Hidden in the Rash - Alcoholic Pellagra Encephalopathy
Keywords:Pellagra, Encephalopathy, Alcohol withdrawal
Pellagra Encephalopathy is a recognised medical condition due to niacin deficiency. Patients with alcohol dependence invariably have vitamin deficiencies, including niacin. Pellagra Encephalopathy can be challenging to diagnose alongside withdrawal delirium. Diarrhoea, skin rashes, memory and attention deficits, paraesthesia and proximal muscle weakness were noted in four patients diagnosed with delirium tremens. Atypical features such as cognitive and neurological deficits were understood as the presentation of pellagra encephalopathy. The presence of neuro-cognitive symptoms in addition to typical dermatological presentation guided consideration of pellagra encephalopathy comorbid with delirium due to alcohol withdrawal. Subtle neurological symptoms indicative of pellagra encephalopathy may be overlooked in patients with delirium.
Pitche PT. Pellagre et érythèmes pellagroïdes. Cah Détudes Rech Francoph. 2005;15(3):205–208.
Cresce ND, McManus KA, Sifri CD, Wilson BB. Encephalopathy despite thiamine repletion during alcohol withdrawal. Cleve Clin J Med. 2014;81(6):350–352.
Mothukuri J, Chennamsetty S, Bhogaraju A. Pellagra in patient with schizophrenia: a case report and review of literature. AP J Psychol Med. 2013;14(1):50–2.
Oldham MA, Ivkovic A. Pellagrous encephalopathy presenting as alcohol withdrawal delirium: a case series and literature review. Addict Sci Clin Pract. 2012;7(1):12.
Guthrie RH. A Review of Cases of Pellagra Admitted to the Boston Psychopathic Hospital from 1922 to 1928 with Special Reference to Alcohol as an Etiological Factor. N Engl J Med. 1929;201(9):414–420.
Roberts SR. Pellagra: its symptoms and treatment. Am J Nurs. 1920;885–890.
Mahajan SK, Aundhakar SC. A study of the prevalence of serum vitamin B12 and folic acid deficiency in Western Maharashtra. J Fam Med Prim Care. 2015;4(1):64.
Ginnaio M, Jacobs A. Pellagra in late nineteenth century Italy: effects of a deficiency disease. Population. 2011;66(3):583–609.
Badawy AA-B. Pellagra and alcoholism: a biochemical perspective. Alcohol Alcohol. 2014;49(3):238–250.
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