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一种异常的食欲:异食癖病例

A Spongy Appetite: A Case of Pica.

作者信息

Miranda Paulo Inês, Marques Carla, Serra Mariana, Âmbar Botelho Carlota, Alcoforado Ana, Pires Catarina M

机构信息

Family Medicine, Family Health Unit Travessa da Saúde, Local Health Unit São José, Lisbon, PRT.

General Practice, Family Health Unit Travessa da Saúde, Local Health Unit São José, Lisbon, PRT.

出版信息

Cureus. 2024 Aug 7;16(8):e66399. doi: 10.7759/cureus.66399. eCollection 2024 Aug.

DOI:10.7759/cureus.66399
PMID:39246937
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11379449/
Abstract

Pica is an eating disorder defined as the compulsive and repeated ingestion of substances that have no nutritional value for at least one month. This condition may be hard to diagnose without complications, as a high degree of suspicion is needed. The subject in this case was a teenager who presented with asthenia and unspecific abdominal pain. The etiological workup showed no abnormalities other than mild anemia and iron and folate deficiencies. After a thorough anamnesis, the patient's mother mentioned sporadic ingestion of synthetic mattress foam since childhood, which had become more frequent in the previous year. With this key information, it was possible to establish a diagnosis before serious complications occurred and thus help the patient get the necessary assistance by referring them to pediatrics, nutrition, and child and adolescent psychiatry consultations. This case report highlights the importance of a detailed anamnesis, particularly when dealing with unspecific symptoms, exploring the possibility of disorders that are rarely thought of, such as pica. It also recaps how important it is to address sensitive topics like eating disorders and create an open environment with no judgment, as these attitudes are crucial to ensuring the correct diagnosis and providing the best care for patients.

摘要

异食癖是一种进食障碍,定义为强迫性且反复摄入对人体没有营养价值的物质,且这种情况持续至少一个月。若无并发症,这种病症可能难以诊断,因为需要高度怀疑。该病例的患者是一名青少年,表现为乏力和非特异性腹痛。病因检查除轻度贫血以及铁和叶酸缺乏外未发现异常。经过全面问诊,患者母亲提到患者自童年起就偶尔食用合成床垫泡沫,且在前一年变得更加频繁。有了这一关键信息,得以在严重并发症发生前确诊,从而通过将患者转诊至儿科、营养科以及儿童和青少年精神科会诊,帮助患者获得必要的帮助。本病例报告强调了详细问诊的重要性,尤其是在处理非特异性症状时,要探究诸如异食癖等很少被想到的病症的可能性。它还概述了处理进食障碍等敏感话题以及营造一个没有评判的开放环境的重要性,因为这些态度对于确保正确诊断和为患者提供最佳护理至关重要。

相似文献

1
A Spongy Appetite: A Case of Pica.一种异常的食欲:异食癖病例
Cureus. 2024 Aug 7;16(8):e66399. doi: 10.7759/cureus.66399. eCollection 2024 Aug.
2
[Pica: a descriptive study of patients in a speciality medical center].[异食癖:某专科医疗中心患者的描述性研究]
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Folic acid supplementation and malaria susceptibility and severity among people taking antifolate antimalarial drugs in endemic areas.在流行地区,服用抗叶酸抗疟药物的人群中,叶酸补充剂与疟疾易感性和严重程度的关系。
Cochrane Database Syst Rev. 2022 Feb 1;2(2022):CD014217. doi: 10.1002/14651858.CD014217.
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PICA.异食癖
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Med Sante Trop. 2015 Jul-Sep;25(3):273-5. doi: 10.1684/mst.2013.0199.
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[Pica and iron-deficiency anemia in a 2-year old Indian child].[一名2岁印度儿童的异食癖与缺铁性贫血]
Pediatr Med Chir. 2002 Jan-Feb;24(1):67-9.
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A strange type of Pica.一种奇怪的异食癖类型。
J Sci Res Med Sci. 2003 Aug;5(1-2):49-50.
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Sodium chloride pica causing recurrent nephrolithiasis in a patient with iron deficiency anemia: a case report.一例缺铁性贫血患者因食癖摄入氯化钠导致复发性肾结石:病例报告
J Med Case Rep. 2017 Nov 18;11(1):325. doi: 10.1186/s13256-017-1499-5.
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Emergence of pica (ingestion of non-food substances) accompanying iron deficiency anemia after gastric bypass surgery.胃旁路手术后缺铁性贫血伴发异食癖(摄入非食物物质)的出现。
Obes Surg. 2005 Nov-Dec;15(10):1491-5. doi: 10.1381/096089205774859371.

本文引用的文献

1
The Association Between Pica and Iron-Deficiency Anemia: A Scoping Review.异食癖与缺铁性贫血之间的关联:一项范围综述
Cureus. 2023 Apr 20;15(4):e37904. doi: 10.7759/cureus.37904. eCollection 2023 Apr.
2
The Neurology and Psychopathology of Pica.异食癖的神经学与精神病理学
Curr Neurol Neurosci Rep. 2022 Aug;22(8):531-536. doi: 10.1007/s11910-022-01218-2. Epub 2022 Jun 8.
3
Fifteen-minute consultation: the child with pica.15分钟会诊:患有异食癖的儿童
Arch Dis Child Educ Pract Ed. 2017 Oct;102(5):226-229. doi: 10.1136/archdischild-2016-312121. Epub 2017 May 9.
4
Pica: an age-old eating disorder that's often missed.异食癖:一种常被忽视的古老饮食失调症。
J Fam Pract. 2014 Jul;63(7):E1-4.
5
Pica: common but commonly missed.异食癖:常见但常被漏诊。
J Am Board Fam Pract. 2000 Sep-Oct;13(5):353-8.
6
[Iron deficiency and pica].[缺铁与异食癖]
Sangre (Barc). 1998 Feb;43(1):31-4.
7
Pica: its frequency and significance in patients with iron-deficiency anemia due to chronic gastrointestinal blood loss.异食癖:其在慢性胃肠道失血所致缺铁性贫血患者中的发生率及意义。
J Gen Intern Med. 1989 Nov-Dec;4(6):512-3. doi: 10.1007/BF02599550.