Pellagra

Pellagra is a disease caused by a lack of niacin (vitamin B3). Niacin is found in most foods. The signs and symptoms of pellagra can be remembered as "the three D's": diarrhoea, dermatitis, and dementia. Sometimes a fourth D, which is death, is used to list the three or four D's. A person may be niacin deficient from poor diet or poverty.

It may also cause a copper-colored 'necklace' across the chest or 'gauntlet' on the hands, called the cascals necklace or gauntlet of pellagra, respectively.. This dermatitis or erythema - which may look like sunburn - can be made worse on areas of the skin that have been exposed to sunlight.

It is endemic in China and Africa.

Symptoms

Some symptoms of pellagra according to a few sources are:

• abdominal cramping
• depression
• diarrhea
• headache
• loss of appetite
• mucus membrane inflammation
• dilated cardiomyopathy
• anxiety

Cause

Other causes of pellagra are chronic alcoholism and gastro-intestinal malabsorption. Dehydration (not drinking enough water) or urinating too much, for example by taking diuretic drugs can cause the body to lose its store of Vitamin B3. B vitamins are water soluble and the other water soluble vitamin is vitamin C. The rest of the vitamins are fat soluble.

It can be prevented by adequate intake of niacin or foods rich in vitamin B3 and offering dietary advice to vulnerable groups.

Related pages

• Ataxia
• Nicotinamide adenine dinucleotide phosphate (NADP+ and NADPH), Krebs cycle