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Pica

MedGen UID:
45917
Concept ID:
C0031873
Mental or Behavioral Dysfunction
Synonym: Pica disease
SNOMED CT: Pica (14077003); Abnormal craving (14077003); Eats abnormal objects (14077003)
 
HPO: HP:0011856
Monarch Initiative: MONDO:0001441

Definition

An appetite for and the persistent ingestion of non-food substances such as clay. In order to diagnose pica, this behavior must have persisted over a period of at least one month. [from HPO]

Conditions with this feature

Chromosome 17q12 deletion syndrome
MedGen UID:
482768
Concept ID:
C3281138
Disease or Syndrome
The 17q12 recurrent deletion syndrome is characterized by variable combinations of the three following findings: structural or functional abnormalities of the kidney and urinary tract, maturity-onset diabetes of the young type 5 (MODY5), and neurodevelopmental or neuropsychiatric disorders (e.g., developmental delay, intellectual disability, autism spectrum disorder, schizophrenia, anxiety, and bipolar disorder). Using a method of data analysis that avoids ascertainment bias, the authors determined that multicystic kidneys and other structural and functional kidney anomalies occur in 85% to 90% of affected individuals, MODY5 in approximately 40%, and some degree of developmental delay or learning disability in approximately 50%. MODY5 is most often diagnosed before age 25 years (range: age 10-50 years).
Intellectual developmental disorder with autism and macrocephaly
MedGen UID:
767287
Concept ID:
C3554373
Disease or Syndrome
CHD8-related neurodevelopmental disorder with overgrowth (CHD8-NDD) is characterized by generalized overgrowth, developmental delay / intellectual disability (DD/ID), autism spectrum disorder (ASD), neuropsychiatric issues, neurologic problems, sleep disturbance, and gastrointestinal issues The most common findings are the development of macrocephaly (most often during infancy) and tall stature (most typically during puberty), which is often accompanied by ASD and/or DD/ID. Most, if not all, affected individuals have some degree of DD, most commonly speech and motor delays. When present, ID is most often in the mild-to-moderate range. Sleep disturbance is characterized by difficulty with both initiation (delayed sleep onset) and maintenance (frequent night awakenings) of sleep. The most common gastrointestinal issue is constipation with or without periods of diarrhea. Less common features are hypotonia (about 30% of affected individuals), seizures (10%-15%), dystonia (rare), and Chiari I malformation (rare).
Intellectual disability, autosomal recessive 58
MedGen UID:
934608
Concept ID:
C4310641
Mental or Behavioral Dysfunction
Any autosomal recessive non-syndromic intellectual disability in which the cause of the disease is a mutation in the ELP2 gene.
Congenital heart defects, dysmorphic facial features, and intellectual developmental disorder
MedGen UID:
1385307
Concept ID:
C4479246
Disease or Syndrome
CDK13-related disorder, reported in 43 individuals to date, is characterized in all individuals by developmental delay / intellectual disability (DD/ID); nearly all individuals older than age one year display impaired verbal language skills (either absent or restricted speech). Other common findings are recognizable facial features in some individuals, behavioral problems (autism spectrum disorder or autistic traits/stereotypies, attention-deficit/hyperactivity disorder), feeding difficulties in infancy, structural cardiac defects, and seizures.
Intellectual disability, autosomal dominant 52
MedGen UID:
1615839
Concept ID:
C4540478
Mental or Behavioral Dysfunction
Neurodevelopmental disorder with movement abnormalities, abnormal gait, and autistic features
MedGen UID:
1647077
Concept ID:
C4693405
Disease or Syndrome
Neurodevelopmental disorder with movement abnormalities, abnormal gait, and autistic features (NEDMAGA) is characterized by infantile-onset global developmental delay with severe to profound intellectual disability, mildly delayed walking with broad-based and unsteady gait, and absence of meaningful language. Patients have features of autism, with repetitive behaviors and poor communication, but usually are socially reactive and have a happy demeanor. More variable neurologic features include mild seizures, spasticity, and peripheral neuropathy (summary by Palmer et al., 2017).
Neurodevelopmental disorder with seizures and speech and walking impairment
MedGen UID:
1672912
Concept ID:
C5193119
Disease or Syndrome
Neurodevelopmental disorder with seizures and speech and walking impairment (NEDSSWI) is an autosomal recessive disorder with onset in infancy. Patients show global developmental delay, particularly of speech acquisition, as well as walking difficulties due to hypotonia, hypertonia, spasticity, or poor coordination. Other features include seizures, mild dysmorphic features, and variable short stature. The pregnancies tend to be complicated by hyper- or hypotension (summary by Ganapathi et al., 2019).
Neurodevelopmental disorder with hypotonia, dysmorphic facies, and skin abnormalities
MedGen UID:
1824058
Concept ID:
C5774285
Disease or Syndrome
Neurodevelopmental disorder with hypotonia, dysmorphic facies, and skin abnormalities (NEDHFS) is an autosomal recessive disorder characterized by severe global developmental delay with impaired intellectual development and poor or absent speech. Affected individuals have dysmorphic facies, including large abnormally shaped ears and strabismus, hypotonia, and dry skin with keratosis pilaris. Some patients develop seizures. Metabolic studies are unremarkable (Morava et al., 2021).

Professional guidelines

PubMed

Moisidis-Tesch CM, Shulman LP
Adv Ther 2022 Jun;39(6):2438-2451. Epub 2022 Apr 30 doi: 10.1007/s12325-022-02157-7. PMID: 35488139
Peitz GW, Sy CA, Grandhi R
Neurosurg Focus 2017 Jun;42(6):E12. doi: 10.3171/2017.3.FOCUS1751. PMID: 28565977
Mairs R, Nicholls D
Arch Dis Child 2016 Dec;101(12):1168-1175. Epub 2016 Jun 28 doi: 10.1136/archdischild-2015-309481. PMID: 27381185

Recent clinical studies

Etiology

Fields VL, Soke GN, Reynolds A, Tian LH, Wiggins L, Maenner M, DiGuiseppi C, Kral TVE, Hightshoe K, Schieve LA
Pediatrics 2021 Feb;147(2) Epub 2021 Jan 6 doi: 10.1542/peds.2020-0462. PMID: 33408069Free PMC Article
Ardeshirian KA, Howarth DA
Aust Fam Physician 2017;46(4):243-248. PMID: 28376581
Borgna-Pignatti C, Zanella S
Expert Rev Hematol 2016 Nov;9(11):1075-1080. Epub 2016 Oct 19 doi: 10.1080/17474086.2016.1245136. PMID: 27701928
Call C, Walsh BT, Attia E
Curr Opin Psychiatry 2013 Nov;26(6):532-6. doi: 10.1097/YCO.0b013e328365a321. PMID: 24064412
Aparna PV, Austin RD, Mathew P
Indian J Dent Res 2012 May-Jun;23(3):426-7. doi: 10.4103/0970-9290.102246. PMID: 23059587

Diagnosis

Schnitzler E
Curr Neurol Neurosci Rep 2022 Aug;22(8):531-536. Epub 2022 Jun 8 doi: 10.1007/s11910-022-01218-2. PMID: 35674869
Bryant-Waugh R, Micali N, Cooke L, Lawson EA, Eddy KT, Thomas JJ
Int J Eat Disord 2019 Apr;52(4):378-387. Epub 2018 Oct 12 doi: 10.1002/eat.22958. PMID: 30312485Free PMC Article
Xiang H, Han J, Ridley WE, Ridley LJ
J Med Imaging Radiat Oncol 2018 Oct;62 Suppl 1:97-98. doi: 10.1111/1754-9485.43_12784. PMID: 30309086
Borgna-Pignatti C, Zanella S
Expert Rev Hematol 2016 Nov;9(11):1075-1080. Epub 2016 Oct 19 doi: 10.1080/17474086.2016.1245136. PMID: 27701928
Call C, Walsh BT, Attia E
Curr Opin Psychiatry 2013 Nov;26(6):532-6. doi: 10.1097/YCO.0b013e328365a321. PMID: 24064412

Therapy

D'Haens G, Dubinsky M, Kobayashi T, Irving PM, Howaldt S, Pokrotnieks J, Krueger K, Laskowski J, Li X, Lissoos T, Milata J, Morris N, Arora V, Milch C, Sandborn W, Sands BE; LUCENT Study Group
N Engl J Med 2023 Jun 29;388(26):2444-2455. doi: 10.1056/NEJMoa2207940. PMID: 37379135
Borner T, Shaulson ED, Ghidewon MY, Barnett AB, Horn CC, Doyle RP, Grill HJ, Hayes MR, De Jonghe BC
Cell Metab 2020 Feb 4;31(2):351-362.e5. Epub 2020 Jan 9 doi: 10.1016/j.cmet.2019.12.004. PMID: 31928886Free PMC Article
Attal M, Lauwers-Cances V, Hulin C, Leleu X, Caillot D, Escoffre M, Arnulf B, Macro M, Belhadj K, Garderet L, Roussel M, Payen C, Mathiot C, Fermand JP, Meuleman N, Rollet S, Maglio ME, Zeytoonjian AA, Weller EA, Munshi N, Anderson KC, Richardson PG, Facon T, Avet-Loiseau H, Harousseau JL, Moreau P; IFM 2009 Study
N Engl J Med 2017 Apr 6;376(14):1311-1320. doi: 10.1056/NEJMoa1611750. PMID: 28379796Free PMC Article
Auerbach M, Adamson JW
Am J Hematol 2016 Jan;91(1):31-8. Epub 2015 Nov 17 doi: 10.1002/ajh.24201. PMID: 26408108
Kucik CJ, Martin GL, Sortor BV
Am Fam Physician 2004 Mar 1;69(5):1161-8. PMID: 15023017

Prognosis

Morschhauser F, Nastoupil L, Feugier P, Schiano de Colella JM, Tilly H, Palomba ML, Bachy E, Fruchart C, Libby EN, Casasnovas RO, Flinn IW, Haioun C, Maisonneuve H, Ysebaert L, Bartlett NL, Bouabdallah K, Brice P, Ribrag V, Le Gouill S, Daguindau N, Guidez S, Pica GM, García-Sancho AM, López-Guillermo A, Larouche JF, Ando K, Gomes da Silva M, André M, Kalung W, Sehn LH, Izutsu K, Cartron G, Gkasiamis A, Crowe R, Xerri L, Fowler NH, Salles G
J Clin Oncol 2022 Oct 1;40(28):3239-3245. Epub 2022 Aug 10 doi: 10.1200/JCO.22.00843. PMID: 35947804Free PMC Article
McClugage SG, Oakes WJ
J Neurosurg Pediatr 2019 Sep 1;24(3):217-226. doi: 10.3171/2019.5.PEDS18382. PMID: 31473667
Morschhauser F, Fowler NH, Feugier P, Bouabdallah R, Tilly H, Palomba ML, Fruchart C, Libby EN, Casasnovas RO, Flinn IW, Haioun C, Maisonneuve H, Ysebaert L, Bartlett NL, Bouabdallah K, Brice P, Ribrag V, Daguindau N, Le Gouill S, Pica GM, Martin Garcia-Sancho A, López-Guillermo A, Larouche JF, Ando K, Gomes da Silva M, André M, Zachée P, Sehn LH, Tobinai K, Cartron G, Liu D, Wang J, Xerri L, Salles GA; RELEVANCE Trial Investigators
N Engl J Med 2018 Sep 6;379(10):934-947. doi: 10.1056/NEJMoa1805104. PMID: 30184451Free PMC Article
Toni G, Berioli MG, Cerquiglini L, Ceccarini G, Grohmann U, Principi N, Esposito S
Nutrients 2017 Aug 19;9(8) doi: 10.3390/nu9080906. PMID: 28825608Free PMC Article
Gavin PJ, Kazacos KR, Shulman ST
Clin Microbiol Rev 2005 Oct;18(4):703-18. doi: 10.1128/CMR.18.4.703-718.2005. PMID: 16223954Free PMC Article

Clinical prediction guides

Pontone G, Guaricci AI, Fusini L, Baggiano A, Guglielmo M, Muscogiuri G, Volpe A, Abete R, Aquaro G, Barison A, Bogaert J, Camastra G, Carigi S, Carrabba N, Casavecchia G, Censi S, Cicala G, De Cecco CN, De Lazzari M, Di Giovine G, Di Roma M, Dobrovie M, Focardi M, Gaibazzi N, Gismondi A, Gravina M, Lanzillo C, Lombardi M, Lorenzoni V, Lozano-Torres J, Martini C, Marzo F, Masi A, Memeo R, Moro C, Nese A, Palumbo A, Pavon AG, Pedrotti P, Marra MP, Pica S, Pradella S, Presicci C, Rabbat MG, Raineri C, Rodriguez-Palomares JF, Sbarbati S, Schoepf UJ, Squeri A, Sverzellati N, Symons R, Tat E, Timpani M, Todiere G, Valentini A, Varga-Szemes A, Masci PG, Schwitter J
JACC Cardiovasc Imaging 2023 Nov;16(11):1387-1400. Epub 2023 May 24 doi: 10.1016/j.jcmg.2023.03.015. PMID: 37227329
Liu H, Burns RT, Spencer BR, Page GP, Mast AE; NHLBI Recipient Epidemiology Donor Evaluation Study (REDS)-III
Transfus Med 2022 Aug;32(4):288-292. Epub 2022 Jun 24 doi: 10.1111/tme.12890. PMID: 35750589Free PMC Article
Ardeshirian KA, Howarth DA
Aust Fam Physician 2017;46(4):243-248. PMID: 28376581
Aparna PV, Austin RD, Mathew P
Indian J Dent Res 2012 May-Jun;23(3):426-7. doi: 10.4103/0970-9290.102246. PMID: 23059587
Ibels LS, Pollock CA
Med Toxicol 1986 Nov-Dec;1(6):387-410. doi: 10.1007/BF03259851. PMID: 3540517

Recent systematic reviews

Ladrón-Arana S, Orzanco-Garralda R, Escalada-Hernández P, Aguilera-Serrano C, Gutiérrez-Valencia M, Urbiola-Castillo J
Eat Weight Disord 2023 Aug 22;28(1):69. doi: 10.1007/s40519-023-01594-9. PMID: 37608142Free PMC Article
Berckemeyer MA, Suarez-Meade P, Carcelen MFV, Ricci MD, Cheshire WP, Trifiletti DM, Middlebrooks EH, Quinones-Hinojosa A, Grewal SS
Neurosurg Rev 2023 Feb 2;46(1):47. doi: 10.1007/s10143-023-01948-y. PMID: 36725770
Moline R, Hou S, Chevrier J, Thomassin K
Clin Psychol Psychother 2021 Jan;28(1):39-55. Epub 2020 Jul 13 doi: 10.1002/cpp.2491. PMID: 32628326
Rohde A, Worrall L, Godecke E, O'Halloran R, Farrell A, Massey M
PLoS One 2018;13(3):e0194143. Epub 2018 Mar 22 doi: 10.1371/journal.pone.0194143. PMID: 29566043Free PMC Article
Petr O, Sejkorová A, Bradáč O, Brinjikji W, Lanzino G
Acta Neurochir (Wien) 2016 Dec;158(12):2415-2428. Epub 2016 Oct 7 doi: 10.1007/s00701-016-2965-3. PMID: 27718027

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