WESTPORT, CT (Reuters Health) – Pica is highly prevalent in children with sickle cell disease, according to a report in the November issue of the Archives of Pediatric and Adolescent Medicine. In addition, there is a high correlation between pica and lower hemoglobin levels.
Between March 1 and June 30, 1990, Dr. Sharada Sarnaik, of Children's Hospital of Michigan, Detroit, and colleagues reviewed the medial records of 480 patients with sickle cell disease. They excluded patients younger than 3 years and those who had a history of stroke, long-term transfusions, pregnancy or acute illness.
Of the 395 patients who were included in the study, 134 (33.9%) had been diagnosed with pica. The most commonly ingested items were paper, fabric, dirt, foam and powders. The investigators note that 35.6% of patients with the Hb SS sickle cell anemia genotype had pica, compared with 25.5% of the group with Hb SC, Hb SD, or Hb S-beta thalassemia (p = 0.03).
"Within genotype, mean Hb levels were significantly lower and reticulocyte counts were significantly higher in the patients with pica," the team reports.
The mean age of children with pica was significantly lower compared with the other study subjects. However, 23.3% of those between the ages of 10 and 14.9 years had pica, as did 14.8% of those between the ages of 15 and 19 years. The authors note that within age groups, patients with pica weighed significantly less than the others.
"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," Dr. Sarnaik and colleagues say. "The association between pica and low body weight suggests a nutritional effect on its prevalence."
Arch Pediatr Adolesc Med 2001;155:1243-1247
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