Pica and refractory iron deficiency anaemia: a case report.
BACKGROUND
Iron deficiency is the most common cause of anaemia worldwide. Pica, the ingestion of substances that are inappropriate for consumption, is associated with iron deficiency and may be under-diagnosed.


METHODS
A 34-year-old woman presented with iron deficiency anaemia refractory to treatment for more than a decade. The clinical presentation, endoscopic findings and laboratory investigations were consistent with pica. Subsequent geophysical analysis confirmed that the ingested material was kaolin, a negatively charged silicate.


CONCLUSIONS
Prolonged unexplained iron deficiency anaemia should prompt clinicians to remember and inquire about pica. In our patient, this would have averted numerous unnecessary investigations and prevented a decade-long suffering.
Medical Outpatient Department, University Hospital Basel, Petersgraben, Basel, Switzerland. christophe.vongarnier@insel.ch
Christophe
C
von Garnier
Holger
H
Stünitz
Michael
M
Decker
Edouard
E
Battegay
Andreas
A
Zeller