Pellagra: nutritional basis and clinical progression

THE CONTEXT

Pellagra is associated with deficiency of tryptophan and niacin. Either tryptophan or niacin can prevent or cure the disease.

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Pellagra is characterized by photosensitive dermatitis.

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As the disease progresses, depressive psychosis and possibly diarrhea develop.

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Untreated pellagra is fatal.

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Riboflavin and vitamin B6 are required for synthesis of nicotinamide from tryptophan; deficiency of either may be an additional factor in pellagra.

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In most outbreaks, twice as many women as men are affected.

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The proposed explanation is inhibition of tryptophan metabolism by estrogen metabolites.

NEETx

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