Pagophagia and Iron Deficiency Anemia

A survey of the prevalence of the various forms of pica was carried out in 38 consecutive patients with iron deficiency from chronic blood loss. Pagophagia, or the ingestion of ice, was found to be the most common finding. Geophagia, starch ingestion, and other forms of pica were much less frequent. In 22 of 23 patients with the symptom of pagophagia and iron deficiency anemia, there was complete disappearance of the symptom when the iron deficiency state was corrected. The correlation of serum iron levels with symptoms of pagophagia was best demonstrated by disappearance of symptoms as serum iron levels rose to above 70 µg/100 ml. The cause of this common form of pica is not known but may be related to factors such as tissue enzyme deficiency.