WILLIAM H. CROSBY, M.D.
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To the editor: Gonzalez and associates (1) in their brief report on clay ingestion as the cause of severe hypokalemia in a young woman claim that clay ingestion also caused the patient's iron deficiency anemia.
It is well established that pica, the compulsive eating of something—in this case clay—is a consequence, not the cause of iron deficiency (2, 3). This report shows the clinical dangers in the authors' misconception. The true cause of the iron-deficiency anemia was not sought. The authors do not state whether stool specimens were examined for blood loss, even in the presence of a hiatus hernia.
CROSBY WH. Clay Ingestion and Iron Deficiency Anemia. Ann Intern Med. ;97:456. doi: 10.7326/0003-4819-97-3-456_1
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Published: Ann Intern Med. 1982;97(3):456.
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