Journal
NUTRITION IN CLINICAL PRACTICE
Volume 35, Issue 5, Pages 860-863Publisher
WILEY
DOI: 10.1002/ncp.10418
Keywords
dementia; dermatitis; diarrhea; niacin; pellagra; vitamin deficiency
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Pellagra, caused by vitamin B3 (niacin) deficiency, is traditionally described as dermatitis, diarrhea, dementia (3D), and even death (4D) syndrome if not recognized and treated promptly. Although full-blown pellagra with all 3D features has become rare, pellagra still exists, especially in high-risk populations, which is actually more prevalent than we think. We report that a recently treated patient with the full spectrum of 3D clinical features of pellagra presents as chronic diarrhea of unknown etiology for 1 year. It reminds us that keeping a high index of suspicion and maintaining a broad differential diagnosis are critical for recognition and management of this potentially fatal but treatable condition.
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