Pellagra disease – what you need to know when you have a vitamin B3 deficiency

Pellagra is a disease associated with a deficiency of vitamin B3, or niacin. This disease is quite common in developing countries. What are the symptoms of Pellagra? What causes the disease? How dangerous is this disease? Let Dr. Nguyen Thi Thao answer your frequently asked questions about Pellagra.

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• 1. Pellagra disease – Vitamin B3 deficiency
• 2. How does Pellagra disease manifest?
• 3. What causes Pellagra?
• 4. Diagnostic method?
• 5. How is this disease treated?

1. Pellagra disease – Vitamin B3 deficiency

Pellagra is a disease caused by a deficiency of vitamin B3 ( vitamin PP ), or niacin. Characteristic conditions include dementia, diarrhea, and dermatitis. This disease is treatable. However, it is quite dangerous, if not treated, the patient can die.

In the past, this disease was more common. Due to improved nutrition today, vitamins are more complete. However, in developing countries, the disease is still relatively common.

2. How does Pellagra disease manifest?

The main symptoms of Pellagra are dermatitis, dementia, and diarrhea. This condition is caused by the effects of a niacin deficiency. Cells in the digestive system and skin have a faster rate of replacing dead cells, so the need for vitamin B3 is also higher. Therefore, when the body is deficient in niacin, the symptoms in these organs appear first.

2.1 Symptoms in the skin

Inflammation of the skin caused by the disease manifests as a rash on the face, lips, feet, and hands. There are also cases of dermatitis appearing around the neck, creating the "Casal necklace" symptom.

Skin lesions around the neck in the form of “Casal chains”

Other manifestations of dermatitis may be:

• Red, scaly skin.
• There are areas of color variation, usually from red to brown.
• Thick, brittle, flaky, or cracked skin.
• Itchy, burning skin

Skin manifestations of Pellagra on the hands

2.2 Neurological symptoms

In some cases, the neurological symptoms of Pellagra appear first. However, because the neurological manifestations are difficult to detect, it may take some time for a patient or loved one to recognize the symptoms of dementia.

As the disease progresses, symptoms of dementia can include:

• Insensitivity.
• Depression .
• Feelings of confusion, irritability, mood changes.
• Headache.
• Feelings of restlessness, anxiety.
• Disoriented, paranoid.

2.3 Other manifestations

In addition to the above symptoms, Pellagra can include:

• Pain in the lips, tongue, or gums.
• Anorexia, feeling of not eating well.
• Having difficulty eating.
• Nausea.

3. What causes Pellagra?

Because there are two main groups of causes, Pellagra disease is divided into:

• Primary Pellagra.
• Secondary Pellagra.

Primary Pellagra is caused by a diet lacking in niacin or tryptophan. Tryptophan can be consumed and converted to niacin when absorbed into the body. Therefore, if the diet is not enough tryptophan, it will lead to disease.

Primary Pellagra is common in developing countries. Due to the lack of food and nutritional care, the diet of a part of people is lacking in essential vitamins. If the deficiency persists, Pellagra will appear.

Primary Pellagra is common in developing countries, where food is scarce

Secondary Pellagra is caused by another cause. When the diet still provides enough vitamins, the patient's body cannot absorb niacin from food. Several conditions can cause this malabsorption:

• Alcoholism.
• Eating disorder.
• Certain medications, such as antiepileptic drugs and immunosuppressants.
• Gastrointestinal disease, such as Crohn's disease or ulcerative colitis.
• Cirrhosis.
• Melanoma.
• Hartnup disease (an inherited metabolic disorder).

Certain medical conditions, such as gastrointestinal disease, can prevent vitamin B3 absorption

4. Diagnostic method?

Pellagra has many different manifestations, so it is quite difficult to diagnose the disease. Furthermore, there is no single test that can confirm a niacin deficiency. Therefore, the doctor will rely on gastrointestinal symptoms, skin rash or neurological disorders to make a diagnosis.

Certain types of tests may also be done, such as a urinalysis. The presumptive diagnosis of niacin supplementation is often made in practice.

5. How is this disease treated?

For primary Pellagra, treatment is either changing to a niacin-rich diet or taking a niacin supplement. Vitamin supplements can also be given as an intravenous infusion.

If treated early, patients usually recover very quickly, within just a few days. Inflammation of the skin may improve gradually over several months. However, if left untreated, the disease can be fatal after about four to five years.

Vitamin B3 is often found in animal meat, nuts, dark green vegetables, etc.

Treatment of secondary Pellagra focuses on the underlying disease. Addressing the cause of niacin malabsorption will help cure the disease. The combination of niacin supplementation therapy may also be beneficial in some cases.

Note that, for skin lesions, the patient should keep the rash well moisturized and use sunscreen.

Pellagra is a disease caused by a deficiency of vitamin B3 or niacin. The cause may be a nutritional problem or an abnormality in the absorption of niacin. If not treated promptly, the disease can be fatal. Therefore, you should pay attention to the symptoms of the disease and seek medical attention when necessary. And remember to always eat healthy to have an abundant health. SignsSymptomsList wishes you all the best.