SouthernSudanMedicalJournalHomeArchiveNewsResearchClinicalGuidanceSearchSSMJAboutSSMJPicaasapersistenteatingdisorderassociatedwithirondeficiencyanaemia:twocasereportsAuthor(s):AzanANyundo(a),GodfreyMwasada(b),BonaventuraC.TMpondo(c)aDepartmentofInternalMedicine(DivisionofPsychiatry),SchoolofMedicineandDentistry,TheUniversityofDodoma,Dodoma,TanzaniabParadiseSpecializedClinic,Mbeya,TanzaniacDepartmentofInternalMedicine,SchoolofMedicineandDentistry,TheUniversityofDodoma,Dodoma,TanzaniaCorrespondence:AzanANyundo[email protected]AbstractIntroduction:Picaisamysteriousconditioncharacterisedbypatientsdevelopingcravingsfornon-nutritivesubstancesthatmayescalateintoseriousmedicalcomplications.Wepresenttwocasereportswithasomewhatunusualnatureofpresentationattributedtoirondeficiency.Thefirstisa25-yearoldAfricanwomanwithabnormaluterinebleedingpresentingwithafondnessforeatingclay,colddrinks,andicepacks.Thesecondis15-yearoldAfricangirlwhopresentedwithbleedingfromthenose,habitualsmellingofsoil,consumingicepacksandchewingrubberbands.Bothpresentedwithhaematologicalparametersdiagnosticofirondeficiencyanaemia.Conclusion:Despitebeingpractisedforcenturies,theclinicalsignificanceofpicasymptomsisoftennotrecognisedparticularlyamongtheyoungerphysicians.Bothourpatientsrespondedwelltomanagingtheprimarycauseofbloodlossandironsupplementation.Weareconvincedthatpicaisanimportantpointertoirondeficiencyandcliniciansshouldsuspectoccultbloodlossinapatientpresentingwithpicasymptoms.Keywords:pica,eatingdisorder,irondeficiencyanaemia,casereport. IntroductionPicaistypicallydefinedasthepersistentingestionofnon-nutritivesubstancesforatleastonemonthatanagewhenthisbehaviourisdevelopmentallyinappropriate.Thedefinitionisoccasionallybroadenedtoincludethechewingnon-nutritivesubstances.Picamaybebenign,oritmayhavelife-threateningconsequences[1].Theconditionismorefrequentinthosewithautismandintellectualdisabilities.Ithasbeenreportedinallages,andbothsexes,andisparticularlyprevalentamongyoungchildren,peopleoflowsocio-e