![]() ![]() On presentation to the outside hospital, she was weak and had a generalized tonic clonic seizure. Ī 54-year-old Caucasian woman was transferred to our MICU from an outside hospital due to altered mental status, seizures, and hyponatremia. Studies have indicated most physicians are unaware of pica and most cases are missed. Ice pica leading to hyponatremia and seizures is rare in clinical practice, and to our knowledge from literature review, prevalence is unknown. We report a case of a patient admitted to medical intensive care unit (MICU) due to severe hyponatremia and seizure, who was found to have iron deficiency-associated pagophagia as the underlying cause. Pagophagia can have significant health risks, including electrolyte abnormalities and metabolic disorders. The reasons why these patients crave ice is unclear, but some studies have indicated that chewing ice might increase alertness in people with iron deficiency anemia. Less commonly, other nutritional disorders may cause craving and chewing ice. Pagophagia (craving and chewing ice) is the excessive consumption of ice cubes or iced drinks it is often associated with iron deficiency with or without anemia. Pica was referenced by the Greeks and Romans in 13th-century but was not addressed in medical texts until 1563. The term pica originates from the Latin word for magpie (Picave), a bird that is famed for its unusual eating behaviors, mainly it is known to eat almost anything. Pica is described as an unusual condition in which patients crave and chew substances (such as ice, clay, soil, dirt, raw rice, or paper) that have no nutritive value.
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