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Home :: Neurology Disorders

Pellagra

 

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Pellagra is a chronic wasting disease associated with skin changes (dermatitis), dementia and diarrhoea. It is most common in areas where the diet consists mainly of corn, which, unlike other grains, lacks niacin as well as the amino acid tryptophan, which the body uses to synthesize the vitamin. Niacin is a B vitamin found in such foods as yeast, liver, meat, fish, whole-grain cereals and breads, and legumes. Results were dramatic; those fed a diet of fresh meat, milk and vegetables instead of a com-based diet recovered from pellagra. Dietary requirements for niacin depend on the age, gender, size, and activity level of the individual.

Dermatitisis bilateral, symmetrical and is present at sites exposed to the sun and is due to photosensitivity. Pellagra no longer stalks the nation as it once did. But during the early part of the 20th-century, pellagra, a disease that results from a diet deficient in niacin killed, many poor Southerners tryptophan can be converted into niacin , foods with tryptophan but without niacin, such as milk , prevent pellagra. It is characterized by scaly skin sores, diarrhea, inflamed mucous membranes, mental confusion, and delusions. It may develop after gastrointestinal diseases or alcoholism. Pellagra is a vitamin deficiency disease caused by dietary lack of niacin (vitamin B3) and protein , especially proteins containing the essential amino acid tryptophan . It can also occur if the body fails to absorb these nutrients. Niacin is plentiful in yeast, organ meats, peanuts, and wheat germ.

Causes of Pellagra

The common Causes of Pellagra :

  • Chronic alcoholism.
  • Prolonged diarrhoea.
  • Gastrointestinal diseases such as ulcerative colitis.
  • Long-term alcoholism.
  • Dietary deficiency of niacin or its amino acid precursor tryptophan results in pellagra.
  • Prolonged febrile illness.
  • Chronic colitis, particularly colitis ulcerosa.
  • Tuberculosis of the GI tract.
  • Malignant carcinoid tumor.
  • Hartnup disease (tryptophan metabolism disorder).
  • Drugs e.g. isoniazide, azathioprine.

Symptoms of Pellagra

Some common Symptoms of Pellagra :

  • weakness.
  • Insomnia.
  • Weight loss.
  • High sensitivity to sunlight.
  • Red skin lesions.
  • Irritability.
  • Poor appetite, abdominal pain, nausea and vomiting are common
  • Diarrhea.
  • Mental confusion.
  • Aggression.

Treatment of Pellagra

Here is the list of the methods for treating Pellagra :

  • Oral therapy with nicotinamide or niacin usually is effective in reversing the clinical manifestations of pellagra.
  • Skin lesions may be treated with topical emollients . Sun protection is important during the recovery phase. Cover up and apply a broad spectrum sunscreen to all exposed areas daily.
  • Because patients are often malnourished and have other vitamin deficiencies, provisions for a high-protein diet and the administration of B-complex vitamins are needed for complete recovery.
  • Pellagra can be effectively cured with intravenous or oral niacin or nicotinamide. Adequate doses to treat secondary pellagra are quite hard to get hold of in New Zealand.
  • In patients with oral dysphagia secondary to glossitis, a liquid or a semisolid diet may be required.
  • An improvement in primary pellagra should be seen within two days of commencing treatment ahigh protein diet supplemented with B-group vitamins is needed for complete recovery. Secondary pellagra may be harder to treat in view of its possible causes.