Pellagra and anorexia nervosa: a case report

Eat Weight Disord. 2020 Oct;25(5):1493-1496. doi: 10.1007/s40519-019-00781-x. Epub 2019 Sep 17.

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).

Keywords: Anorexia nervosa; Case report; Niacin deficiency; Pellagra.