title: Characterization of pica prevalence among patients with sickle cell disease.
abstract: OBJECTIVE
  To determine the prevalence of pica and its characteristics among children with sickle cell disease.
  
  
  METHODS
  Retrospective, observational study.
  
  
  METHODS
  An urban, ambulatory care, interdisciplinary center.
  
  
  METHODS
  The medical records of all 480 patients who visited the center from March 1, 1998, to June 30, 1999, were reviewed. Patients were excluded for history of stroke, long-term transfusions, pregnancy, acute illness, or age younger than 3 years.
  
  
  METHODS
  Sex, age, weight, height, Tanner stage, complete blood cell count, sickle cell genotype, pica history, and levels of iron, zinc, lead, and fetal hemoglobin (Hb).
  
  
  RESULTS
  Of 395 study patients, 134 (33.9%) reported pica. Ingested items included paper, foam, and powders. There was a significantly higher prevalence of pica among patients homozygous for Hb S (Hb SS, sickle cell anemia) compared with the combined group of double heterozygous patients with Hb SC, Hb SD, and Hb Sbeta thallasemia (Sbeta(+)or Sbeta(0)) (35.6% vs 25.5%; P =.03). Within genotype, mean Hb levels were significantly lower and reticulocyte counts were significantly higher in the patients with pica. Overall, the mean age of patients with pica was significantly lower; however, the prevalence was 23.3% (27/116) among those aged 10.0 to 14.9 years and 14.8% (8/54) among those aged 15.0 to 19.0 years. Within age groups, patients with pica weighed significantly less.
  
  
  CONCLUSIONS
  Pica appeared to have an unusually high prevalence in patients with sickle cell disease and a correlation with lower Hb levels. 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. The association between pica and low body weight suggests a nutritional effect on its prevalence.
authors.affiliation: Sickle Cell Center, Children's Hospital of Michigan, 3901 Beaubien, Detroit, MI 48201, USA.
authors.forename: N S
authors.initials: NS
authors.lastname: Ivascu
authors.forename: S
authors.initials: S
authors.lastname: Sarnaik
authors.forename: J
authors.initials: J
authors.lastname: McCrae
authors.forename: W
authors.initials: W
authors.lastname: Whitten-Shurney
authors.forename: R
authors.initials: R
authors.lastname: Thomas
authors.forename: S
authors.initials: S
authors.lastname: Bond
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D015897:Comorbidity; D005260:Female; D006450:Hemoglobin SC Disease / Q000097:blood / Q000453:epidemiology*; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D008297:Male; D010842:Pica / Q000097:blood / Q000453:epidemiology*; D015995:Prevalence; D012189:Retrospective Studies
chemical_list: D006454:Hemoglobins