This rare condition is caused by an inadequate intake of niacin (vitamin B3) and inadequate amounts of protein. As maize (corn) lacks sufficient amounts of niacin, pellagra was once common in regions where maize was a staple food. Here's what you need to know about it:
Causes
A deficiency of niacin in the diet is the primary cause of pellagra. Niacin is needed for energy production, DNA repair, and cellular signaling in the body. When niacin is not sufficiently consumed, along with inadequate protein intake, pellagra can develop. It is possible to develop pellagra as a result of certain factors, including poverty, malnutrition, alcoholism, and gastrointestinal disorders that impair nutrient absorption.
Symptoms
The hallmark symptoms of pellagra include dermatitis, diarrhea, dementia, and death (if left untreated). Dermatitis typically presents as a photosensitive rash on sun-exposed areas of the skin, such as the hands, neck, and face. Symptoms of dementia include confusion, disorientation, memory loss, and behavioral changes. Diarrhea is often chronic and may be accompanied by abdominal pain and bloating. In some cases, pellagra can lead to severe complications and even death if left untreated.
Diagnosis
Symptoms of pellagra include a physical examination as well as a detailed review of the individual's medical history and diet. It may also be necessary to perform blood tests to measure blood niacin levels and other nutrients. A skin biopsy may also be performed to assess the characteristic changes associated with pellagra-related dermatitis. To rule out other conditions with similar symptoms, a differential diagnosis may be necessary.
Treatment
Through dietary changes and/or supplementation, pellagra is treated by replenishing niacin levels. By increasing the consumption of foods rich in niacin, such as meat, fish, poultry, legumes, nuts, and whole grains, the deficiency can be addressed. For severe cases of niacin deficiency, oral or intravenous supplements may be prescribed. The long-term management of malnutrition also requires addressing the underlying factors, such as poverty and gastrointestinal disorders.
Prevention
By eating a balanced diet, you can prevent pellagra. A variety of nutrient-dense foods, including meat, fish, poultry, legumes, nuts, and whole grains, can help prevent niacin deficiency. The access to nutrition education, food assistance programs, and healthcare services is crucial for individuals at risk of malnutrition due to poverty, food insecurity, or other socioeconomic factors. The risk of developing pellagra can also be reduced by avoiding excessive alcohol consumption and treating gastrointestinal disorders that impair nutrient absorption.
