Letters to the Editor the study group, 22 of 55 (40%) patients were reported by their parents to have ongoing pica behavior. Sixty-eight percent of them had geophagia, 13.7% of them had eaten paper, 9% salt, 4.5% soap, and 4.5% matches. Only three children (5.7%) from the control group had pica, and all of them had geophagia (p<0.05). In the study group, the mean hemoglobin level (9.2 ±1.8 g/dL vs 11.2 +0.9 g/dL) and zinc level (7.2 pg/mL vs 8.5 ±1.1 pg/mL) were lower than those of the control group (p<0.01, p<0.05, respectively).Accidental ingestions of some substances are frequent events during childhood and may lead to acute intoxication. Because children exhibiting pica eat compulsively, substances eaten could cause intoxication. The type of pica will usually determine the type of complications. The most well-recognized relationship between pica and intoxication is lead intoxication, which can be seen in geophagia. Lead-containing soil could lead to chronic lead accumulation and poisoning.2It is known that children with pica are more prone to zinc deficiency.3 Prevention of intoxication may result in lower mortality and morbidity rates. One of the preventive measures for intoxication could be increased awareness and treating of pica.

GAPO refers to a syndrome of growth retardation (G), alopecia (A), pseudoanodontia (P), and optic atrophy (O). We present for the first time children (two brothers) with GAPO syndrome associated with partially empty sella. We suggest that radiographic evaluation of the sella turcica and endocrinological follow-up are necessary in children with GAPO syndrome.

Chronic idiopathic hyperphosphatasia (CIH), also known as juvenile Paget's disease, is characterized by increased bone turnover, persistently elevated serum alkaline phosphatase concentrations and progressive bone deformities. The pathogenesis of the disease is unknown. Currently, there is no specific treatment and agents that reduce bone turnover have been tried in some cases with limited success. In this report, we present our experience with alendronate treatment in a 17 year-old boy with CIH. Ten weeks of treatment with alendronate resulted in marked clinical improvement and normalization of serum alkaline phosphatase activity. Serum osteocalcin and urinary deoxypyridinoline levels were decreased approximately 50% compared to pretreatment values, indicating decreased bone turnover rate. Alendronate seems to be a promising and safe agent for treatment of CIH.

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