Azathioprine‐induced pellagra

  title={Azathioprine‐induced pellagra},
  author={Ana Oliveira and Madalena Sanches and Manuela Selores},
  journal={The Journal of Dermatology},
Dear Editor, Pellagra is a forgotten disease, particularly in developed countries. Its etiology is vitamin B3 (niacin) deficiency, occurring in malnourished people or in those medicated with drugs that block niacin’s metabolism. Pellagra is clinically characterized by dermatitis, diarrhea, dementia and death. If the disease is promptly treated, however, this tetrad can be overlooked. We present the case of a 47-year-old woman presenting with a 10-day history of a painful, cervical, cutaneous… 
Azathioprine-induced pellagra in neuromyelitis optica: A case report and review of literature.
It is reported that a well-nourished patient experienced serious pellagra while receiving oral azathioprine for treating her NMO, raising concerns regarding patient safety.
A case of isoniazid-induced pellagra aggravated by secondary anorexia presenting with an amino acid and vitamin-deficient profile
This is the first report of prurigo associated with systemic sclerosis in the English literature and suggests that interleukin (IL)-31 plays a role in the therapeutic effects of narrow-band UVB.
Aetiological doctrines and prevalence of pellagra: 18th century to middle 20th century
The reasons for, and the legitimacy of, the persistent association between pellagra and the consumption of maize are examined and the global spread of the disease from the early 18th century until the middle of the 20th century is reviewed.
An unexpected case of pellagra
An anxious 50-year-old woman presented with recurrence of a painful, well demarcated violaceous eruption with erythematous margins and large areas of blistering on her ankles and dorsa of her feet, with surrounding hyperpigmentation.
Pellagra in South Africa from 1897 to 2019: a scoping review
Although pellagra, diagnosed based on dermatological symptoms, appears to be largely eradicated in South Africa, it does not rule out the potential for subclinical niacin deficiency.
An observational study to analyze the association of Acne Vulgaris, Seborrhea and Alcohol consumption in clinically diagnosed cases of Dyssebacia
It was found in this study that Acne vulgaris and Seborrheic dermatitis indeed have a strong association with Dyssebacia and alcohol consumption does not seem add risk to the causation, except in case of chronicity.
Assessment of nutritional deficiency manifestations in patients with rheumatic diseases
Abstract Background Inflammatory diseases can interfere with adequate nutrition and even lead to a malnourished state. Nutritional deficiency manifestations may be similar to rheumatologic
Pellagra affecting a patient with Crohn's disease*
A female patient presented with clinical features of pellagra as a complication of Crohn's disease, a nutritional disease caused by a deficiency of niacin.
Azathioprine‐induced pellagra in a child with autoimmune hepatitis: A case report and literature review
Pellagra is a clinical syndrome resulting from niacin deficiency with variety of manifestations. Azathioprine is among drugs that can lead to such condition. Physicians should be aware as proper
Photosensitivity disorders in children: part II.
Part II of this 2-part review covers hereditary photodermatoses caused by defects in nucleotide excision repair, double strand break repair, or localized or systemic biochemical abnormalities.


Pellagra‐like erythema on sun‐exposed skin of patients with anorexia nervosa
The anterior neck was suggestive of Casal’s necklace, characteristic of this disease, and azathioprine was the cause of pellagra, taking into account that it was the only medication known to interfere in the niacin pathway.
Pellagra: a still existing disease
Pellagra is no longer the medico-social problem it was in the past but in countries with a low nutritional level it continues to a considerable degree in endemic form and in areas of the so-called 'civilized world' where nutritional problems do not really exist, occasional cases are found.
Pellagra: Dermatitis, dementia, and diarrhea
The findings of this once mysterious disorder, one that still challenges clinicians world‐wide, are reviewed.
Pellagra associated with esophageal carcinoma and alcoholism.
A case of pellagra caused by esophageal carcinoma and alcoholism is described and a review of the literature is reviewed.
Azathioprine‐lnduced Megaloblastic Anemia with Pancytopenia 22 Years after Living‐Related Renal Transplantation
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The conversion from Az to a less myelosuppressive drug, such as FK506, should be considered in renal transplant recipients with severe myelOSuppression caused by long‐term Az treatment, as well as in patients with severe megaloblastic anemia with pancytopenia.
Pellagra, azathioprine and inflammatory bowel disease
Two patients are described who developed pellagra during treatment with azathioprine for inflammatory bowel disease and further studies are needed to determine the mechanism of action.
Metabolic and Storage Diseases
Disorders of metabolism, which are bound up with the storage of physiological substances, can also bring about changes in the skeleton, producing a reactive osteoporosis and often leading to localized bone necroses.
Nutritional Biochemistry of the Vitamins
1. The vitamins 2. Vitamin A: Retinol and Beta-Carotene 3. Vitamin D 4. Vitamin E: Tocopherols and Tocotrienols 5. Vitamin K 6. Vitamin B1: Thiamin 7. Vitamin B2: Riboflavin 8. Niacin 9. Vitamin B6
In: Stargrove MB, Treasure J, Mackee DL. Herb, Nutrient and Drug Interactions: Clinical Implications and Therapeutic Strategies, 1st edn
  • 2008
Pellagra: dermatitis, dementia, diarrhea
  • Int J Dermatol
  • 2004