Skip to main content
Select Source:

Pellagra

Pellagra

Definition

Pellagra is a disorder brought on by a deficiency of the nutrient called niacin or nicotinic acid, one of the B-complex vitamins.

Description

Nicotinic acid plays a crucial role in the cellular process called respiration. Respiration is the process by which nutrients (specifically sugar, or glucose) and oxygen are taken in, chemical reactions take place, energy is produced and stored, and carbon dioxide and wastes are given off. This process is absolutely central to basic cell functioning, and thus the functioning of the body as a whole.

Niacin is a B vitamin found in such foods as yeast, liver, meat, fish, whole-grain cereals and breads, and legumes. Niacin can also be produced within the body from the essential amino acid called tryptophan. Dietary requirements for niacin depend on the age, gender, size, and activity level of the individual. Niacin requirements range from 5 mg in infants up to 20 mg in certain adults.

Causes and symptoms

Pellagra can be either primary or secondary. Primary pellagra results when the diet is extremely deficient in niacin-rich foods. A classic example occurs in geographic locations where Indian corn (maize) is the dietary staple. Maize does contain niacin, but in a form which cannot be absorbed from the intestine (except when it has been treated with alkali, as happens in the preparation of tortillas). People who rely on maize as their major food source often develop pellagra. Pellagra can also occur when a hospitalized patient, unable to eat for a very prolonged period of time, is given fluids devoid of vitamins through a needle in the vein (intravenous or IV fluids).

Secondary pellagra occurs when adequate quantities of niacin are present in the diet, but other diseases or conditions interfere with its absorption and/or processing. This is seen in various diseases that cause prolonged diarrhea, with cirrhosis of the liver and alcoholism, with long-term use of the antituberculosis drug called isoniazid, in patients with malignant carcinoid tumor, and in patients suffering from Hartnup disease (an inherited disorder which results in disordered absorption of amino acids from the intestine and kidney).

Pellagra causes a variety of symptoms affecting the skin; mucous membranes (moist linings of the mouth, organs, etc.); central nervous system (including the brain and nerves); and the gastrointestinal system. The classic collection of symptoms includes redness and swelling of the mouth and tongue, diarrhea, skin rash, and abnormal mental functioning, including memory loss. While early patients may simply have a light skin rash, over time the skin becomes increasingly thickened, pigmented, and may slough off in places. Areas of the skin may become prone to bacterial infection. The mouth and tongue, and sometimes the vagina, become increasingly thick, swollen, and red. Abdominal pain and bloating occur, with nausea and vomiting, and bloody diarrhea to follow. Initial mental changes appear as inability to sleep (insomnia), fatigue, and a sense of disconnected-ness (apathy). These mental changes progress to memory loss, confusion, depression, and hallucinations (in which the individual sees sights or hears sounds that do not really exist). The most severe states include stiffness of the arms and legs, with resistance to attempts to move the limbs; variations in level of consciousness; and the development of involuntary sucking and grasping motions. This collection of symptoms is called "encephalopathic syndrome."

Diagnosis

Diagnosis is purely based on the patient's collection of symptoms, together with information regarding the patient's diet. When this information points to niacin deficiency, replacement is started, and the diagnosis is then partly made by evaluating the patient's response to increased amounts of niacin. There are no chemical tests available to definitively diagnose pellagra.

KEY TERMS

Niacinamide A form of niacin, which is usually used as a dietary supplement for people with insufficient niacin.

Respiration Respiration is the process by which nutrients (specifically sugar, or glucose) and oxygen are taken in to a cell; chemical reactions take place; energy is produce and stored; and carbon dioxide and wastes are given off.

Treatment

Treatment of pellagra usually involves supplementing the individual's diet with a form of niacin called niacinamide (niacin itself in pure supplementation form causes a number of unpleasant side effects, including sensations of itching, burning, and flushing). The niacinamide can be given by mouth (orally) or by injection (when diarrhea would interfere with its absorption). The usual oral dosage is 300-500 mg each day; the usual dosage of an injection is 100-250 mg, administered two to three times each day. When pellagra has progressed to the point of the encephalopathic syndrome, a patient will require 1,000 mg of niacinamide orally, and 100-250 mg of niacinamide by injection. Once the symptoms of pellagra have subsided, a maintenance dose of niacin can be calculated, along with attempting (where possible) to make appropriate changes in the diet. Because many B-complex vitamin deficiencies occur simultaneously, patients will usually require the administration of other B-complex vitamins as well.

Prognosis

Untreated pellagra will continue progressing over the course of several years, and is ultimately fatal. Often, death is due to complications from infections, massive malnutrition brought on by continuous diarrhea, blood loss due to bleeding from the gastrointestinal tract, or severe encephalopathic syndrome.

Prevention

Prevention of pellagra is completely possible; what is required is either a diet adequate in niacin-rich foods, or appropriate supplementation. However, in many geographic locations in the world such foods are unavailable to the general population, and pellagra becomes an unavoidable complication of poverty.

Resources

ORGANIZATIONS

American Dietetic Association, 216 W. Jackson Blvd., Chicago, IL 60606-6995. (800) 745-0775. http://www.eatright.org/cdr.html.

Cite this article
Pick a style below, and copy the text for your bibliography.

  • MLA
  • Chicago
  • APA

"Pellagra." Gale Encyclopedia of Medicine, 3rd ed.. . Encyclopedia.com. 16 Aug. 2017 <http://www.encyclopedia.com>.

"Pellagra." Gale Encyclopedia of Medicine, 3rd ed.. . Encyclopedia.com. (August 16, 2017). http://www.encyclopedia.com/medicine/encyclopedias-almanacs-transcripts-and-maps/pellagra

"Pellagra." Gale Encyclopedia of Medicine, 3rd ed.. . Retrieved August 16, 2017 from Encyclopedia.com: http://www.encyclopedia.com/medicine/encyclopedias-almanacs-transcripts-and-maps/pellagra

Pellagra

Pellagra

Pellegra is a disease caused by a dietary deficiency of, or a failure to absorb, niacin (vitamin B3) or the amino acid tryptophan, a precursor of niacin. First reported in 1735 by Don Gasper Casal, a Spanish physician, pellagra means "rough skin." Primary symptoms include the "3 Ds": dementia (mental symptoms), dermatitis (scaly skin sores), and diarrhea. A pellagra epidemic emerged during the 1900s in the United States, when corn (maize) began to replace other sources of dietary protein among the rural poor. Niacin in corn is tightly bound to protein, and thus poorly absorbed. Niacin enrichment of cereal grains and diets adequate in protein and calories eventually eradicated pellagra from the United States. Seasonal epidemics still occur in parts of Southeast Asia and Africa, however.

Kiran B. Misra

Cite this article
Pick a style below, and copy the text for your bibliography.

  • MLA
  • Chicago
  • APA

"Pellagra." Nutrition and Well-Being A to Z. . Encyclopedia.com. 16 Aug. 2017 <http://www.encyclopedia.com>.

"Pellagra." Nutrition and Well-Being A to Z. . Encyclopedia.com. (August 16, 2017). http://www.encyclopedia.com/food/news-wires-white-papers-and-books/pellagra

"Pellagra." Nutrition and Well-Being A to Z. . Retrieved August 16, 2017 from Encyclopedia.com: http://www.encyclopedia.com/food/news-wires-white-papers-and-books/pellagra

pellagra

pellagra (pəlăg´rə), deficiency disease due to a lack of niacin (nicotinic acid), one of the components of the B complex vitamins in the diet. Niacin is plentiful in yeast, organ meats, peanuts, and wheat germ. The disease manifests itself in lesions of the skin and mucous membrane, diarrhea and other gastrointestinal symptoms, neurological derangement, and mental confusion. It is most common in areas where the diet consists mainly of corn, which, unlike other grains, lacks niacin as well as the amino acid tryptophan, which the body uses to synthesize the vitamin. Treatment includes large doses of niacin and the institution of a proper diet to prevent recurrences.

See D. A. Roe, A Plague of Corn: A Social History of Pellagra (1973).

Cite this article
Pick a style below, and copy the text for your bibliography.

  • MLA
  • Chicago
  • APA

"pellagra." The Columbia Encyclopedia, 6th ed.. . Encyclopedia.com. 16 Aug. 2017 <http://www.encyclopedia.com>.

"pellagra." The Columbia Encyclopedia, 6th ed.. . Encyclopedia.com. (August 16, 2017). http://www.encyclopedia.com/reference/encyclopedias-almanacs-transcripts-and-maps/pellagra

"pellagra." The Columbia Encyclopedia, 6th ed.. . Retrieved August 16, 2017 from Encyclopedia.com: http://www.encyclopedia.com/reference/encyclopedias-almanacs-transcripts-and-maps/pellagra

pellagra

pellagra The disease due to deficiency of the vitamin niacin and the amino acid tryptophan. Signs include a characteristic symmetrical photosensitive dermatitis (especially on the face and back of the hands), resembling severe sunburn; mental disturbances (a depressive psychosis sometimes called dementia); and digestive disorders (most commonly diarrhoea); fatal if untreated.

Most commonly associated with a diet based on maize or sorghum, which are poor sources of both tryptophan and niacin, with little meat or other vegetables.

Cite this article
Pick a style below, and copy the text for your bibliography.

  • MLA
  • Chicago
  • APA

"pellagra." A Dictionary of Food and Nutrition. . Encyclopedia.com. 16 Aug. 2017 <http://www.encyclopedia.com>.

"pellagra." A Dictionary of Food and Nutrition. . Encyclopedia.com. (August 16, 2017). http://www.encyclopedia.com/education/dictionaries-thesauruses-pictures-and-press-releases/pellagra

"pellagra." A Dictionary of Food and Nutrition. . Retrieved August 16, 2017 from Encyclopedia.com: http://www.encyclopedia.com/education/dictionaries-thesauruses-pictures-and-press-releases/pellagra

pellagra

pel·la·gra / pəˈlagrə; -ˈlāgrə; -ˈlägrə/ • n. a deficiency disease caused by a lack of nicotinic acid or its precursor tryptophan in the diet. It is characterized by dermatitis, diarrhea, and mental disturbance, and is often linked to overdependence on corn as a staple food. DERIVATIVES: pel·la·grous / -grəs/ adj.

Cite this article
Pick a style below, and copy the text for your bibliography.

  • MLA
  • Chicago
  • APA

"pellagra." The Oxford Pocket Dictionary of Current English. . Encyclopedia.com. 16 Aug. 2017 <http://www.encyclopedia.com>.

"pellagra." The Oxford Pocket Dictionary of Current English. . Encyclopedia.com. (August 16, 2017). http://www.encyclopedia.com/humanities/dictionaries-thesauruses-pictures-and-press-releases/pellagra-0

"pellagra." The Oxford Pocket Dictionary of Current English. . Retrieved August 16, 2017 from Encyclopedia.com: http://www.encyclopedia.com/humanities/dictionaries-thesauruses-pictures-and-press-releases/pellagra-0

pellagra

pellagra (pil-ag-ră) n. a nutritional disease due to a deficiency of nicotinic acid (a B vitamin). It is common in maize-eating communities. The symptoms of pellagra are scaly dermatitis on exposed surfaces, diarrhoea, and depression.

Cite this article
Pick a style below, and copy the text for your bibliography.

  • MLA
  • Chicago
  • APA

"pellagra." A Dictionary of Nursing. . Encyclopedia.com. 16 Aug. 2017 <http://www.encyclopedia.com>.

"pellagra." A Dictionary of Nursing. . Encyclopedia.com. (August 16, 2017). http://www.encyclopedia.com/caregiving/dictionaries-thesauruses-pictures-and-press-releases/pellagra

"pellagra." A Dictionary of Nursing. . Retrieved August 16, 2017 from Encyclopedia.com: http://www.encyclopedia.com/caregiving/dictionaries-thesauruses-pictures-and-press-releases/pellagra

pellagra

pellagra Disease caused by a deficiency of nicotinic acid, one of the B group of vitamins. Its symptoms are lesions of the skin and mucous membranes, diarrhoea and mental disturbance.

Cite this article
Pick a style below, and copy the text for your bibliography.

  • MLA
  • Chicago
  • APA

"pellagra." World Encyclopedia. . Encyclopedia.com. 16 Aug. 2017 <http://www.encyclopedia.com>.

"pellagra." World Encyclopedia. . Encyclopedia.com. (August 16, 2017). http://www.encyclopedia.com/environment/encyclopedias-almanacs-transcripts-and-maps/pellagra

"pellagra." World Encyclopedia. . Retrieved August 16, 2017 from Encyclopedia.com: http://www.encyclopedia.com/environment/encyclopedias-almanacs-transcripts-and-maps/pellagra

pellagra

pellagra deficiency disease marked by cracked skin. XIX. — It., f. pelle skin (:— L. pellis FELL1) + -agra, after PODAGRA.

Cite this article
Pick a style below, and copy the text for your bibliography.

  • MLA
  • Chicago
  • APA

"pellagra." The Concise Oxford Dictionary of English Etymology. . Encyclopedia.com. 16 Aug. 2017 <http://www.encyclopedia.com>.

"pellagra." The Concise Oxford Dictionary of English Etymology. . Encyclopedia.com. (August 16, 2017). http://www.encyclopedia.com/humanities/dictionaries-thesauruses-pictures-and-press-releases/pellagra-1

"pellagra." The Concise Oxford Dictionary of English Etymology. . Retrieved August 16, 2017 from Encyclopedia.com: http://www.encyclopedia.com/humanities/dictionaries-thesauruses-pictures-and-press-releases/pellagra-1

pellagra

pellagra A disease resulting from a deficiency of nicotinic acid, which is characterized by dermatitis and mental disorder.

Cite this article
Pick a style below, and copy the text for your bibliography.

  • MLA
  • Chicago
  • APA

"pellagra." A Dictionary of Biology. . Encyclopedia.com. 16 Aug. 2017 <http://www.encyclopedia.com>.

"pellagra." A Dictionary of Biology. . Encyclopedia.com. (August 16, 2017). http://www.encyclopedia.com/science/dictionaries-thesauruses-pictures-and-press-releases/pellagra

"pellagra." A Dictionary of Biology. . Retrieved August 16, 2017 from Encyclopedia.com: http://www.encyclopedia.com/science/dictionaries-thesauruses-pictures-and-press-releases/pellagra

pellagra

pellagrajarrah, para, Tara •abracadabra, Aldabra •Alhambra • Vanbrugh •Cassandra, Sandra •Aphra, Biafra •Niagara, pellagra, Viagra •bhangra, Ingres •Capra • Cleopatra •mantra, tantra, yantra •Basra •Asmara, Bukhara, carbonara, Carrara, cascara, Connemara, Damara, Ferrara, Gemara, Guadalajara, Guevara, Honiara, Lara, marinara, mascara, Nara, Sahara, Samara, samsara, samskara, shikara, Tamara, tiara, Varah, Zara •candelabra, macabre, sabra •Alexandra • Agra • fiacre •Chartres, Montmartre, Sartre, Sinatra, Sumatra •Shastra • Maharashtra • Le Havre •gurdwara •Berra, error, Ferrer, sierra, terror •zebra • ephedra • Porto Alegre •belles-lettres, Petra, raison d'être, tetra •Electra, plectra, spectra •Clytemnestra • extra •chèvre, Sèvres •Ezra

Cite this article
Pick a style below, and copy the text for your bibliography.

  • MLA
  • Chicago
  • APA

"pellagra." Oxford Dictionary of Rhymes. . Encyclopedia.com. 16 Aug. 2017 <http://www.encyclopedia.com>.

"pellagra." Oxford Dictionary of Rhymes. . Encyclopedia.com. (August 16, 2017). http://www.encyclopedia.com/humanities/dictionaries-thesauruses-pictures-and-press-releases/pellagra

"pellagra." Oxford Dictionary of Rhymes. . Retrieved August 16, 2017 from Encyclopedia.com: http://www.encyclopedia.com/humanities/dictionaries-thesauruses-pictures-and-press-releases/pellagra