Significant laboratory results included hemoglobin of 7.7 gm/dL and hematocrit of 24.6%. Vital signs were remarkable for blood pressure of 220/110 mmHg, which was later stabilized to 140/84 mmHg. Provisional diagnosis of dementia of the Alzheimer's type with coprophagia was reached, and she was admitted to the acute medical floor for evaluation and possible treatment of uncontrolled hypertension and mixed iron deficiency and macrocytic anemia. She drew half the circle resembling a clock and placed the numbers appropriately but had trouble spacing the numbers from 7 to 11, and she missed placement of hands. She scored 23 out of 30 on the Folstein Mini-Mental State Examination, and her thinking was concrete.
#Pica syndrome poop registration
Cognitive examination revealed 0 out of 3 on registration and recall. She did not appear to be internally preoccupied. There was no evidence of paranoia, fixed delusional systems, or ruminations. Psychomotor activity and gait were normal.
Her affect was fair and her mood congruent. She maintained good eye contact and was cooperative. Mental status examination showed an alert Caucasian woman oriented to person and place but not to time.
She was a poor historian, which limited psychiatric review of systems. She was admitted to the acute medical floor for evaluation of anemia and uncontrolled hypertension. She also reported that she knew it was wrong, but she did not know why she was doing it. Upon presentation to the emergency department, she reported eating her own feces but could not provide further details. She reportedly had started smearing her feces 2 weeks before her presentation in the emergency department and had started eating her feces 2 days before. K, an 83-year-old Caucasian woman with a protracted history of Alzheimer's disease and major depressive disorder, was brought to the emergency department after being found eating her own feces at an assisted living facility.