Pellagra – Definition, Symptoms & Treatment

Pellagra

Pellagra is a condition that happens because of a lack of vitamin B3, also called niacin. Pellagra can create symptoms like dermatitis, dementia and diarrhoea.

Pellagra is widespread among poor and food-limited populations. The disease is more extensive in certain parts of the world, where people have a lot of untreated corn in their diet.

Corn is a deprived source of tryptophan, and niacin in corn is strictly bound to other parts of the grain. Niacin is discharged from corn if soaked in limewater overnight. This method is underutilised in the United States and may be related with acute alcholism or medical causes of malnutrition symptoms.

Causes

Pellagra is caused by having very little tryptophan or niacin in the diet. It can also happen if the body fails to ingest these nutrients.

Pellagra can also develop because of:

• Bariatric surgery
• Gastrointestinal disease
• Excess alcohol consumption
• Anorexia
• Few medicines, like 5-fluorouracil, isoniazid, 6-mercaptopurine, pyrazinamide, phenobarbital, hydantoin, ethionamide,  azathioprine, and chloramphenicol
• Carcinoid syndrome (group of symptoms linked with carcinoid tumours of the small intestine, appendix, colon and bronchial tubes in the lungs.

Symptoms

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

Diagnosis

Pellagra is challenging to diagnose because it creates a range of symptoms. There is no particular test for diagnosing niacin deficiency.   

Alternatively, your doctor will start by checking for any gastrointestinal issues, rashes or changes in your mental state. They may also test the urine. In most cases, diagnosing pellagra involves seeing if the symptoms respond to niacin.

Treatment

Primary pellagra is treated with dietary changes and a niacotinamide supplement. It may also required to be given intravenously. Nicotinamide is a variant of vitamin B-3. With prompt treatment, many people make a complete recovery and start feeling better within a few days after starting treatment.

Skin improvements may take many months. Nevertheless, if left untreated, primary pellagra can result in death in four or five years. Treating secondary pellagra typically focuses on treating the hidden cause.  Yet, in some cases, secondary pellagra also responds well to taking niacin or nicotinamide.

While recovering from primary or secondary pellagra, it is crucial to keep any rashes moisturised and protected with sunscreen.

Preventive Measures

• Daily 15-20 mg niacin consumption prevents pellagra in all kinds of age groups.
• Niacin supplements are suggested for patients taking long-term medications known to create pellagra, like isoniazid and ethionamide.
• Topical emollients may assist in reliving skin symptoms  

Potential Complications of Pellagra

You can lower your risk of grim complications by following the treatment plan you and your doctor designed particularly for you. Depression and dementia symptoms are the potential complications of pellagra.

Conclusion

Pellagra is a serious health condition which is caused by low levels of niacin because of either malnutrition or an absorption problem. If left untreated, it can lead to even death. While primary pellagra works well with niacin supplementation, secondary pellagra is difficult to treat based on the fundamental cause.

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