How to Cite
1.
Rojas Chaves S, Cárdenas Quirós MF. The importance of pellagra in the differential. Rev.méd.sinerg. [Internet]. 2019May1 [cited 2024Nov.24];4(5):111 - 6. Available from: https://revistamedicasinergia.com/index.php/rms/article/view/226
Abstract
Pellagra is the name of a condition resulting from the vitamin B3 or Niacin deficiency, a potential deathly desease which is characterized by a classic triad of Diarrhea, Dermatitis, and Delirium, which is associated with risk factors such as malnutrition, poverty, intake of certain drugs, metabolic disturbances, among others. Pellagra’s diagnosis can be made on clinical grounds alone, but it’s hardly in the clinicians differential for hospitalized patients or in the emergency department; this is of great importance due the mortality that represents a late diagnosis.
Keywords
niacin. pellagra. avitaminosis. dermatitis. alcoholism.
References
1. Wilson WH. The Diet Factor in Pellagra. Journal of Hygiene. 1921 07;20(01):1-59. https://doi.org/10.1017/s0022172400043205
2. Blue R. Pellagra in California. California state journal of medicine. 1910; 8(3): 101-102
3. Hegyi J, Schwartz RA, Hegyi V. Pellagra: Dermatitis, dementia, and diarrhea. International Journal of Dermatology. 2004 01;43(1):1-5. https://doi.org/10.1111/j.1365-4632.2004.01959.x
4. Hegyi V. Dermatologic Manifestations of Pellagra. Medscape [internet]. 2018 Feb 206 [cited 2019 Jan 15]. Avariable from: https://emedicine.medscape.com/article/1095845-overview
5. Klauder JV, Winkelman NW. Pellagra among chronic alcoholic addicts. Journal of the American Medical Association. 1928 02 04;90(5):364-371. https://doi.org/10.1001/jama.1928.02690320026008
6. Li R, Yu K, Wang Q, Wang L, Mao J, Qian J. Pellagra Secondary to Medication and Alcoholism. Nutrition in Clinical Practice. 2016 08 19;31(6):785-789. https://doi.org/10.1177/0884533616660991
7. Park YK, Sempos CT, Barton CN, Vanderveen JE, Yetley EA. Effectiveness of food fortification in the United States: the case of pellagra. American Journal of Public Health. 2000 05;90(5):727-738. https://doi.org/10.2105/ajph.90.5.727
8. Oldham MA, Ivkovic A. Pellagrous encephalopathy presenting as alcohol withdrawal delirium: A case series and literature review. Addiction Science & Clinical Practice. 2012 07 06;7(1). https://doi.org/10.1186/1940-0640-7-12
9. Matapandeu G, Dunn SH, Pagels P. An Outbreak of Pellagra in the Kasese Catchment Area, Dowa, Malawi. The American Journal of Tropical Medicine and Hygiene. 2017 02 20; 96(5): 1244–1247. https://doi.org/10.4269/ajtmh.16-0423
10. Sardesai V. Introduction to Clinical Nutrition. 2 ed. New York: CRC Press; 2003. 179-186 p.
11. Terakata M, Fukuwatari T, Kadota E, Sano M, Kanai M, Nakamura T, Funakoshi H, Shibata K. The Niacin Required for Optimum Growth Can Be Synthesized from L-Tryptophan in Growing Mice Lacking Tryptophan-2,3-Dioxygenase. The Journal of Nutrition. 2013 05 22;143(7):1046-1051. https://doi.org/10.3945/jn.113.176875
12. Wildman RE, Medeiros DM. Advanced Human Nutrition. Florida: CRC Press; 2000. 521p.
13. Institute of Medicine (US) Standing Committee on the Scientific Evaluation of Dietary Reference Intakes and its Panel on Folate, Other B Vitamins, and Choline. Dietary Reference Intakes for Thiamin, Riboflavin, Niacin, Vitamin B6, Folate, Vitamin B12, Pantothenic Acid, Biotin, and Choline. Washington (DC): National Academies Press (US); 1998. 123–149 p.
14. Dalgliesh CE. Interrelationships of tryptophan, nicotinic acid and other b vitamins. British Medical Bulletin. 1956 01;12(1):49-51. https://doi.org/10.1093/oxfordjournals.bmb.a069514
15. World Health Organization. The management of nutrition in major emergencies. Geneva: WHO Library Cataloguing-in-Publication; 2000. 31–32p.
16. Dawson B, Favaloro EJ, Taylor J, Aggarwal A. Unrecognized pellagra masquerading as odynophagia. Internal Medicine Journal. 2006 07;36(7):472-474. https://doi.org/10.1111/j.1445-5994.2006.01108.x
17. Kertesz SG. Pellagra in 2 Homeless Men. Mayo Clinic Proceedings. 2001 03;76(3):315-318. https://doi.org/10.4065/76.3.315
18. Spivak JL, Jackson DL. Pellagra. An analysis of 18 patients and a review of the literature. In Johns Hopkins Medical Journal. 01 Jun 1977; 140(6):295-309.
19. Karthikeyan K, Thappa DM. Pellagra and skin. International Journal of Dermatology. 2002 08;41(8):476-481. https://doi.org/10.1046/j.1365-4362.2002.01551.x
20. Junqueira-Franco MVM, Troncon E, Garcia P, Del Alma M, Jordao A, Vannucchi H. Intestinal permeability and oxidative stress in patients with alcoholic pellagra. Clinical Nutrition. 2006 Dec;25(6):977-983. https://doi.org/10.1016/j.clnu.2006.03.010
21. Charness ME. Brain Lesions in Alcoholics. Alcoholism: Clinical and Experimental Research. 1993 02;17(1):2-11. https://doi.org/10.1111/j.1530-0277.1993.tb00718.x
22. Brown TM. Pellagra: An Old Enemy of Timeless Importance. Psychosomatics. 2010 03;51(2):93-97. https://doi.org/10.1016/s0033-3182(10)70668-x
23. Cambridge Biomedical.Vitamin B3 Niacin in Plasma [internet]. Cambridge: Cambridge Biomedical Inc. 2016 [cited: 2019 feb 20]. Avariable from: https://www.cambridgebiomedical.com/s/Vitamin-B3.pdf. Accessed 2016 May 05
24. World Health Organization. Pellagra and its prevention and control in major emergencies. USA: World Health Organization. 2000 [cited: 2019 feb 20]. Avariable from: from https://www.who.int/nutrition/publications/en/pellagra_prevention_control.pdf
2. Blue R. Pellagra in California. California state journal of medicine. 1910; 8(3): 101-102
3. Hegyi J, Schwartz RA, Hegyi V. Pellagra: Dermatitis, dementia, and diarrhea. International Journal of Dermatology. 2004 01;43(1):1-5. https://doi.org/10.1111/j.1365-4632.2004.01959.x
4. Hegyi V. Dermatologic Manifestations of Pellagra. Medscape [internet]. 2018 Feb 206 [cited 2019 Jan 15]. Avariable from: https://emedicine.medscape.com/article/1095845-overview
5. Klauder JV, Winkelman NW. Pellagra among chronic alcoholic addicts. Journal of the American Medical Association. 1928 02 04;90(5):364-371. https://doi.org/10.1001/jama.1928.02690320026008
6. Li R, Yu K, Wang Q, Wang L, Mao J, Qian J. Pellagra Secondary to Medication and Alcoholism. Nutrition in Clinical Practice. 2016 08 19;31(6):785-789. https://doi.org/10.1177/0884533616660991
7. Park YK, Sempos CT, Barton CN, Vanderveen JE, Yetley EA. Effectiveness of food fortification in the United States: the case of pellagra. American Journal of Public Health. 2000 05;90(5):727-738. https://doi.org/10.2105/ajph.90.5.727
8. Oldham MA, Ivkovic A. Pellagrous encephalopathy presenting as alcohol withdrawal delirium: A case series and literature review. Addiction Science & Clinical Practice. 2012 07 06;7(1). https://doi.org/10.1186/1940-0640-7-12
9. Matapandeu G, Dunn SH, Pagels P. An Outbreak of Pellagra in the Kasese Catchment Area, Dowa, Malawi. The American Journal of Tropical Medicine and Hygiene. 2017 02 20; 96(5): 1244–1247. https://doi.org/10.4269/ajtmh.16-0423
10. Sardesai V. Introduction to Clinical Nutrition. 2 ed. New York: CRC Press; 2003. 179-186 p.
11. Terakata M, Fukuwatari T, Kadota E, Sano M, Kanai M, Nakamura T, Funakoshi H, Shibata K. The Niacin Required for Optimum Growth Can Be Synthesized from L-Tryptophan in Growing Mice Lacking Tryptophan-2,3-Dioxygenase. The Journal of Nutrition. 2013 05 22;143(7):1046-1051. https://doi.org/10.3945/jn.113.176875
12. Wildman RE, Medeiros DM. Advanced Human Nutrition. Florida: CRC Press; 2000. 521p.
13. Institute of Medicine (US) Standing Committee on the Scientific Evaluation of Dietary Reference Intakes and its Panel on Folate, Other B Vitamins, and Choline. Dietary Reference Intakes for Thiamin, Riboflavin, Niacin, Vitamin B6, Folate, Vitamin B12, Pantothenic Acid, Biotin, and Choline. Washington (DC): National Academies Press (US); 1998. 123–149 p.
14. Dalgliesh CE. Interrelationships of tryptophan, nicotinic acid and other b vitamins. British Medical Bulletin. 1956 01;12(1):49-51. https://doi.org/10.1093/oxfordjournals.bmb.a069514
15. World Health Organization. The management of nutrition in major emergencies. Geneva: WHO Library Cataloguing-in-Publication; 2000. 31–32p.
16. Dawson B, Favaloro EJ, Taylor J, Aggarwal A. Unrecognized pellagra masquerading as odynophagia. Internal Medicine Journal. 2006 07;36(7):472-474. https://doi.org/10.1111/j.1445-5994.2006.01108.x
17. Kertesz SG. Pellagra in 2 Homeless Men. Mayo Clinic Proceedings. 2001 03;76(3):315-318. https://doi.org/10.4065/76.3.315
18. Spivak JL, Jackson DL. Pellagra. An analysis of 18 patients and a review of the literature. In Johns Hopkins Medical Journal. 01 Jun 1977; 140(6):295-309.
19. Karthikeyan K, Thappa DM. Pellagra and skin. International Journal of Dermatology. 2002 08;41(8):476-481. https://doi.org/10.1046/j.1365-4362.2002.01551.x
20. Junqueira-Franco MVM, Troncon E, Garcia P, Del Alma M, Jordao A, Vannucchi H. Intestinal permeability and oxidative stress in patients with alcoholic pellagra. Clinical Nutrition. 2006 Dec;25(6):977-983. https://doi.org/10.1016/j.clnu.2006.03.010
21. Charness ME. Brain Lesions in Alcoholics. Alcoholism: Clinical and Experimental Research. 1993 02;17(1):2-11. https://doi.org/10.1111/j.1530-0277.1993.tb00718.x
22. Brown TM. Pellagra: An Old Enemy of Timeless Importance. Psychosomatics. 2010 03;51(2):93-97. https://doi.org/10.1016/s0033-3182(10)70668-x
23. Cambridge Biomedical.Vitamin B3 Niacin in Plasma [internet]. Cambridge: Cambridge Biomedical Inc. 2016 [cited: 2019 feb 20]. Avariable from: https://www.cambridgebiomedical.com/s/Vitamin-B3.pdf. Accessed 2016 May 05
24. World Health Organization. Pellagra and its prevention and control in major emergencies. USA: World Health Organization. 2000 [cited: 2019 feb 20]. Avariable from: from https://www.who.int/nutrition/publications/en/pellagra_prevention_control.pdf
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