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Pellagra and anorexia nervosa: a case report

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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).

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Funding

None of the authors received funding for this study.

Author information

Author notes

  1. Sandra Portale and Michele Sculati equally contributed to this article.

Authors and Affiliations

  1. Laboratory of Dietetics and Clinical Nutrition, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Via Bassi 21, 27100, Pavia, PV, Italy

    Sandra Portale & Hellas Cena

  2. Department of Public Health, Experimental and Forensic Medicine, Master Course in Dietetics and Clinical Nutrition, University of Pavia, Via Bassi 21, 27100, Pavia, PV, Italy

    Michele Sculati

  3. Department of Medicine-Neuroendocrine Division, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, Boston, MA, 02114, USA

    Fatima Cody Stanford

  4. Department of Pediatrics-Endocrinology, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, Boston, MA, 02114, USA

    Fatima Cody Stanford

  5. Clinical Nutrition and Dietetics Service, Unit of Internal Medicine and Endocrinology, ICS Maugeri IRCCS, Via S.Maugeri 10, 27100, Pavia, PV, Italy

    Hellas Cena

Authors
  1. Sandra Portale
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  2. Michele Sculati
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  3. Fatima Cody Stanford
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  4. Hellas Cena
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Corresponding author

Correspondence to Sandra Portale.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research commitee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

The reported case report was drafted after acquisition of written informed consent signed by the patient.

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Portale, S., Sculati, M., Stanford, F.C. et al. Pellagra and anorexia nervosa: a case report. Eat Weight Disord 25, 1493–1496 (2020). https://doi.org/10.1007/s40519-019-00781-x

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  • DOI: https://doi.org/10.1007/s40519-019-00781-x

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