What is the definition of Pellagra?

Pellagra is a disease that occurs when a person does not get enough niacin (one of the B complex vitamins) or tryptophan (an amino acid).

What are the alternative names for Pellagra?

Vitamin B3 deficiency; Deficiency - niacin; Nicotinic acid deficiency

What are the causes for Pellagra?

Pellagra is caused by having too little niacin or tryptophan in the diet. It can also occur if the body fails to absorb these nutrients.

Pellagra may also develop due to:

• Gastrointestinal diseases
• Weight loss (bariatric) surgery
• Anorexia
• Excessive alcohol use
• Carcinoid syndrome (group of symptoms associated with tumors of the small intestine, colon, appendix, and bronchial tubes in the lungs)
• Certain medicines, such as isoniazid, 5-fluorouracil, 6-mercaptopurine

The disease is common in parts of the world (certain parts of Africa) where people have a lot of untreated corn in their diet. Corn is a poor source of tryptophan, and niacin in corn is tightly bound to other components of the grain. Niacin is released from corn if soaked in limewater overnight. This method is used to cook tortillas in Central America where pellagra is rare.

What are the symptoms for Pellagra?

Symptoms of pellagra include:

• Delusions or mental confusion
• Diarrhea
• Weakness
• Loss of appetite
• Pain in abdomen
• Inflamed mucous membrane
• Scaly skin sores, especially in sun-exposed areas of the skin

What are the current treatments for Pellagra?

The goal of treatment is to increase your body's niacin level. You will be prescribed niacin supplements. You may also need to take other supplements. Follow your provider's instructions exactly on how much and how often to take the supplements.

Symptoms due to the pellagra, such as skin sores, will be treated.

If you have conditions that are causing the pellagra, these will also be treated.

What is the outlook (prognosis) for Pellagra?

People often do well after taking niacin.

What are the possible complications for Pellagra?

Left untreated, pellagra can result in nerve damage, particularly in the brain. Skin sores may become infected.

When should I contact a medical professional for Pellagra?

Call your provider if you have any symptoms of pellagra.

How do I prevent Pellagra?

Pellagra can be prevented by following a well-balanced diet.

Get treated for health problems that may cause pellagra.

REFERENCES

Elia M, Lanham-New SA. Nutrition. In: Kumar P, Clark M, eds. Kumar and Clarke's Clinical Medicine. 9th ed. Philadelphia, PA: Elsevier; 2017:chap 10.

Meisenberg G, Simmons WH. Micronutrients. In: Meisenberg G, Simmons WH, eds. Principles of Medical Biochemistry. 4th ed. Philadelphia, PA: Elsevier; 2017:chap 31.

So YT. Deficiency diseases of the nervous system. In: Daroff RB, Jankovic J, Mazziotta JC, Pomeroy SL, eds. Bradley's Neurology in Clinical Practice. 7th ed. Philadelphia, PA: Elsevier; 2016:chap 85.