‘Brain on Fire’: an extraordinary cinematic depiction of the phenomenon of diagnostic overshadowing

Das, Soumitra; Kulkarni, Karishma

doi:10.1136/gpsych-2021-100504

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2022

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“…Although endemic in India, China and parts of Africa, pellagra is almost eradicated in Western countries due to food product fortification 10. When a diagnosis is suspected, prompt treatment with oral nicotinamide is crucial and has the potential to be lifesaving 8.…”

Section: Discussionmentioning

confidence: 99%

Pellagra as a differential diagnosis in the confused patient on the acute medical unit

et al. 2022

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A man in his 80s was admitted via the acute medical take after presenting with increased confusion and features of alcohol withdrawal. He had a several-month history of a worsening pruritic rash surrounding his neck, arms and legs in addition to new, profuse diarrhoea. In view of the background of known chronic alcoholism and the coexisting symptoms of rash, confusion and diarrhoea, pellagra was diagnosed via a multidisciplinary approach. Oral nicotinamide supplementation was commenced and his symptoms responded rapidly. The bias and challenge of reaching a unified diagnosis in the context of a multisystem condition are exemplified in this case report.

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Section: Discussionmentioning

confidence: 99%