A follow-up on desiderosmia (olfactory craving), a novel symptom associated with iron deficiency anemia

Relationship Between "Geosminophilia" (Liking the Smell of Earth) and Pica in Patients With Iron Deficiency

BACKGROUND

Iron deficiency is a critical global health issue. One of the intriguing manifestations linked to iron deficiency is the presence of pica. The physiological relationship between the senses of smell and taste suggests that pica may be accompanied by an inclination towards the smell of earth (geosmin). The smell of geosmin is distinct and generally recognized as a pleasing scent. The objective of this study is to explore this potential association. The sign of liking the smell of earth will now be referred to as "geosminophilia", for the first time, in this study.

METHODS

Patients aged 18 years and above who visited the Iron Deficiency Outpatient Clinic between September 2021 and August 2022 were chosen for this cross-sectional study. The dataset excluded those with ferritin concentrations over 100 mcg/L and transferrin saturation over 45%. Demographics, presence of pica, history of geosminophilia, and laboratory findings were documented in physical and digital patient data. The descriptive statistics, chi-square test, and independent group comparison tests were performed.

RESULTS

With a mean age of 38.7±11.7 years, the study sample comprised 280 patients, of which 263 were female and 17 were male. Ninety-six patients (34.3%) had geosminophilia, while 29 patients (10.4%) had pica. The only factors that significantly distinguished the groups based on the presence of geosminophilia were gender (p=0.04) and age (p=0.02). Using the chi-square test to compare the presence of pica and geosminophilia, a statistically significant relationship was identified (p<0.001). Additionally, 72.4% of patients who presented with pica had geosminophilia. Pica was absent in 96% of patients who did not have geosminophilia. A total of 93.8% (15/16) of pica cases with geophagia subtype exhibited the presence of geosminophilia. A significant correlation (r=0.27, p<0.001) was also observed between geosminophilia and pica.

CONCLUSION

In iron deficiency patients, geosminophilia and the presence of pica may accompany each other. Therefore, geosminophilia has the potential to be a new symptom of iron deficiency.

International consensus statement on allergy and rhinology: Olfaction

BACKGROUND

The literature regarding clinical olfaction, olfactory loss, and olfactory dysfunction has expanded rapidly over the past two decades, with an exponential rise in the past year. There is substantial variability in the quality of this literature and a need to consolidate and critically review the evidence. It is with that aim that we have gathered experts from around the world to produce this International Consensus on Allergy and Rhinology: Olfaction (ICAR:O).

METHODS

Using previously described methodology, specific topics were developed relating to olfaction. Each topic was assigned a literature review, evidence-based review, or evidence-based review with recommendations format as dictated by available evidence and scope within the ICAR:O document. Following iterative reviews of each topic, the ICAR:O document was integrated and reviewed by all authors for final consensus.

RESULTS

The ICAR:O document reviews nearly 100 separate topics within the realm of olfaction, including diagnosis, epidemiology, disease burden, diagnosis, testing, etiology, treatment, and associated pathologies.

CONCLUSION

This critical review of the existing clinical olfaction literature provides much needed insight and clarity into the evaluation, diagnosis, and treatment of patients with olfactory dysfunction, while also clearly delineating gaps in our knowledge and evidence base that we should investigate further.

Sudden Sensorineural Hearing Loss Associated with Nutritional Anemia: A Nested Case-Control Study Using a National Health Screening Cohort

Previous studies have suggested an association of anemia with hearing loss. The aim of this study was to investigate the association of nutritional anemia with sudden sensorineural hearing loss (SSNHL), as previous studies in this aspect are lacking. We analyzed data from the Korean National Health Insurance Service-Health Screening Cohort 2002-2015. Patients with SSNHL (n = 9393) were paired with 37,572 age-, sex-, income-, and region of residence-matched controls. Both groups were assessed for a history of nutritional anemia. Conditional logistic regression analyses were performed to calculate the odds ratios (ORs) (95% confidence interval, CI) for a previous diagnosis of nutritional anemia and for the hemoglobin level in patients with SSNHL. Subgroup analyses were conducted for age and sex. Age, sex, income, and region of residence were stratified. Obesity, smoking, drinking alcohol, systolic/diastolic blood pressure, fasting blood glucose, total cholesterol, and the Charlson Comorbidity Index were considered in the regression models. Nutritional anemia was present in 4.8% (449/9393) of patients with SSNHL and 4.0% (1494/37,572) of controls (p < 0.001). The SSNHL group demonstrated 1.20-fold higher odds for nutritional anemia (95% CI = 1.08-1.34, p = 0.001). Hemoglobin levels were not associated with SSNHL. In subgroups <60 years old, there was a consistent positive association of nutritional anemia with SSNHL (adjusted OR = 1.55, 95% CI = 1.11-2.15, p = 0.010 for men <60 years old, and adjusted OR = 1.22, 95% CI = 1.02-1.45, p = 0.028 for women <60 years old). Nutritional anemia, but not hemoglobin level, was associated with an increased risk of SSNHL.

High prevalence of kaolin consumption in migrant women living in a major urban area of France: A cross-sectional investigation

Geophagia is a feeding behavior involving the regular intake of soil, including clay-like kaolin. Frequent in Africa, kaolin consumption is associated with heavy metal intoxication, iron and other micronutrient deficiencies, geohelminth infection and inactivation of concomitantly taken drugs. It is expected that this practice would be imported into an asylum country during the immigration process. To confirm this hypothesis, a single center, cross-sectional study was conducted at the University Hospital of Nantes, France, whose main objective was to assess whether the prevalence of kaolin consumers was high in a migrant population living in a large French metropolitan area (the city of Nantes). Each woman consulting for the first time at the Medical and Psychosocial Gynecology Obstetric Unit during the inclusion period ranging from January 1, 2017, to July 1, 2017, was asked for consent to be included in the study. The main outcome was the proportion of positive answers regarding consumption of kaolin within the last twelve months, with its 95% confidence interval (CI). A logistic regression was performed to identify drivers of consumption, and a clustering approach was conducted to identify profiles of consumers. A total of 284 women were included in the study, of whom 110 (38.7%) were pregnant. Our main finding was a 14.1% (95% CI: 10.5-18.6) prevalence of clay consumers. Second, the characteristic most strongly associated with consumption was Central or West Africa origin (adjusted Odds Ratio (aOR) = 52.7; 95% CI: 13.7-202.2). Finally, 60% of consumers showed signs of addictive-like phenomena, and three profiles were identified, depicting a continuum of patients in regard to their control over their kaolin consumption. Our results suggest that kaolin consumption is frequent in particular subpopulations of migrants. This warrants further study of the clinical consequences of kaolin consumption and its associated addictive-like symptoms.