Sandra Portale1, Michele Sculati2, Fatima Cody Stanford3,4, Hellas Cena5,6. 1. Laboratory of Dietetics and Clinical Nutrition, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Via Bassi 21, 27100, Pavia, PV, Italy. sandra.portale@gmail.com. 2. Department of Public Health, Experimental and Forensic Medicine, Master Course in Dietetics and Clinical Nutrition, University of Pavia, Via Bassi 21, 27100, Pavia, PV, Italy. 3. Department of Medicine-Neuroendocrine Division, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, Boston, MA, 02114, USA. 4. Department of Pediatrics-Endocrinology, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, Boston, MA, 02114, USA. 5. Laboratory of Dietetics and Clinical Nutrition, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Via Bassi 21, 27100, Pavia, PV, Italy. 6. Clinical Nutrition and Dietetics Service, Unit of Internal Medicine and Endocrinology, ICS Maugeri IRCCS, Via S.Maugeri 10, 27100, Pavia, PV, Italy.
Abstract
BACKGROUND: While pellagra appears to be a rare entity currently, it may still develop. It is important to recognize how the disease manifests to ensure adequate and timely treatment. CASE PRESENTATION: We present a case of pellagra secondary to anorexia nervosa in a 28-year-old woman. We observed the classical signs: erythema in the neck region, diarrhea, and neurologic symptoms. Diagnosis was made on a clinical basis, and the patient had a rapid recovery after undergoing therapy with nicotinamide and tryptophan. CONCLUSIONS: In our case, the patient did not exhibit any sign of being severely underweight with marked malnutrition such as the typical manifestation expected in pellagra. This case demonstrated that clinicians should have a high level of suspicion in making a diagnosis of pellagra, especially in patients with a history of eating disorders. LEVEL OF EVIDENCE: IV (case study).
BACKGROUND: While pellagra appears to be a rare entity currently, it may still develop. It is important to recognize how the disease manifests to ensure adequate and timely treatment. CASE PRESENTATION: We present a case of pellagra secondary to anorexia nervosa in a 28-year-old woman. We observed the classical signs: erythema in the neck region, diarrhea, and neurologic symptoms. Diagnosis was made on a clinical basis, and the patient had a rapid recovery after undergoing therapy with nicotinamide and tryptophan. CONCLUSIONS: In our case, the patient did not exhibit any sign of being severely underweight with marked malnutrition such as the typical manifestation expected in pellagra. This case demonstrated that clinicians should have a high level of suspicion in making a diagnosis of pellagra, especially in patients with a history of eating disorders. LEVEL OF EVIDENCE: IV (case study).
Entities:
Keywords:
Anorexia nervosa; Case report; Niacin deficiency; Pellagra
Authors: Kvido Smitka; Petra Prochazkova; Radka Roubalova; Jiri Dvorak; Hana Papezova; Martin Hill; Jaroslav Pokorny; Otomar Kittnar; Martin Bilej; Helena Tlaskalova-Hogenova Journal: Front Endocrinol (Lausanne) Date: 2021-04-19 Impact factor: 5.555