Internal Medicine

0521779407-15 CUNY1086/Karliner 0 521 77940 7 June 7, 2007 18:43

1050 Niacin Deficiency

NIACIN DEFICIENCY

ELISABETH RYZEN, MD

history & physical

History

■high corn protein diets, diarrhea, cirrhosis, alcoholism, prolonged

infusions without vitamins, prolonged isoniazide treatment, malig-

nant carcinoid

Signs & Symptoms

■dermatitis, diarrhea, dementia=symptoms of pellagra; cutae-

nous erythema, intertrigo, cutaneous hypertrophy, mucous mem-

brane inflammation, tongue edema, abdominal distention, psy-

chosis, encephalopathy, stomatitis

tests

Laboratory

■Basic urine studies:

➣N-methylnicotinamide excretion <0.8 mg/day

differential diagnosis

n/a

management

n/a

specific therapy

■balanced diet, niacinamide orally in divided doses

Side Effects & Contraindications

■None

follow-up

n/a

complications and prognosis

■Reversible with replacement