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Pellagra

Pellagra is a disease that occurs when a person does not get enough niacin (one of the B complex vitamins) or tryptophan (an amino acid).

Causes

Pellagra is caused by having too little niacin or tryptophan in the diet. It can also occur if the body fails to absorb these nutrients. It may develop after gastrointestinal diseases or with alcohol use, HIV/AIDS, or anorexia.

The disease is common in parts of the world where people have a lot of corn in their diet.

Symptoms

Symptoms of pellagra include:

  • Delusions or mental confusion
  • Diarrhea
  • Nausea (sometimes)
  • Inflamed mucous membrane
  • Scaly skin sores

Exams and Tests

Your health care provider will perform a physical exam. You will be asked about the foods you eat.

Tests that may be done include urine tests to check if your body has enough niacin. Blood tests may also be done.

Treatment

The goal of treatment is to increase your body's niacin level. You will be prescribed niacin supplements. You may also need to take other supplements. Follow your provider's instructions exactly on how much and how often to take the supplements.

Symptoms due to the pellagra, such as skin sores, will be treated.

If you have conditions that are causing the pellagra, these will also be treated.

Outlook (Prognosis)

People often do well after taking niacin.

Possible Complications

Left untreated, pellagra can result in nerve damage, particularly in the brain. Skin sores may become infected.

When to Contact a Medical Professional

Call your provider if you have any symptoms of pellagra.

Prevention

Pellagra can be prevented by following a well-balanced diet.

Get treated for health problems that may cause pellagra.

Alternative Names

Vitamin B3 deficiency; Deficiency - niacin; Nicotinic acid deficiency

References

Crook MA. The importance of recognizing pellagra (niacin deficiency) as it still occurs. Nutrition. 2014;30(6):729-730. PMID: 24679717 www.ncbi.nlm.nih.gov/pubmed/24679717.

So YT. Deficiency diseases of the nervous system. In: Daroff RB, Jankovic J, Mazziotta JC, Pomeroy SL, eds. Bradley's Neurology in Clinical Practice. 7th ed. Philadelphia, PA: Elsevier; 2016:chap 85.

Review Date 12/10/2016

Updated by: Linda J. Vorvick, MD, Clinical Associate Professor, Department of Family Medicine, UW Medicine, School of Medicine, University of Washington, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.