Iron deficiency anaemia and pica.

Pica was a surprise finding in 8 cases of severe iron deficiency anaemia of unknown cause and 2 patients with pregnancy-related anaemia who had a mixed picture of iron deficiency and megaloblastic features owing to folic acid deficiency. The pica cases demonstrated an apparently consistent pattern: severe anaemia, young age, normal psychiatric assessment, good nutrition and lack of an overtly disadvantaged background. Pica was significantly absent in other forms of anaemia in a series of 53 subjects. The literature is briefly reviewed to highlight the unanswered questions about this disorder. The cases reported do not furnish any clues to the enigma of pica, but reveal an obscure form of idiopathic iron deficiency anaemia. Pica may be commoner than is thought.