Pellagra

A disease due to deficiency of NIACIN, a B-complex vitamin, or its precursor TRYPTOPHAN. It is characterized by scaly DERMATITIS which is often associated with DIARRHEA and DEMENTIA (the three D's).

Also Known As:

Networked: 395 relevant articles (9 outcomes, 19 trials/studies)

Relationship Network

Disease Context: Research Results

Related Diseases

1.	Neurologic Manifestations (Neurological Manifestations)
2.	Dermatitis
3.	Diarrhea
4.	Dementia (Dementias)
5.	Beriberi

Experts

1.	Mponda, Kelvin: 4 articles (01/2022 - 02/2016)
2.	Fukuwatari, Tsutomu: 3 articles (01/2014 - 01/2003)
3.	Shibata, Katsumi: 3 articles (01/2014 - 01/2003)
4.	Williams, Adrian C: 3 articles (01/2013 - 01/2007)
5.	Lanska, Douglas J: 3 articles (01/2012 - 01/2010)
6.	Cheung, Edith: 3 articles (09/2007 - 01/2007)
7.	van den Briel, Tina: 3 articles (09/2007 - 01/2007)
8.	Auld, Andrew F: 2 articles (01/2022 - 01/2020)
9.	Buono, Nicole: 2 articles (01/2022 - 01/2020)
10.	Chisuwo, Laphiod: 2 articles (01/2022 - 01/2020)

Drugs and Biologics

Drugs and Important Biological Agents (IBA) related to Pellagra:

1.	Niacin (Nicotinic Acid)FDA LinkGeneric 01/01/2021 - "Although pellagra, diagnosed based on dermatological symptoms, appears to be largely eradicated in South Africa, it does not rule out the potential for subclinical niacin deficiency." 10/01/2022 - "Further studies are required to investigate whether niacin prevents pellagra-like symptoms caused by PFD in patients with IPF." 01/01/2021 - "However, studies on urinary excretion of metabolites conducted in 1960s and 1970s suggested a high prevalence of subclinical (sub-pellagra) niacin deficiency, especially in previously disadvantaged Black populations. " 01/01/2015 - "The objective of this study was to identify the causal mutation in the pellagra-like condition and investigate the mechanism by which niacin confers clinical benefit. " 12/01/2006 - "The study was divided into two phases: in Phase 1 we studied ten patients with pellagra before treatment with niacin, and in Phase 2 we studied the same patients after 27 days of treatment with niacin. "
2.	VitaminsIBA 01/01/2010 - "Vitamin fortification of foodstuffs during World War II ultimately eradicated endemic pellagra in the United States. " 01/01/1946 - "Pellagra, a study in human nutrition; the multiple-factor principle of the determination of minimum vitamin requirements." 05/01/2017 - "The incidence of pellagra is quite rare presently because of increased awareness and strategies such as vitamin fortification. " 01/01/2010 - "In the United States, pellagra became epidemic among poor Southerners in the early 20th century, in part because of economically-driven reliance on monotonous, nutritionally inadequate diets, combined with new manufacturing methods that removed vitamins from processed grain. " 01/01/1982 - "Moreover, the more recent aspects concerning the aetiological factors responsible for the appearance of Pellagra, with special emphasis to vitamins, is reported."
3.	Vitamin B Complex (B Vitamins)IBA 01/01/1959 - "[Bacteriogram of stool culture from patients with chronic or endemic pellagra, and on a pellagrogenic diet compared with subjects receiving vitamin B complex]." 09/01/1981 - "Since present-day refining and food selection patterns, as well as pure corn diets, deplete both the B vitamins and W3-EFA, the existence of therapeutically cross-reacting homologous catalyst and substrate deficiency forms of pellagra are postulated, the first contributing to the B vitamin deficiency epidemics of 50-100 years ago, the second to the more recent endemic "Diseases of Western Civilization" which express in certain genetic subgroups as the major mental illnesses of today." 01/01/2010 - "This historical review addresses major neurological disorders associated with deficiencies of water-soluble B vitamins: beriberi, Wernicke-Korsakoff syndrome, pellagra, neural tube defects, and subacute combined degeneration of the spinal cord. " 01/01/1982 - "About 1900, modern food selection and processing caused widespread epidemics of the B vitamin deficiency diseases of beriberi and pellagra which, for genetic reasons, often expressed as different diseases ranging from bowel and heart disease to dermatoses and psychoses. " 01/01/2022 - "Those with isoniazid-associated pellagra who discontinued isoniazid and adhered to multi-B vitamin treatment showed 30-day clinical improvement. "
4.	Niacinamide (Nicotinamide)FDA LinkGeneric 04/13/2022 - "In most developed countries, pellagra is successfully eradicated by vitamin B3 fortification programs. " 11/26/2019 - "As NAD+ status is critical in maintaining cellular energy, vitamin B3 deficiency mainly affects tissues that need high cellular energy causing pellagra and skin sun sensitivity. " 12/01/2012 - "Because L-Trp is also a precursor to nicotinamide, administration of the free form of L-Trp is a very good method of preventing pellagra. " 07/06/2012 - "Whenever pellagra is suspected, treatment with oral nicotinamide (100 mg three times daily for 3-4 weeks) prior to laboratory confirmation is recommended as an inexpensive, safe, and potentially life-saving intervention." 11/01/2005 - "Arguably Pellagra would have disappeared if dietary measures suggested at the time had been implemented before Nicotinamide was even discovered. "
5.	Thiamine (Aneurin)FDA Link 01/01/1982 - "Of the three pellagra patients in the study, none showed biochemical vitamin B1 deficiency. " 06/01/2011 - "Because of lack of response to thiamine therapy, we concluded that the psychosis and laryngitis were caused by pellagra. " 06/01/2011 - "She was diagnosed with pellagra after detection of decreased serum levels of niacin and thiamine. " 08/01/1988 - "The relationship between pellagra occurring during thiamine and pyridoxine therapy and 'nicotinic acid deficiency' is discussed. " 11/01/2019 - "Food fortification efforts have nearly eradicated diseases of extreme B vitamin deficiency, such as beriberi from thiamin deficiency and pellagra from niacin deficiency. "
6.	Pyruvic Acid (Pyruvate)IBA 01/01/1977 - "In 25 cases of pellagra and 10 healthy controls, the blood pyruvic acid levels in the fasting stage and after 60 and 90 minutes of glucose load were estimated by the technique of Friedmann & Haugen (1943). " 01/01/1977 - "The following conclusions were drawn from this study: (i) that there is impairment of pyruvic acid metabolism in cases of pellagra, which is more marked in pellagrins with neurological manifestations than in those without; (ii) that after administration of nicotinic acid alone for 15 days the pyruvic acid levels returned to normal, thereby indicating that nicotinic acid deficiency is the cause of deranged pyruvate metabolism; (iii) that there is significant improvement in neurological status after nicotinic acid therapy."
7.	Riboflavin (Vitamin B2)FDA LinkGeneric 07/11/1931 - "VITAMIN B(2) AND PELLAGRA: THE ETIOLOGY OF PELLAGRA." 01/01/1930 - "The heat-stability of the (antidermatitis, "anti-pellagra") water-soluble vitamin B(2). " 07/31/1931 - "1. Isolated cases of a dermatitis resembling histologically that of human pellagra have occurred in rats supplied with sufficient vitamin B(2) (G) in the form of beef extract or neutral autoclaved yeast to produce good growth. " 07/31/1931 - "IS THE RAT DERMATITIS CONSEQUENT ON VITAMIN B(2) (G) DEFICIENCY TRUE PELLAGRA?" 01/01/1930 - "Heat-stability of the (anti-dermatitis, "anti-pellagra") water-soluble vitamin B(2)."
8.	AcidsIBA 02/01/1997 - "Antiinflammatory treatment for Crohn's disease was given and the gastrointestinal and articular symptoms improved, excretion of 5-hydroxyindolacetic acid returned to normal and there was no relapse of pellagra. " 02/01/1997 - "Crohn's disease associated with pellagra and increased excretion of 5-hydroxyindolacetic acid." 05/01/2003 - "To further corroborate a diagnosis of pellagra in anorexic patients, specific 24-hour urine tests for niacin metabolites and 5-hydroxy-indole-acetic acid could be run prior to treatment with niacin being instituted. " 02/01/1997 - "In the current case, the pathogenesis of pellagra may be accounted to wastage of tryptophan by an increased pool of intestinal argyrophilic cells, suggested by increased urinary excretion of 5-hydroxyindolacetic acid." 05/01/2014 - "Skin photosensitivity in pellagra may be due to decreased synthesis of the Trp metabolite picolinic acid → zinc deficiency → decreased skin levels of the histidine metabolite urocanic acid and possibly also increased levels of the haem precursor 5-aminolaevulinic acid (5-ALA) and photo-reactive porphyrins. "
9.	Tryptophan (L-Tryptophan)FDA Link 07/01/1997 - "It is known that deaths attributable to pellagra, which is considered to be a disease caused by the disturbance of tryptophan metabolism, have been approximately two-fold higher in women than in men. " 03/01/1990 - "A less frequent complication of the changes in the tryptophan metabolism due to carcinoidosis is the disease pellagra. " 05/01/1987 - "Pellagra treated with tryptophan." 06/01/1982 - "Plasma tryptophan in pellagra patients was 2.07 +/- 1.27 mumol/dl, and in the controls 4.84 +/- 2.21 mumol/dl (p less than 0.001). " 06/01/1970 - "Tryptophan: abnormal metabolism in pellagra patients."
10.	EnzymesIBA 10/31/1975 - "[Letter: Enzyme reactions in pellagra?]." 06/01/1982 - "Tryptophan metabolism in alcoholic pellagra patients: measurements of urinary metabolites and histochemical studies of related muscle enzymes." 01/01/1991 - "These results suggest that the lower availability of NADP+ is responsible, at least in part, for some metabolic derangements in pellagra-like disease, such as a decrease in the activity of NADP(+)-dependent enzymes observed in quail muscle." 06/01/1971 - "Tryptophan metabolism in patients with pellagra: problem of vitamin B 6 enzyme activity and feedback control of tryptophan pyrrolase enzyme." 03/01/1980 - "On the basis of the in vitro enzyme inhibition studies, it is not possible to explain why patients treated with isoniazid (without supplementary vitamin B(6)) develop clinical pellagra, while those treated with Benserazide or Carbidopa do not, despite biochemical evidence of niacin deficiency. "

Therapies and Procedures

1.	Therapeutics 11/10/1954 - "[Clinico-experimental study of the pathogenesis and therapy of pellagra]." 01/25/2009 - "[The history of pellagra therapy]." 01/01/2005 - "Singular medicaments even may have been appropriate for a causal therapy in somatically based mental diseases like "pellagra"." 12/01/1990 - "[Pellagra in anticonvulsive therapy]." 11/01/1963 - "PROGRESSION OF CLASSIC SIGNS OF NEUROPATHY AND PELLAGRA DURING THERAPY."
2.	Aftercare (After-Treatment) 08/15/1998 - "Recognition of pellagra is important; the prognosis is good after treatment." 06/01/1959 - "Gastroscopic findings in pellagra; their correlation with the clinical manifestations before and after treatment." 01/01/1976 - "A patient with tuberculous meningitis developed a pellagra-like skin eruption after treatment with isoniazid. " 09/01/1976 - "Detailed studies of protein metabolism were undertaken in a patient with pellagra and hypoproteinemia associated with the carcinoid syndrome both before and after treatment. " 12/01/2006 - "The results suggest that niacin and vitamin E deficiency in patients with pellagra could be important factors in increased intestinal permeability and decreased antioxidant conditions, recovering to normal values after treatment with niacin, associated to alcohol abstinence and a balanced diet."
3.	Drug Therapy (Chemotherapy) 01/01/1968 - "[Neurological form of pellagra induced by antitubercular chemotherapy]." 12/01/2016 - "Herein, we report a case of pellagra in a young alcoholic who underwent combined chemotherapy for tuberculosis. " 01/01/1983 - "Pellagra secondary to antituberculous chemotherapy can result from isoniazide therapy, as well as from pyrazinamide treatment. " 10/10/2018 - "Pellagra Secondary to GI Malignancy and Fluorouracil-Based Chemotherapy." 01/01/1983 - "Pellagra probably due to pyrazinamide: development during combined chemotherapy of tuberculosis."
4.	Intravenous Administration 08/01/1984 - "These results suggest that pellagra is one of the disorders which exhibit an abnormal hyperresponse of GH to intravenous administration of TRH." 03/01/2008 - "The triad of typical dermatitis, delirium, and diarrhea led to a diagnosis of pellagra, and all the symptoms disappeared after intravenous administration of nicotinate and vitamins. "
5.	Bariatric Surgery 05/01/2023 - "Micronutrient deficiencies such as pellagra are rarely seen after bariatric surgery and can be challenging to diagnose and manage. " 05/01/2023 - "Pellagra is a nutritional disease resulting from a deficiency of vitamin B3 (niacin) primarily due to corn consumption, especially in developing countries, but in developed countries, it can occur secondarily as a consequence of chronic alcoholism, malabsorption, certain drugs, and bariatric surgery. "