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    Pellagra

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    Pellagra is a niacin (vitamin B3) deficiency disease characterized by dermatitis, diarrhea, dementia, and death. It is caused by a diet primarily consisting of corn, which is low in niacin. Symptoms include a distinctive rash around the neck known as Casal's necklace, inflammation of the mouth and tongue, gastrointestinal issues like diarrhea, and neurological problems like dementia. Diagnosis is based on symptoms and improvement with niacin treatment. Treatment involves supplementation with 100-200mg of nicotinamide 3 times daily along with a balanced diet.

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    Pellagra

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    Pellagra is a niacin (vitamin B3) deficiency disease characterized by dermatitis, diarrhea, dementia, and death. It is caused by a diet primarily consisting of corn, which is low in niacin. Symptoms include a distinctive rash around the neck known as Casal's necklace, inflammation of the mouth and tongue, gastrointestinal issues like diarrhea, and neurological problems like dementia. Diagnosis is based on symptoms and improvement with niacin treatment. Treatment involves supplementation with 100-200mg of nicotinamide 3 times daily along with a balanced diet.

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    Pellagra is a niacin (vitamin B3) deficiency disease characterized by dermatitis, diarrhea, dementia, and death. It is caused by a diet primarily consisting of corn, which is low in niacin. Symptoms include a distinctive rash around the neck known as Casal's necklace, inflammation of the mouth and tongue, gastrointestinal issues like diarrhea, and neurological problems like dementia. Diagnosis is based on symptoms and improvement with niacin treatment. Treatment involves supplementation with 100-200mg of nicotinamide 3 times daily along with a balanced diet.

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    © All Rights Reserved
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    Download as pptx, pdf, or txt
    38 views13 pages

    Pellagra

    Uploaded by

    Spam Spam
    Pellagra is a niacin (vitamin B3) deficiency disease characterized by dermatitis, diarrhea, dementia, and death. It is caused by a diet primarily consisting of corn, which is low in niacin. Symptoms include a distinctive rash around the neck known as Casal's necklace, inflammation of the mouth and tongue, gastrointestinal issues like diarrhea, and neurological problems like dementia. Diagnosis is based on symptoms and improvement with niacin treatment. Treatment involves supplementation with 100-200mg of nicotinamide 3 times daily along with a balanced diet.

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    PELLAGRA

    BY- RANJITHA
    K
    PELLAGRA
     Vitamin B3 niacin(nicotinamide) deficiency causes a metabolic
    encephalopathy called pellagra.

     It is found mostly in populations in which corn is the major source of


    energy in parts of China, Africa and India. Pellagra means raw skin.

    2
    VITAMIN B3 (NIACIN)
     Sources

     Actions: NAD/NADP are co-factors for many enzymatic redox


    reactions.
     RDA: Dosed as a “niacin equivalent”(NE), in which 1 NE is equal to
    1mg of niacin, or 60mg of dietary tryptophan. RDA is 6-12 mg daily in
    children, 16 mg for adult males and 14 mg daily for nonpregnant adult
    females

    3
    CAUSES OF PELLAGRA
     Inadequate intake
     Generalized malabsorption(rate)
     Drug Induced:
    1. Prolonged ioniazid therapy
    2. Pyrazinamide
    3. 6-mercaptopurine
    4. 5-fluouracil
    5. Azathioprine
     Other disorders:
    1. Hartnup’s disease
    2. Carcinoid syndrome

    4
    CLINICAL FEATURES
    Pellagra has been easily remembered a disease of four D’s namely:

    1. Dermatitis
    2. Diarrhea
    3. Dementia
    4. Death

    5
    SKIN MANIFESTATIONS
     Casal’s necklace or collar rash: Characteristic skin rash develops that is
    hyperpigmented and scaling that develops in skin areas exposed to sunlight.
    This rash forms a ring around the neck and is termed Casal’s necklace.

     Dermatitis: Lesions of the skin may progress to vesiculation, cracking,


    exudation and secondary infection. Symmetrical chronic thickening dryness
    and pigmentation may be seen on the dorsal surfaces of the hands.

    6
    Casal’s Necklace Gauntlet of pellagra

    Dermatitis

    7
    GASTROINTESTINAL(GI)

    TRACT
    Diarrhea: It may be in part due to proctitis and in part due to malabsorption. It
    is often a feature accompanied by anorexia, nausea and dysphagia indicating
    noninfective inflammation of the entire GI tract.
     Other features include:
    1. Glossitis
    2. Angular stomatitis
    3. Vaginitis
    4. Esophagitis
    5. Vertigo
    6. Burning dysesthesias

    8
    Angular Stomatitis Glossitis

    9
    DEMENTIA
     This occurs in chronic severe deficiency and may also develop
    hallucinations and acute psychosis.
     Milder deficiency may present with depression, apathy and sometimes
    thought disorders.
     Other neurologic symptoms include
    1. Insomnia
    2. Anxiety
    3. Disorientation
    4. Tremor
    5. Delusions
    6. Dementia
    7. Encephalopathy
    10
    DIAGNOSIS
     Diagnosis in endemic region depends on the clinical features. Other vitamin
    deficiencies can also produce similar changes(e.g. Angular stomatitis)

     Dramatic improvement: The response is usually rapid in the skin(within


    24 hours), diarrhea and a striking improvement occurs in the patient’s
    mental state with nicotinamide treatment.

     Niacin status can be assessed by measuring urinary N-


    methylnicotinamide, 2-pyridonenicotinamide or by measuring the
    erythrocyte NAD:NADP (ratio).

    11
    TREATMENT
     Nicotinamide: 100-200 mg 3 times daily orally( approximately 300 mg
    daily) with a maintenance dose of 50 mg daily.
     High-protein diet with adequate nutrients and treatment of malnutrition.
     Supplementation of other vitamin B complex with iron and folic acid is
    also given as other deficiencies are often likely to be present.
     In moderate-to-high doses (1-3 gm a day), niacin is a well established
    antihyperlipidemic agent.

    12
    THANK YOU

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