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Pellagra is a disease that occurs when a person does not get enough niacin (one of the B complex vitamins) or tryptophan (an amino acid).

Causes of Pellagra

Pellagra is caused by having too little niacin or tryptophan in the diet. It can also occur if the body fails to absorb these nutrients. It may develop after gastrointestinal diseases or with alcoholism, HIV/AIDS, or anorexia.

The disease is common in parts of the world where people have a lot of corn in their diet.

Pellagra Symptoms

Symptoms of pellagra include:

  • Delusions or mental confusion
  • Diarrhea
  • Nausea (sometimes)
  • Inflamed mucus membranes
  • Scaly skin sores

Tests and Exams

Your health care provider will perform a physical exam. You will be asked about the foods you eat.

Tests that may be done include urine tests to check if your body has enough niacin. Blood tests may also be done.

Treatment of Pellagra

The goal of treatment is to increase your body's niacin level. You will be prescribed niacin supplements. You may also need to take other supplements. Follow your provider's instructions exactly on how much and how often to take the supplements.

Symptoms due to the pellagra, such as skin sores, will be treated.

If you have conditions that are causing the pellagra, these will also be treated.

Prognosis (Outlook)

People often do well after taking niacin.

Potential Complications

Left untreated, pellagra can result in nerve damage, especially in the brain. Skin sores may become infected.

When to Contact a Health Professional

Call your health care provider if you have any symptoms of pellagra.

Prevention of Pellagra

Pellagra can be prevented by following a well-balanced diet.

Get treated for health problems that may cause pellagra.


Brown TM. Pellagra: an old enemy of timeless importance. Psychosomatics. 2010;51:93-97. PMID 20332283

Crook MA. The importance of recognizing pellagra (niacin deficiency) as it still occurs. Nutrition. 2014;30:729-730. PMID 24679717

Kumar N. Neurologic presentation of nutritional deficiencies. Neurol Clin. 2010;28:107-170. PMID 19932379

So YT, Simon RP. Deficiency diseases of the nervous system. In: Daroff RB, Fenichel GM, Jankovic J, Mazziotta JC, eds. Bradley's Neurology in Clinical Practice. 6th ed. Philadelphia, PA: Elsevier; 2012:chap 57.

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Review Date: 11/2/2014
Reviewed By: Linda J. Vorvick, MD, Medical Director and Director of Didactic Curriculum, MEDEX Northwest Division of Physician Assistant Studies, Department of Family Medicine, UW Medicine, School of Medicine, University of Washington, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.
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