慢性腎不全患者にみられた煙草灰異食症

Eating Cigarette Ashes Pica in a Patient with Chronic Renal Failure

　55歳，女性，主婦。4年前に卵巣癌（Stage ⅢA）に対して手術および化学療法を施行したのち，徐々に腎機能が悪化し，血液透析導入となった。うつ病の既往があったが現在は軽快していた。1日1箱近い喫煙習慣があったが，透析導入の3週間ほど前から自分の吸った煙草の灰を「美味しい」と食する奇行が出現した。腎不全による精神症状は明らかでなく，透析導入のあと，異食症を止めるよう厳しく生活指導をすることで奇行はみられなくなった。

A 55-year-old housewife who had undergone chemo-therapy for stage Ⅲ ovarian tumor developed chronic renal failure and was admitted for hemodialysis therapy. She had a history of depression, which was relived at the time of admission. She showed pica behavior such as "eating cigarette ash" , which had appeared three weeks before the initiation of hemodialysis. She did not have any appar-ent uremic encephalopathy or signs of nicotine intoxication. With appropriate institution of hemodialysis therapy and disciplinary guidance to quit pica, her bizarre behavior ceased.