001) [26].…”

Section: Discussionmentioning

confidence: 92%

Iron Profile in Children with Behavioural Disorders: A Prospective Study in a Tertiary Care Hospital in North India

Mahajan

Sikka

Rusia

et al. 2011

Indian J Hematol Blood Transfus

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Iron deficiency anemia is the most frequent micronutrient deficiency in the developing countries like India especially affecting pregnant women and young children. Iron is an essential element involved in myelin formation, neurotransmitter synthesis and neuro-metabolism. Several behavioural disturbances have been reported in iron deficient children. In the present study, we determined the prevalence of iron deficiency anemia in children with behavioural disorders and assessed the improvement in terms of symptoms (by child behaviour check list), haematological parameters and iron status after treatment with oral iron. In this prospective study, 44 children in the age group of 3-12 years who were diagnosed with behavioural disorders were evaluated. Complete blood counts using automated hematology analyzer and iron parameters (serum iron, total iron binding capacity, % transferrin saturation and serum ferritin) were measured in all the patients to assess the prevalence of iron deficiency in these children. Thirty age matched controls were also studied. Iron deficiency was found in 32 (73%) children, as assessed by transferrin saturation \16% and/or serum ferritin \16 lg/l. Following treatment with iron for 100 ± 10 days, there was a statistically (P B 0.05) significant improvement in the clinical features, haematological profile and iron status. The presence of iron deficiency in children with behavioural disorders and subsequent improvement in clinical features, haematological profile and iron status suggests a possible causal relationship between iron deficiency and behavioural disorders.

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Low plasma zinc and iron in pica

Abstract: These findings suggest that hypozincemia with low iron levels may be the possible cause of pica and contradict the contention that low levels of plasma Zn and Fe could be an effect of pica.

Cited by 42 publications

References 27 publications

Pica: An Uncommon Cause of Acute Abdominal Pain in Children

Pica: An Uncommon Cause of Acute Abdominal Pain in Children

Evaluation of Status of Trace and Toxic Metals in Biological Samples (Scalp Hair, Blood, and Urine) of Normal and Anemic Children of Two Age Groups

Iron Profile in Children with Behavioural Disorders: A Prospective Study in a Tertiary Care Hospital in North India

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