Pellagra: Understanding, manifestations, visuals, and additional insights

Pellagra: Understanding, Manifestations, Visual Representations, and Beyond

Pellagra is an ailment caused by deficiency in vitamin B3, commonly known as niacin. If left untreated, it can be fatal. In this piece, learn more about pellagra, including its risk factors and treatments.

Description

Pellagra is a disorder that emerges when an individual fails to consume enough niacin or vitamin B-3.

Pellagra exists in two forms: primary and secondary. Primary pellagra arises from a lack of niacin in the diet, while secondary pellagra develops when the body can't absorb niacin.

Niacin is present in both animal proteins and plant-based foods like fruits and vegetables. The body can also generate niacin from essential amino acids obtained from sources like chicken and sunflower seeds.

In regions heavily relying on maize as a staple food, primary pellagra is more prevalent. This is due to the niacin in corn being in the form of niacytin, which is difficult for the body to digest and absorb.

Alcohol use disorder and HIV are among the conditions that hinder the body's ability to absorb niacin, resulting in secondary pellagra.

Symptoms

Pellagra manifests as gastrointestinal, dermatological, and neurological issues. Its primary symptoms include:

diarrhea
skin inflammation
cognitive decline

Gastrointestinal symptoms

Diarrhea, characterized by passing loose and watery stools frequently, is the most common gastrointestinal symptom. Diarrhea can cause severe dehydration and malnutrition over time due to impaired nutrient absorption from food. It is often the initial symptom to surface.

Other gastrointestinal symptoms include:

vomiting
abdominal pain
nausea
indigestion
reduced appetite
oral ulcers
swelling of the tongue

Dermatological symptoms

Pellagra-related dermatitis frequently leads to thickened and flaky skin, rashes, and discoloration. Doctors may refer to this as a Casal collar or Casal necklace, as affected skin becomes sensitive to light and has a sunburn-like appearance.

Additional dermatological symptoms include cheilitis, characterized by inflamed and cracked corners of the mouth, and angular palpebritis, which causes redness and cracking in the eyelid corners.

Neurological symptoms

Early signs of pellagra may include neurological conditions like anxiety and depression. As pellagra progresses, individuals may experience dementia symptoms such as:

memory loss
delusions
confusion
in some instances, psychosis

Alcohol-induced pellagra often goes unnoticed because its symptoms resemble those of alcohol withdrawal delirium.

Without proper treatment, pellagra can be fatal.

Additional Resources

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Causes and Risk Factors

The underlying causes of primary and secondary pellagra vary.

Primary pellagra arises when a person's diet is deficient in niacin, commonly affecting those whose diet relies heavily on maize. In developed countries, manufacturers routinely fortify flour with niacin.

Secondary pellagra develops when the body is unable to absorb niacin despite consuming a diet rich in this vitamin. Alcohol use disorder is a significant risk factor for secondary pellagra, as alcohol can hinder niacin absorption.

An article from 2014 posits that alcohol use disorder may cause pellagra through malnutrition. This may result from insufficient food intake containing niacin, or alcohol's inhibition of niacin absorption in the body.

Alcohol can also interfere with specific proteins required for niacin production, increasing the risk of pellagra.

Treatment

A doctor can diagnose pellagra if symptoms such as diarrhea, dermatitis, and dementia appear simultaneously. However, if these symptoms do not present themselves simultaneously, a doctor may perform urine and blood tests to measure niacin deficiency and other pellagra-related abnormalities.

Individuals with primary pellagra can manage the condition by consuming a nutrient-rich diet, with foods like meat, eggs, fish, and legumes being particularly beneficial. However, a doctor may prescribe vitamin supplements to aid in reaching healthy niacin levels.

Treatment for secondary pellagra is similar, but it also includes addressing the underlying cause. Symptoms should begin to improve rapidly, and individuals may experience relief within 2 days of receiving treatment, often including high doses of niacin for 5 days.

Conclusion

Pellagra is a serious condition that can significantly impact an individual's health and quality of life. Seek medical attention if pellagra symptoms arise.

To ward off pellagra, it's crucial to stick to the daily suggested intake (DSI) of niacin.

The DSI of niacin is:

14-16 milligrams (mg) on a daily basis for grown-ups
18 mg per day for ladies who are expecting or breastfeeding
6-16 mg per day for individuals under the age of 18 years

Generally, individuals who don't primarily consume maize as their food won't grow pellagra's primary form.

After a person has been treated for both pellagra and any underlying issues, it's possible to fully recuperate one's health.

Effective treatments for pellagra often involve increasing niacin intake, either through diet or supplements.
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