严重贫血的维生素B12缺乏表现为渴望漂白粉:异食癖的一个奇怪的案例。

Q4 Medicine
Case Reports in Psychiatry Pub Date : 2025-08-22 eCollection Date: 2025-01-01 DOI:10.1155/crps/8779524
Emmanuel D Meram, Sesilia Kammo, Shea Repins, Gregory C Mahr
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引用次数: 0

摘要

异食癖,即摄入非营养性物质,是一种复杂而鲜为人知的现象。虽然它本质上是一种精神疾病,但它与其他精神、生理和病理状态有着复杂的关系,表明其病因是高度多因素的。在急性环境中识别和解决异食癖是至关重要的,因为它会给患者带来重大的健康风险,包括潜在的有毒摄入。我们的报告强调的情况下,一个36岁的妇女与复杂的精神病史谁提出了急诊科(ED)严重的症状性贫血。她的贫血被发现是大细胞贫血和自身免疫引起的维生素B12缺乏的结果。进一步调查发现,在入院前,患者表现出对漂白粉气味的渴望,并发展到将有毒物质含在嘴里一个多月。这是第一例漂白剂渴求患者的维生素B12缺乏症没有共存的铁缺乏症。这一独特的介绍强调了精神病学咨询作为紧急医疗环境中综合临床评估的一部分的重要性。我们还认为异食癖的表现可能是微妙的,因此了解驱动这种行为的生物心理社会因素和在适当的医学领域进行目标干预是至关重要的。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Severe Anemia From Vitamin B12 Deficiency Presenting With a Craving for Bleach Powder: An Odd Case of Pica.

Pica, the ingestion of nonnutritive substances, represents a complex and poorly understood phenomenon. Although it is inherently a psychiatric condition, it has an intricate relationship with other psychiatric, physiological, and pathological states, suggesting a highly multifactorial etiology. Recognizing and addressing pica in acute settings is crucial, as it poses significant health risks for patients, including the potential of toxic ingestion. Our presentation highlights the case of a 36-year-old woman with a complex psychiatric history who presented to the emergency department (ED) with severe symptomatic anemia. Her anemia was found to be macrocytic and a result of autoimmune-induced vitamin B12 deficiency. Further inquiry uncovered that, prior to admission, the patient exhibited a craving for smelling bleach powder that progressed to mouthing the toxic substance for more than a month. This is the first report of a case of bleach craving in a patient with vitamin B12 deficiency absent coexisting iron-deficiency. This unique presentation underscores the importance of psychiatric consultations as a part of comprehensive clinical assessments in emergency medical settings. We also suggest that pica presentations may be nuanced and thus it is critical to understand the biopsychosocial factors driving this behavior and target interventions in the appropriate medical domains.

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来源期刊
Case Reports in Psychiatry
Case Reports in Psychiatry Medicine-Psychiatry and Mental Health
CiteScore
1.00
自引率
0.00%
发文量
49
审稿时长
12 weeks
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