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Pellagra encephalopathy among tuberculous patients: its relation to isoniazid therapy
Abstract:
Eight cases of pellagra, diagnosed on the grounds of neuropathological findings and retrospective study of clinical data, were found among 106 necropsy cases of tuberculosis. Although these eight patients had shown various mental, neurological and gastrointestinal symptoms, as well as skin lesions, the diagnosis of pellagra had not been made clinically. In all the patients, pellagra symptoms appeared during isoniazid therapy. Death occurred 4 to 16 weeks later. Isoniazid inhibits the conversion of tryptophan to niacin and may induce pellagra, particularly in poorly nourished patients. Pellagra should be suspected whenever tuberculous patients under treatment with isoniazid develop mental, neurological or gastrointestinal symptoms, even in the absence of typical pellagra dermatitis.
Insights
Isoniazid therapy for tuberculosis may induce pellagra, a niacin deficiency disease, especially in malnourished patients. Neurological and gastrointestinal symptoms in TB patients on isoniazid warrant suspicion for pellagra, even without skin lesions.
Area of Science:
- Medical Research
- Neurology
- Infectious Diseases
Background:
- Pellagra is a disease caused by niacin deficiency.
- Tuberculosis (TB) is a common infectious disease.
- Isoniazid is a primary drug used to treat TB.