Pica/Pagophagia-Associated Hyponatremia: Patient Presenting With Seizure

Abstract

Pica is an unusual condition in which patients crave and chew substances with no nutritional value. Ice pica (pagophagia) is commonly seen in patient with iron deficiency. People chew ice cubes or add ice to their drinks to cool or refresh themselves, and they may not consider this as an abnormal behavior. Excessive ice chewing/eating can have significant health risks, including electrolyte abnormalities and metabolic disorders. We report a patient admitted to our hospital with severe hyponatremia and seizures due to iron deficiency-associated pagophagia. Ice pica leading to hyponatremia and seizure is not commonly seen in clinical practice. It was a challenging case and the patient was seen and investigated at outpatient clinic for polyuria, though an underlying cause was not identified. Patients may be secretive or reluctant to mention their pica habit. Studies have also shown that most physicians are unaware of pica and most cases can be easily missed.

The Association Between Pica and Iron-Deficiency Anemia: A Scoping Review

“…The patient was treated with iron supplementation and psychiatric medication and improved significantly. The last manifestation was a patient who presented with seizures due to pica-associated hyponatremia [ 16 ]. All patients who presented with neurological symptoms resolved all symptoms of pica with the treatment of iron deficiency.…”