Pica associated with iron deficiency or depletion: clinical and laboratory correlates in 262 non-pregnant adult outpatients

BMC Hematology

Research Article

J Clayborn Barton¹  Luigi F Bertoli²  James C Barton³ 

[1] Southern Iron Disorders Center, Birmingham, Alabama, USA;Southern Iron Disorders Center, Birmingham, Alabama, USA;Department of Medicine, Brookwood Medical Center, BirminghamAlabama, USA;Brookwood Biomedical, Birmingham, Alabama, USA;Southern Iron Disorders Center, Birmingham, Alabama, USA;Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA;Department of Medicine, Brookwood Medical Center, BirminghamAlabama, USA;

关键词: Iron Deficiency;    Serum Ferritin;    Mean Corpuscular Volume;    Iron Depletion;    Gastrointestinal Blood Loss;   

DOI  :  10.1186/1471-2326-10-9

 received in 2010-04-26, accepted in 2010-12-22,  发布年份 2010

来源: Springer

【 摘 要 】

BackgroundThere are many descriptions of the association of pica with iron deficiency in adults, but there are few reports in which observations available at diagnosis of iron deficiency were analyzed using multivariable techniques to identify significant predictors of pica. We sought to identify clinical and laboratory correlates of pica in adults with iron deficiency or depletion using univariable and stepwise forward logistic regression analyses.MethodsWe reviewed charts of 262 non-pregnant adult outpatients (ages ≥18 y) who required treatment with intravenous iron dextran. We tabulated their sex, age, race/ethnicity, body mass index, symptoms and causes of iron deficiency or depletion, serum iron and complete blood count measures, and other conditions at diagnosis before intravenous iron dextran was administered. We excluded patients with serum creatinine >133 μmol/L or disorders that could affect erythrocyte or iron measures. Iron deficiency was defined as both SF <45 pmol/L and TS <10%. Iron depletion was defined as serum ferritin (SF) <112 pmol/L. We performed univariable comparisons and stepwise forward logistic regression analyses to identify significant correlates of pica.ResultsThere were 230 women (184 white, 46 black; ages 19-91 y) and 32 men (31 white, 1 black; ages 24-81 y). 118 patients (45.0%) reported pica; of these, 87.3% reported ice pica (pagophagia). In univariable analyses, patients with pica had lower mean age, black race/ethnicity, and higher prevalences of cardiopulmonary and epithelial manifestations. The prevalence of iron deficiency, with or without anemia, did not differ significantly between patients with and without pica reports. Mean hemoglobin and mean corpuscular volume (MCV) were lower and mean red blood cell distribution width (RDW) and platelet count were higher in patients with pica. Thrombocytosis occurred only in women and was more prevalent in those with pica (20.4% vs. 8.3%; p = 0.0050). Mean total iron-binding capacity was higher and mean serum ferritin was lower in patients with pica. Nineteen patients developed a second episode of iron deficiency or depletion; concordance of recurrent pica (or absence of pica) was 95%. Predictors of pica in logistic regression analyses were age and MCV (negative associations; p = 0.0250 and 0.0018, respectively) and RDW and platelet count (positive associations; p = 0.0009 and 0.02215, respectively); the odds ratios of these predictors were low.ConclusionsIn non-pregnant adult patients with iron deficiency or depletion, lower age is a significant predictor of pica. Patients with pica have lower MCV, higher RDW, and higher platelet counts than patients without pica.

【 授权许可】

CC BY   
© Barton et al; licensee BioMed Central Ltd. 2010