Pellagra



Pellagra uses color pictures and clear explanations to teach you about this nutritional disease which affects the skin.

Table of contents:
Chapter 1. What causes Pellagra?
Chapter 2. What are the symptoms and signs of Pellagra?
Chapter 3. What investigations are done for Pellagra?
Chapter 4. What are the differential diagnosis for Pellagra?
Chapter 5. What is the treatment for Pellagra?
Chapter 6. What are the complications of Pellagra?
Chapter 7. How can Pellagra be prevented?

BOOK EXCERPT
Chapter 1
WHAT CAUSES PELLAGRA?
Pellagra is a nutritional disease that is caused by deficiency of vitamin B3 or niacin which is a water soluble vitamin.

Pellagra can be classified in the following way:
1. Primary pellagra
Primary pellagra develops as a result of inadequate dietary niacin intake. Primary pellagra can also develop as a result of inadequate dietary tryptophan intake since this amino acid is converted to niacin in the body. The causes of primary pellagra include poverty related malnutrition, maize (corn) based diet, anorexia nervosa, chronic parenteral nutrition, fad diets and severe elimination diets.  

2. Secondary pellagra
Secondary pellagra develops despite adequate dietary niacin due to poor niacin intake, absorption, and processing by the body. Causes of secondary pellagra include:
a. Gastrointestinal diseases such as chronic diarrhea, Crohn’s disease, ulcerative colitis, regional enteritis, gastrointestinal tuberculosis, and liver cirrhosis.
b. Chronic alcoholism and chronic drug addiction
c. Anorexia nervosa
d. Chronic dialysis
e. Malignant carcinoid tumors since the tryptophan is used to form the serotonin.
f. Hartnup syndrome which is an inherited disorder of amino acid transport which results in defective absorption of tryptophan by the gastrointestinal tract and kidneys.
g. Medications such as isoniazid which competes with niacin, pyrazinamide, 5-fluorouracil, 6-mercaptopurine, azathioprine, chloramphenicol, and phenytoin.

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