<\/span><\/h2>\nPellagra is a disease characterized by diarrhoea, dermatitis<\/span> and dementia. If left untreated, death is the usual result. It occurs as a result of niacin (vitamin B-3) deficiency. Niacin is required for most cellular<\/span> processes. Since tryptophan in the diet can be converted to niacin in the body, both must be deficient for pellagra to develop.<\/p>\n<\/span>What causes pellagra?<\/span><\/h2>\nPellagra is caused by a deficiency of niacin. This can happen in 2 ways:<\/p>\n
\n- \nPrimary<\/span> Pellagra is the result of inadequate niacin and\/or tryptophan in the diet (primarily in developing countries or poverty-stricken areas)<\/li>\n
- Secondary pellagra occurs when there is enough niacin in the diet, but something prevents its absorption and processing. Causes of secondary pellagra include:\n
\n- \nChronic<\/span> alcoholism\n<\/li>\n
- prolonged diarrhea<\/li>\n
- Gastrointestinal diseases such as ulcerative. colitis<\/span>\n<\/li>\n
- Liver cirrhosis<\/span>\n<\/li>\n
- carcinoid tumors<\/li>\n
- Hartnup disease (tryptophan metabolism<\/span> disorder)<\/li>\n
- drugs e.g. isoniazid, azathioprine\n<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n
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<\/span>What are the signs and symptoms of pellagra?<\/span><\/h2>\nThe classic triad of symptoms are diarrhoea, dermatitis and dementia.<\/p>\n\n<\/span>Pellagra in a patient with Hartnup disease<\/span><\/h5>\n<\/section>\n\n\n
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\n\n\n| Site<\/th>\n | Clinical features<\/th>\n<\/tr>\n |
\n| Skin<\/td>\n | \n\n- First sign<\/span> is reddened skin with superficial climbing<\/span> in areas exposed to sunlight, heat and friction. This may look like a severe sunburn and then gradually fades away leaving a dark reddish-brown discoloration.<\/li>\n
- the eruption<\/span> It is usually symmetrical<\/span> with a clear border between affected and unaffected skin<\/li>\n
- There may be itching or a burning sensation.<\/li>\n
- Over time the skin becomes thick, hard, scaly<\/span> and cracked Bleeding can lead to blackened scabs<\/li>\n
- The lesions can occur anywhere on the body, especially the hands, arms, legs, feet, face, and neck (known as Casal's collar)<\/li>\n
- Lips, tongue, and gums may be sore and scaly<\/li>\n<\/ul>\n<\/td>\n<\/tr>\n
\n| Gastrointestinal<\/td>\n | \n\n- Diarrhea occurs in 50% cases.<\/li>\n
- Poor appetite, abdominal pain, nausea, and vomiting are common.<\/li>\n
- May be difficult to eat and drink, leading to further malnutrition\n<\/li>\n<\/ul>\n<\/td>\n<\/tr>\n
\n| Neurological<\/td>\n | \n\n- Symptoms of apathy and mild depression may initially go unnoticed<\/li>\n
- Other symptoms include headache, confusion, irritability, restlessness, anxiety, tremor, delusions, disorientation, and psychosis.<\/li>\n
- Patients eventually become stuporous, comatose, and may die.<\/li>\n<\/ul>\n<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n
<\/span>What treatment is available?<\/span><\/h2>\nPellagra can be effectively cured with intravenous or oral niacin or nicotinamide. Adequate doses to treat secondary pellagra are quite hard to come by in New Zealand!<\/p>\n An improvement in primary pellagra should be seen within two days of starting treatment. A high-protein diet supplemented with B vitamins is needed for full recovery. Secondary pellagra may be more difficult to treat in view of its possible causes.<\/p>\n Skin lesions can be treated with current<\/span> emollients<\/span>. Sun protection is important during the recovery phase. Cover up and apply a broad-spectrum sunscreen daily to all exposed areas.<\/p>\n<\/section>","protected":false},"excerpt":{"rendered":"\u00bfQu\u00e9 es la pelagra? La pelagra es una enfermedad caracterizada por diarrea, dermatitis y demencia Si no se trata, la muerte es el resultado habitual. Ocurre como resultado de la…<\/p>","protected":false},"author":8,"featured_media":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","format":"standard","meta":{"footnotes":""},"categories":[],"tags":[],"class_list":["post-8311","wiki","type-wiki","status-publish","format-standard"],"_links":{"self":[{"href":"https:\/\/doctorhoogstra.com\/en\/wp-json\/wp\/v2\/wiki\/8311","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/doctorhoogstra.com\/en\/wp-json\/wp\/v2\/wiki"}],"about":[{"href":"https:\/\/doctorhoogstra.com\/en\/wp-json\/wp\/v2\/types\/wiki"}],"author":[{"embeddable":true,"href":"https:\/\/doctorhoogstra.com\/en\/wp-json\/wp\/v2\/users\/8"}],"replies":[{"embeddable":true,"href":"https:\/\/doctorhoogstra.com\/en\/wp-json\/wp\/v2\/comments?post=8311"}],"version-history":[{"count":0,"href":"https:\/\/doctorhoogstra.com\/en\/wp-json\/wp\/v2\/wiki\/8311\/revisions"}],"wp:attachment":[{"href":"https:\/\/doctorhoogstra.com\/en\/wp-json\/wp\/v2\/media?parent=8311"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/doctorhoogstra.com\/en\/wp-json\/wp\/v2\/categories?post=8311"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/doctorhoogstra.com\/en\/wp-json\/wp\/v2\/tags?post=8311"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}} | | |