Background: There are many descriptions of the association of pica with iron deficiency in adults, but there are\r\nfew reports in which observations available at diagnosis of iron deficiency were analyzed using multivariable\r\ntechniques to identify significant predictors of pica. We sought to identify clinical and laboratory correlates of pica\r\nin adults with iron deficiency or depletion using univariable and stepwise forward logistic regression analyses.\r\nMethods: We reviewed charts of 262 non-pregnant adult outpatients (ages =18 y) who required treatment with\r\nintravenous iron dextran. We tabulated their sex, age, race/ethnicity, body mass index, symptoms and causes of\r\niron deficiency or depletion, serum iron and complete blood count measures, and other conditions at diagnosis\r\nbefore intravenous iron dextran was administered. We excluded patients with serum creatinine >133 �µmol/L or\r\ndisorders that could affect erythrocyte or iron measures. Iron deficiency was defined as both SF <45 pmol/L and TS\r\n<10%. Iron depletion was defined as serum ferritin (SF) <112 pmol/L. We performed univariable comparisons and\r\nstepwise forward logistic regression analyses to identify significant correlates of pica.\r\nResults: There were 230 women (184 white, 46 black; ages 19-91 y) and 32 men (31 white, 1 black; ages 24-81 y).\r\n118 patients (45.0%) reported pica; of these, 87.3% reported ice pica (pagophagia). In univariable analyses, patients\r\nwith pica had lower mean age, black race/ethnicity, and higher prevalences of cardiopulmonary and epithelial\r\nmanifestations. The prevalence of iron deficiency, with or without anemia, did not differ significantly between\r\npatients with and without pica reports. Mean hemoglobin and mean corpuscular volume (MCV) were lower and\r\nmean red blood cell distribution width (RDW) and platelet count were higher in patients with pica. Thrombocytosis\r\noccurred only in women and was more prevalent in those with pica (20.4% vs. 8.3%; p = 0.0050). Mean total ironbinding\r\ncapacity was higher and mean serum ferritin was lower in patients with pica. Nineteen patients developed\r\na second episode of iron deficiency or depletion; concordance of recurrent pica (or absence of pica) was 95%.\r\nPredictors of pica in logistic regression analyses were age and MCV (negative associations; p = 0.0250 and 0.0018,\r\nrespectively) and RDW and platelet count (positive associations; p = 0.0009 and 0.02215, respectively); the odds\r\nratios of these predictors were low.\r\nConclusions: In non-pregnant adult patients with iron deficiency or depletion, lower age is a significant predictor\r\nof pica. Patients with pica have lower MCV, higher RDW, and higher platelet counts than patients without pica.
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