Department of Hospitalist, Charlton Memorial Hospital, Fall River, MA, USA.
Department of Hospitalist, Prima CARE, P.C., Fall River, MA, USA.
Nutr Clin Pract. 2020 Oct;35(5):860-863. doi: 10.1002/ncp.10418. Epub 2019 Oct 9.
Pellagra, caused by vitamin B3 (niacin) deficiency, is traditionally described as dermatitis, diarrhea, dementia (3D), and even death (4D) syndrome if not recognized and treated promptly. Although full-blown pellagra with all 3D features has become rare, pellagra still exists, especially in high-risk populations, which is actually more prevalent than we think. We report that a recently treated patient with the full spectrum of 3D clinical features of pellagra presents as chronic diarrhea of unknown etiology for 1 year. It reminds us that keeping a high index of suspicion and maintaining a broad differential diagnosis are critical for recognition and management of this potentially fatal but treatable condition.
糙皮病，由维生素 B3（烟酸）缺乏引起，传统上被描述为皮炎、腹泻、痴呆（3D），甚至死亡（4D）综合征，如果不及时识别和治疗。尽管典型的糙皮病（具有所有 3D 特征）已变得罕见，但糙皮病仍然存在，尤其是在高危人群中，其实际发病率比我们想象的要高。我们报告了一位最近接受治疗的患者，具有糙皮病的全谱 3D 临床特征，表现为原因不明的慢性腹泻 1 年。这提醒我们，保持高度怀疑指数和广泛的鉴别诊断对于识别和管理这种潜在致命但可治疗的疾病至关重要。
