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2017 ; 11
(1
): 325
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Sodium chloride pica causing recurrent nephrolithiasis in a patient with iron
deficiency anemia: a case report
#MMPMID29149910
Rogers B
; Kramer J
; Smith S
; Bird V
; Rosenberg EI
J Med Case Rep
2017[Nov]; 11
(1
): 325
PMID29149910
show ga
BACKGROUND: Iron deficiency anemia is a common finding in women of child-bearing
age. Pica, or the ingestion of non-food or non-nutritive items, is a well-known
manifestation of iron deficiency. A high sodium diet increases risk for
nephrolithiasis. We describe the case of a 31-year-old woman with recurrent
calcium nephrolithiasis and anemia who ate ice chips as well as spoons of salt
daily. Treatment of pica may prove effective in preventing recurrent
nephrolithiasis. CASE PRESENTATION: A 31-year-old white woman with a past medical
history of menorrhagia, anemia, and recurrent calcium nephrolithiasis presented
for preoperative evaluation prior to ureterolithotomy. She described a daily
pattern of eating continually from a cup of ice chips accompanied by multiple
spoons of salt directly out of a salt shaker. These cravings had been present for
many years, were bothersome to her, and interfered with her daily life.
Laboratory findings revealed hemoglobin of 10.9 g/dL with ferritin of 3 ng/mL.
History, physical, and laboratory data were consistent with pica secondary to
iron deficiency anemia. She was prescribed orally administered ferrous sulfate
325 mg three times a day with meals. She continues to struggle with the symptoms
of pica and orally administered supplementation. CONCLUSIONS: It is important
that clinicians consider the possible diagnosis of sodium chloride pica in
patients with iron deficiency anemia and recurrent nephrolithiasis. Treatment of
anemia and resolution of pica may prove effective in preventing future
nephrolithiasis. Specific questioning about pica symptoms in patients with iron
deficiency anemia and recurrent nephrolithiasis may be helpful diagnostically and
therapeutically.