Pellagra: Dermatitis, dementia, and diarrhea

Abstract

Pellagra defines systemic disease as resulting from a marked cellular deficiency of niacin. It is characterized by 4 "D's": diarrhea, dermatitis, dementia, and death. Diagnosis of pellagra is difficult in the absence of the skin lesions, and is often facilitated by the presence of characteristic ones. The dermatitis begins as an erythema. Acute pellagra resembles sunburn in its first stages, but tanning occurs more slowly than typically in sunburn. Exacerbation follows re-exposure to sunlight. In this work we review the findings of this once mysterious disorder, one that still challenges clinicians world-wide.

Thoughts on B-vitamins and dementia

“…Niacin deficiency is a known cause of pellagra, a disease characterized by symptoms of dementia, diarrhea, and dermatitis that can be resolved through niacin supplementation [7][8][9] Disease effects on the central nervous system begin with neurasthenia followed by symptoms of psychosis, including disorientation, memory loss, and confusion. Pellagra is endemic to populations that consume maize or sorghum as the primary food, but can occur as the result of alcoholism and gastrointestinal disease.…”

Induction of regulatory T cells: A role for probiotics and prebiotics to suppress autoimmunity

“…Gut microbiota also produce niacin. Niacin deficiency in humans results in pellagra, characterized by intestinal inflammation, diarrhoea, dermatitis, and dementia [169]. It is of great clinical relevance that lower abundance of GPR109A ligands, niacin and butyrate in gut is associated with colonic inflammation.…”

Maize meal fortification is associated with improved vitamin A and iron status in adolescents and reduced childhood anaemia in a food aid-dependent refugee population

“…Micronutrient deficiencies often occur in combination and while we collected no information on other deficiencies it is likely that the study population was deficient in a number of other micronutrients (23) . In particular, vitamin B deficiency is frequently found in maizeconsuming populations and health staff in the camp reported isolated clinical cases of pellagra during the intervention period (24) . Niacin and other B vitamins were included in the maize meal fortificant and it is reasonable to suppose that consumption of the fortified maize meal may have led to improvements in population micronutrient status.…”