Trichotillomania in celiac disease patient refractory to iron replacement.

Trichotillomania is characterized by recurring hair pulling behavior and repeated attempts to decrease or stop the behavior. This behavior can cause a trichobezoar, which is a mass of hair found in the stomach. Patients with diagnosed celiac disease may have an urge to swallow their hair due to iron or folat deficiency, which is called pica. We report a case of an 11-year old girl with celiac disease who has had trichotillomania for a duration of 2 years, and required an operation due to residual gastric hair mass. In this case trichotillomania was more likely caused by behavioral disorders secondary to celiac disease, rather than the iron deficiency due to malabsorption.