Skip to main content
SpringerLink
Log in

Low plasma zinc and iron in pica

  • Original Article
  • Published:
The Indian Journal of Pediatrics Aims and scope Submit manuscript

Abstract

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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Scot C, Datton R. Vegetative disorders. In Behrman RE, Kliegman RM, Jenson HB, eds.Nelson Textbook of Pediatrics, 16th edn. Philadelphia: WB Saunder 2000; 72.

    Google Scholar 

  2. Cooper M. Pica Springfield, Charles C Thomas, 1957.

    Google Scholar 

  3. Barltrop D. Prevalence of pica.Am J Dis CM 1966; 112:116–123.

    CAS  Google Scholar 

  4. Millican FK, Layman EM, Lowrie RS, Takashashi L, Dublin CC. Prevalence of ingestion and mouthing of non-edible substances by children.Clin Proc Child Hosp Wash 1962; 18: 207–214.

    CAS  Google Scholar 

  5. Geissler PB, Mwaniki DL, Thiong’o F, Friis H. Geophagy among school children in western Kenya.Trop Med Int Health 1997; 7:624–630.

    Article  Google Scholar 

  6. Glickman TL, Chaudry IV, Constantino J, Clark FB, Cypess RH, Winslow L. Pica patterns, toxocariasis and elevated blood lead levels in children.Am J Trop Med Hyg 1981; 30: 77–80.

    PubMed  CAS  Google Scholar 

  7. Crosby WH Pica: compulsion caused by iron deficiency.Br J Haematol 1976; 34:341–342.

    PubMed  CAS  Google Scholar 

  8. McGehee FT Jr, Buchanan GR. Trichoghagia and trichobezoar: etiologic role of iron deficiency.J Pediatr 1980; 97: 946–948.

    Article  PubMed  Google Scholar 

  9. Phillips MR, Zaheer S, Drugas GT. Gastric trichobezoar: case report and literature review.Mayo Clin Proc 1998; 7: 653–656.

    Google Scholar 

  10. Gonzaelez JJ, Owens W, Ungaro PC, Werk EE, Hurtz PH. Clay ingestion: a rare cause of hypokalemia.Ann Intern Med 1982; 97:65–66.

    Google Scholar 

  11. Menge H, Lang A, Cuntze H. Pica in Germany-amylophagia as the etiology of iron deficiency anemia.Z Gastroenterol 1998; 8: 635–640.

    Google Scholar 

  12. Jacobziner H. Lead poisoning in childhood: epidemiology, manifestation and prevention.Clin Pediatr 1966; 5:277–286.

    Google Scholar 

  13. Federman DG, Kirsner RS, Federman GS. Pica: are you hungry for the facts ?Conn Med 1997; 4:207–209.

    Google Scholar 

  14. Lanzkowsky P. Investigation into the aetiology and treatment of pica.Arch Dis Child 1959; 34:140–148.

    PubMed  CAS  Google Scholar 

  15. Munoz JA, Marcos J, Risueno CE, de Cos C, Lopez R, Capote FJet al. Iron deficiency and pical.Sangre (Barc) 1988; 43:31–34.

    Google Scholar 

  16. Prasad AS, Miale A, Farid Z, Sansted H, Schuler AR. Zinc metabolism in patients with the syndrome of iron deficiency anemia, hepatosplenomegaly, dwarfism and hypogonadism.J Lab Clin Med 1963; 61: 537–549.

    PubMed  CAS  Google Scholar 

  17. Hambidge MK, Silverman A. Pica with rapid improvement after dietary zinc supplementation.Am J Clin Nutr 1971; 24: 1021–1022.

    Google Scholar 

  18. Singhi S, Singhi P, Adwani CB. Role of psychosocial stress in the etiology of pica.Clin Pediatr 1981; 20: 783–785.

    Article  CAS  Google Scholar 

  19. Bithoney WG, Synder J, Michalek J, Newberger EH. Childhood ingestions as a symptom of family distress.Am J Dis Child 1985; 139:456–459.

    PubMed  CAS  Google Scholar 

  20. Kumar S, Rao KSJ. Plasma and erythrocytic zinc levels in protein caloric malnutrition.Nutr Metabol 1973; 15:364–371.

    CAS  Google Scholar 

  21. Nath R. Proceedings of integrated programme on heavy metals. Training camp-cum-workshop on analysis and quality control of heavy metals in biological samples. Chandigarh, PGMER 1986; 18–20.

    Google Scholar 

  22. Gutelius MF, Millican FK, Layman EM, Cohen GJ, Dubin CC. Nutritional studies of children with pica: I. Controlled study evaluating nutritional status II. Treatment of pica with iron given intramusculary.Pediatrics 1962; 29:1012–1023.

    PubMed  CAS  Google Scholar 

  23. Halstead JA. Geophagia in man: Its nature and nutritional effects.Am J Clin Nutr 1968; 21:1384–1393.

    Google Scholar 

  24. Okcuoglu CA, Arcasoy A, Minnich V, Tarcon Y, Clin S, Yorukoglu Oet al. Pica in Turkey I. The incidence and association with anemia.Am J Clin Nutr 1966; 19:125–131.

    PubMed  CAS  Google Scholar 

  25. Minnich V, Okcuoglu CA, Tarcon Y, Arcasoy A, Clin S, Yorukoglu Oet al. Pica in Turkey II. Effect of clay on iron absorption.Am J Clin Nutr 1968; 21: 78–86.

    PubMed  CAS  Google Scholar 

  26. Johnson NE, Stephens Dl. Geomelophagia. Unusual pica in iron deficiency anemia.Am J Med 1982; 73:931–932.

    Article  PubMed  CAS  Google Scholar 

  27. Shapiro MD, Linas SL. Sodium chloride pica secondary to iron deficiency anemia.Am J Kidney Dis 1985 ; 5:67–68.

    PubMed  CAS  Google Scholar 

  28. Bhalla JN, Khanna PK, Srivastava JR, Sur BK, Bhalla M. Serum zinc levels in pica.Indian Pediatr 1983; 19: 615–618.

    Google Scholar 

  29. Chen XC, Yin TA, He HS, Ma QY, Han Zm, Li LX. Low levels of zinc in hair and blood, pica, anorexia and poor growth in Chinese pre-school children.Am J Cli Nutr 1985; 45:694–700.

    Google Scholar 

  30. Sipahi T, Akar Net al. Plasma zinc levels in patients with irondeficiency anemia.J Trop Pediatr 2001; 2:122–123.

    Google Scholar 

  31. Thomas FB, Falko JM, Zuckerman K. Inhibition of intestinal iron absorption by laundry starch.Gastoenterology 1976; 71: 1028–1032.

    CAS  Google Scholar 

  32. Arcasoy A, Cavadar AO, Babacan E. Decreased iron and zinc absorption in Turkish children wih iron deficiency and geophagia.Acta Haematol 1978; 60: 76–84.

    Article  PubMed  CAS  Google Scholar 

  33. Danford DE, Huber AM. Pica among mentally retarded adults.Am J Ment Defic 1982; 87:141–146.

    PubMed  CAS  Google Scholar 

  34. Kendall NR, Telfer SB. Induction of zinc deficiency in sheep and its correction with a soluble glass bolus containing zinc.Vet Rec 2000; 22: 634–637.

    Google Scholar 

  35. Singhi P, Singhi S. Pica type of non-food articles eaten by Ajmer children and their significance.Indian J Pediatr 1982; 49: 681–684.

    PubMed  CAS  Google Scholar 

  36. Kumar A, Dey PK, Singla PN, Ambasht RS, Upadhyay SK. Blood lead levels in children with neurological disorders.J Trop Paediatr 1998; 44:320–322.

    Article  CAS  Google Scholar 

Download references

Author information

Author notes

  1. Pratibha Singhi (Professor)

    Present address: Department of Pediatrics, Postgraduate Institute of Medical Education and Research, 160012, Chandigarh, India

Authors and Affiliations

  1. Department of Pediatrics, Postgraduate Institute of Medical Education and Research, 160012, Chandigarh, India

    Sunit Singhi & R. Ravishanker

  2. Department of Biochemistry, Postgraduate Institute of Medical Education and Research, Chandigarh, India

    R. Nath

Authors
  1. Sunit Singhi
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. R. Ravishanker
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Pratibha Singhi
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. R. Nath
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Singhi, S., Ravishanker, R., Singhi, P. et al. Low plasma zinc and iron in pica. Indian J Pediatr 70, 139–143 (2003). https://doi.org/10.1007/BF02723740

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF02723740

Key words

Search

Navigation