Polipica durante el embarazo: geofagia asociada al consumo de tiza y pagofagia a la ingesta de jabón / Polypica during pregnancy: geophagia associated to chalk consumption and pagophagia simultaneous to soap intake

La polipica es un trastorno que se manifiesta por el consumo persistente de dos o más sustancias no nutritivas. Se describen dos casos de puérperas que presentaron este hábito durante el embarazo, una refiere el consumo diario de tierra y tiza; la otra gestante manifiesta la ingesta diaria de hielo junto con el consumo de jabón con una frecuencia 1 vez a la semana. Ambas mujeres presentaron antecedentes familiares para el trastorno. La evaluación antropométrica fue adecuada tanto para las gestantes como para los neonatos, no obstante en las mujeres la ingesta de hierro resultó deficiente y los parámetros bioquímicos revelaron anemia ferropénica.

Polypica is a disorder that manifests itself through the persistent consumption of two or more non-nutritious substances. Two cases were reported regarding puerperal women who presented the habit during pregnancy, one of them referred due to her daily consumption of earth and chalk and the other gestating woman because she revealed the daily intake of ice together with soap consumption with a frequency of one time a week. Both women had family backgrounds for the disorder. The anthropometric evaluation was adequate both for pregnant women and neonates; however, iron intake was deficient for women and biochemical parameters revealed iron deficiency anemia.

Low plasma zinc and iron in pica.

OBJECTIVE: To determine role of trace elements in causation of pica with specific reference to zinc and iron we studied plasma levels of iron (Fe), Zinc (Zn), calcium (Ca) and magnesium (Mg) and blood lead (Pb) levels by atomic absorption spectrophotometer in 31 children with pica (Pica Group) and 60 controls matched for age, sex and nutrition (Control Group) in an observational case and control study in the settings of outpatient clinic of a tertiary care, teaching hospital. METHODS: Data from each group were further stratified by hemoglobin level <9 and >9 g/dl into two subgroups pica-1 and pica-2, and control-1 and control-2 respectively, to control for confounding effect of iron deficiency anemia. RESULTS: The plasma Fe level (mean +/- SD) in children with pica (42.7 +/- 9.2) mg/dl) was about 20% lower than that in controls (51.5 +/- 10.0 mg/dl, p < 0.001). Plasma Zn levels in the pica group (60 +/- 4.4 mg/dl) was about 45% lower than those in controls (110.2 +/- 8.5 mg/dl, p<0.001). Correlation of Zn and Fe levels with pica-related variables such as age at onset, duration and frequency and number of inedible objects ingested was not significant. CONCLUSION: These findings suggest that hypozincemia with low iron levels may be the possible cause of pica and contradict the contention that low levels of plasma Zn and Fe could be an effect of pica.

Blood lead levels of children with pica and surma use.

Blood lead levels of 253 Delhi children were estimated by dithizone method. In 82 (controls) children with no symptoms mean blood lead level was 9.6 micrograms/dl (+/- SD 6.8: median 10 micrograms); only 6 had high levels between 30-33 micrograms/dl. In 88 children with pica, the mean blood lead level was 23.0 micrograms/dl (+/- SD 13.82; median 17 micrograms) which was significantly higher than the control; 26 had high levels between 30-92 micrograms/dl. Sixteen children with pica and surma-use and 46 children suspected of lead poisoning showed lead level patterns like the pica group. However, 21 surma-using children without pica resembled the control group. Children with pica were significantly more anemic than the controls and showed higher prevalence of abdominal-neurological symptoms. Because, in India, blood lead cannot be estimated in most of the hospitals, it is suggested that children with severe pica, anemia, abdominal-neurological symptoms and exposure to surma or lead, be suspected of lead poisoning, kept in lead-free environment with corrected nutrition, and be given a short cautious therapeutic trial with oral penicillamine.