13 years old student, hard-working, having good grades was taken from a declamation contest due to a bloody vomit. The patient said, that he felt anxious, began to sweat and the camera flashes started to irritate him. In examination there was no pain in the abdomen but in the left epigastrium a resistance was felt. There is no blood in a stool and no problem with defecation. Recently he had stomach problem and diarrhoea. In CT of the stomach tweezers, a staple and a paper-clip were found. The father has seen recent changes in his son's behaviour: he was moody and distant. After conversation with the boy, we could say that his contact with his parents was not good, because they've been traveling all the time and on the occasion where they stayed at home they were fighting frequently. Before a long talk boy admitted that this is not the first time he vomited blood and that there is something in his head which tells him to eat metal things. What is the reason for this?

Despite first suspiction about psychical disorders it turned out that boy has an unusually rare syndrome - PICA. The reason which persuaded the doctors to diagnose this syndrome was a deficiency of zinc, repeating episodes of vomiting and untamed urge to consume anything with with zinc.