ABSTRACT
The relationship between pagophagia (ice pica) and iron deficiency anemia was studied. All 81 patients with iron deficiency anemia defined as hemoglobin <12.0 g/dl and ferritin level <12 ng/ml were interviewed about their habits of eating ice or other non-food substances. Pagophagia was defined as compulsive and repeated ingestion of at least one tray of ice or ice eating which was relieved after iron administration. Pagophagia was present in 13 patients (16.0%). All patients who received oral iron were periodically assessed employing a questionnaire on pagophagia and laboratory data. Iron therapy can cure the pagophagia earlier than hemoglobin recovery and repair of tissue iron deficiency. Although the pathogenesis of pagophagia is unclear, a biochemical approach involving the central nervous system might elucidate the mechanism underlying these abnormal behaviors.
Subject(s)
Anemia, Iron-Deficiency/complications , Ice , Pica/etiology , Adult , Aged , Anemia, Iron-Deficiency/blood , Anemia, Iron-Deficiency/diagnosis , Anemia, Iron-Deficiency/drug therapy , Biomarkers/blood , Biomarkers/metabolism , Cholestyramine Resin , Female , Ferritins/blood , Hemoglobins/metabolism , Humans , Japan/epidemiology , Male , Pica/drug therapy , Pica/epidemiology , PrevalenceABSTRACT
A 68-year-old man was admitted for bleeding tendency and generalized lymphadenopathy. A diagnosis of idiopathic thrombocytopenic purpura (ITP) associated with mantle cell lymphoma was made. The anti-CD20 monoclonal antibody rituximab 375 mg/m2 was given intravenously once weekly for four consecutive weeks. The patient's platelet counts increased gradually from 0.6 x 10(4)/microliter to 5.8 x 10(4)/microliter. At eighteen weeks after discontinuation of rituximab medication, his platelet count increased again to 10. 3 x 10(4)/microliter and this value has been sustained up to the time of writing. This suggests that rituximab is useful in the treatment of ITP associated with malignant lymphoma.
