What do the '3 Ds' indicate about the symptoms of 'Classic pellagra'?

Key Points

• Dermatitis is a condition that causes inflammation of the skin, resulting in red, itchy, and swollen areas. In pellagra, dermatitis typically occurs in sun-exposed areas, such as the hands, arms, face, and neck.
• Diarrhea is one of the classic symptoms of pellagra, involving frequent and loose bowel movements. It can lead to dehydration and weight loss if not managed properly.
• Dementia is characterized by cognitive impairment, including memory loss, confusion, and difficulty concentrating. It is a severe symptom of pellagra that affects mental functions.
• Pellagra is caused by a deficiency of niacin (vitamin B3) or its precursor tryptophan in the diet. The '3 Ds' are diagnostic indicators of this deficiency.

Additional Information

• Pellagra:
  • Pellagra is a disease that arises due to a deficiency of niacin (vitamin B3) and is most commonly seen in areas where maize is a major part of the diet, as it is low in niacin and tryptophan.
  • The disease can also be caused by conditions that affect the absorption of niacin or tryptophan, such as certain gastrointestinal diseases, chronic alcoholism, or prolonged diarrhea.
  • In addition to the '3 Ds' (Dermatitis, Diarrhea, Dementia), if untreated, pellagra can lead to the fourth 'D' - Death.
  • Treatment includes supplementation with niacin or nicotinamide, along with a balanced diet to prevent recurrence.
• Niacin (Vitamin B3):
  • Niacin is an essential nutrient that plays a key role in cellular metabolism and energy production.
  • It is involved in the synthesis of NAD (nicotinamide adenine dinucleotide) and NADP (nicotinamide adenine dinucleotide phosphate), which are important coenzymes in redox reactions.
  • Food sources of niacin include meat, fish, poultry, whole grains, and fortified cereals.
  • Niacin is also used therapeutically to manage cholesterol levels, as it can reduce LDL (bad cholesterol) and triglycerides while increasing HDL (good cholesterol).