Giudicelli J, Combes J C
Service de Pédiatrie (Unité d'Adolescents), Centre Hospitalier Départemental Félix-Guyon, Saint-Denis.
Arch Fr Pediatr. 1992 Nov;49(9):779-83.
Pica is a habit disorder involving the compulsive, irrational ingestion of nutrient or non-nutrient substances which usually, in young infants, include clay and earth. Pica is rare in adolescents but is more likely to occur in subjects with severe iron deficiency.
17 (16 girls, 1 boy) cases of pica were recognized over a period of 4 years in an adolescent unit. 15 of the cases presented with anemia and/or iron deficiency. Hematological and biochemical investigations included measurements of hemoglobin content, MCV, serum iron and ferritin, transferrin saturation and serum iron-binding capacity. Blood loss was considered as a possible cause in all patients.
13 of the patients ingested large amounts of raw rice and 11 ingested ice cubes; 10 patients ingested both substances. Their mean serum ferritin was 7.17 ng/ml and the mean hemoglobin was 8.7 g/dl. One out of 7 patients showed intestinal blood loss. Excessive menstrual bleeding occurred in 8 girls. All patients were treated with adequate amounts of iron. Pica disappeared within a few weeks, although biochemical evidence of iron deficiency persisted in some patients. In one case, pica persisted despite correction of the iron deficiency.
Pica is more prevalent in lower socio-economic classes and in some areas, such as the island of Reunion. It may be masked, and must be looked for in adolescents presenting with signs of iron deficiency. Treatment of the iron deficiency is usually followed by its disappearance.
异食癖是一种行为障碍，表现为强迫性、非理性地摄入营养或非营养物质，在幼儿中通常包括黏土和泥土。异食癖在青少年中较为罕见，但更易发生于严重缺铁的人群。
在一个青少年病房的4年时间里共确诊了17例（16名女孩，1名男孩）异食癖患者。其中15例伴有贫血和/或缺铁。血液学和生化检查包括血红蛋白含量、平均红细胞体积、血清铁和铁蛋白、转铁蛋白饱和度及血清铁结合能力的测定。所有患者均考虑失血可能是病因之一。
13例患者大量食用生米，11例食用冰块；10例患者两种物质都食用。他们的平均血清铁蛋白为7.17 ng/ml，平均血红蛋白为8.7 g/dl。7例患者中有1例出现肠道失血。8名女孩有月经过多现象。所有患者均接受了足量的铁剂治疗。异食癖在几周内消失，尽管部分患者仍有缺铁的生化证据。有1例患者尽管缺铁已得到纠正，但异食癖仍持续存在。
异食癖在社会经济地位较低的阶层以及某些地区（如留尼汪岛）更为普遍。它可能被掩盖，在有缺铁迹象的青少年中必须加以排查。缺铁得到治疗后，异食癖通常会消失。
