Pellagra Information

Pellagra is a chronic wasting disease. The disease is common in parts of the world where people have a lot of corn in their diet. It is characterized by scaly skin sores, diarrhea, inflamed mucous membranes, mental confusion, and delusions. The disease is caused by dietary lack of niacin and protein, especially proteins containing the essential amino acid tryptophan. Pellagra typically is an adult disease. Adolescents and young children could develop pellagra if exposed to a pellagragenic diet. Pellagra rarely occurs during infancy. Nicotinic acid plays a crucial role in the cellular process called respiration. Pellagra is defined by the systemic disease resulting from niacin deficiency, and it is characterized by diarrhea, dermatitis, dementia, and death, which usually appear in this order. Pellagra can be either primary or secondary. Primary pellagra results when the diet is extremely deficient in niacin-rich foods. Secondary pellagra occurs when adequate quantities of niacin are present in the diet, but other diseases or conditions interfere with its absorption and processing. 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 plentiful in yeast, organ meats, peanuts, and wheat germ. Pellagra may develop after gastrointestinal diseases or alcoholism. Pellagra can be common in persons who obtain most of their food energy from maize, since untreated corn is a poor source of niacin. This disease can be common among people who live in rural South America where corn is a staple. Pellagra can also occur when a hospitalized patient, unable to eat for a very prolonged period of time, is given fluids devoid of vitamins through a needle in the vein. Pellagra was first described in Spain in 1735. It was an endemic disease in northern Italy, where it was named "pelle agra" (pelle, skin; agra, sour) by Francesco Frapoli of Milan. The symptoms usually appear during spring, increase in the summer due to greater sun exposure, and return the following spring. Untreated pellagra results in death from multiorgan failure. Treatment of pellagra usually involves supplementing the individual's diet with a form of niacin called niacinamide. The niacinamide can be given by mouth (orally) or by injection.

Causes of Pellagra

The common causes and risk factor's of Pellagra include the following:

• Chronic alcoholism.
• Prolonged diarrhoea.
• Gastrointestinal diseases such as ulcerative colitis.
• Prolonged febrile illness.
• Liver cirrhosis.
• Hartnup disease (tryptophan metabolism disorder).
• Carcinoid tumours.

Symptoms of Pellagra

Some sign and symptoms related to Pellagra are as follows:

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

Treatment of Pellagra

Here is list of the methods for treating Pellagra:

• Nicotinamide or niacin taken orally is usually effective in reversing the clinical manifestations of pellagra.
• 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.
• 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.
• Bed rest is mandatory in treatment of severe cases of pellagra.
• In patients with oral dysphagia secondary to glossitis, a liquid or a semisolid diet may be required.