RARE DISEASE
Pellagra
Pellagra
Pellagra
Drug discovery
0
drugs
With orphan designations
Overview
Pellagra is a systemic disease caused by severe niacin (vitamin B3) deficiency, characterized by the classic triad of dermatitis (Casal’s necklace pattern), diarrhea, and dementia. Secondary causes include malabsorption, alcoholism, and certain medications. Diagnosis is clinical, supported by rapid symptom resolution with niacin supplementation. Untreated, it progresses to neuropsychiatric complications and death [3][6][16].
Burden
Categories: rare skin diseases
Research Papers
504 drug discovery papers about Pellagra, with 1 first-in-class emerging drug candidates forecasted to outperform the average preclinical success rate. Recent publications:
504 drug discovery papers about Pellagra, with 1 first-in-class emerging drug candidates forecasted to outperform the average preclinical success rate. Recent publications:
categories:
Small molecules
small molecules
2026-06-16 | Pruritic rash and diarrhoea in a man with chronic alcohol use disorder
This report describes a 62-year-old man with long-term heavy alcohol consumption, who presented with pruritic, hyperpigmented scaly plaques on sun-exposed skin and recent nonbloody diarrhoea. Skin histopathology showed psoriasiform hyperplasia and superficial perivascular lymphocytic infiltration, supporting the diagnosis of pellagra. The patient responded well to oral nicotinamide supplementation, with gradual and complete resolution of skin lesions within 3 months. This case emphasizes that alcoholic pellagra should be considered in patients with chronic alcoholism and typical photosensitive dermatitis.
2026-04-20 | Pellagra From Tryptophan Depletion in Carcinoid Syndrome due to a Pulmonary Atypical Carcinoid Neuroendocrine Tumor.
Pellagra may complicate functioning pulmonary atypical carcinoid and present as a subtle acral dermatosis rather than the classical photo-distributed rash. In neuroendocrine tumor patients with chronic diarrhea and new skin changes, clinicians should suspect niacin deficiency and consider empiric nicotinamide, even when niacin assays are unavailable.
2026-04-08 | Pellagra presenting as Casal’s necklace dermatitis and upper limbs dermatitis in a person with chronic alcohol dependence: A rare case report
Abstract Chronic alcohol dependence can lead to a deficiency of Vitamin B3 (niacin). Niacin deficiency secondary to chronic alcoholism can present with a triad of three Ds in the form of dermatitis, diarrhea, and dementia. If not recognized early and treated promptly, it can lead to the fourth D, known as death. In the present case report, we have highlighted a clinical picture of a 34-year-old male who had chronic alcohol dependence who presented with Casal’s necklace dermatitis and both upper limb dermatitis characteristic of pellagra. Early diagnosis and proper intervention led to his complete recovery.
2026-02-26 | Molecular Level Study Through Thermodynamic and Acoustic Properties of Vitamin B 3 in Two Different Electrolyte Salt Solutions
ABSTRACT Treatment for pellagra depends on knowing the nature of biological processes and how bio‐physical qualities affect structural aspects of bodily systems. To circumvent this issue, an attempt was made in this study to provide a picture of the chemical interactions that took place in the solutions, which may be able to assist in choosing a suitable salt for preserving healthy blood pressure. Under circumstances of ambient temperature. Experimental measurements were made of the density and ultrasonic velocity of vitamin B 3 at concentrations of 0.02, 0.04, 0.06, 0.08, 0.1, 0.12, 0.14, 0.16, 0.18, and 0.2 mol/kg in 0.1 mol/kg electrolyte salt solutions (NaCl and KCl) at two distinct temperatures (i.e., 283 and 293 K). The different thermo‐acoustic characteristics have been investigated based on the aforementioned experimental findings. Because of this, the present study's goal is to employ electrolytic (NaCl and KCl) techniques for arriving at how salts, water, and vitamin B 3 interact molecularly. It is evident from the whole study that vitamin B 3 interacts with KCl salt ions more than NaCl salt ions. This leads to vitamin B 3 forging a stronger interaction with a K + containing solvent and impacting hypertension more quickly than a Na + containing one.
2026-02-24 | Marchiafava-Bignami Disease and Pellagra in a Chronic Alcohol User: A Reversible Case of Cognitive Impairment.
Marchiafava-Bignami disease (MBD) is a rare complication of chronic alcoholism characterized by demyelination of the corpus callosum. Pellagra, resulting from niacin (vitamin B3) deficiency, typically presents with dermatitis, diarrhea, and dementia. Both MBD and pellagra are often associated with severe nutritional deficiencies. We describe the case of a 56-year-old man with alcohol use disorder admitted after a syncopal episode, presenting with disorientation, apathy, and photosensitive desquamative lesions on sun-exposed skin. Brain MRI revealed T2 hyperintensity in the splenium and body of the corpus callosum, compatible with subacute MBS. Laboratory tests confirmed niacin deficiency, establishing concomitant pellagra. The patient received B-complex vitamin supplementation and was maintained in alcohol abstinence. His cognitive and dermatologic condition improved markedly, with near-complete recovery after six months. This case underlines the importance of recognizing nutritional deficiencies in alcohol-related neuropsychiatric presentations.
cell therapies
2023-09-09 | Impact of Bifidobacterium longum BB536 on nausea caused by pirfenidone in a mouse model of pellagra
Introduction: Pirfenidone is used for anti-fibrotic therapy of idiopathic pulmonary fibrosis (IPF). Pirfenidone causes some adverse effects (AEs) such as photosensitivity and nausea, which appear pellagra-like. Our pharmacological studies using mice had indicated that gut microbiota might play an important role in the development of these phenotypes. Here, we investigated the effect of Bifidobacterium longum BB536 on pellagra-related nausea caused by pirfenidone in our mouse model. Aims: We investigated the role of BB536 in the development of pellagra-related nausea. Methods: Mice kept under low-niacin diets were administered vehicle or pirfenidone (1,0 or 3.0 mg/mg/animal, twice daily, 5 days) and some mice were treated with BB536using HydroGel (a non-wetting water gel for animal hydration). The resulting nausea was evaluated based on their pica behavior and the urinary metabolite levels were analyzed using liquid chromatography coupled with mass spectrometry. Furthermore, the profiles of gut microbiota were investigated. Results: A modulation of the gut microbiota profile caused by pirfenidone were observed, which appeared to play an important role in the development of pellagra-related nausea. A therapeutic effect of BB536 against nausea caused by pirfenidone was also identified. Finally, the urinary ratio of nicotinamide / N-methylnicotinamide was shown to be a biomarker of pellagra-like AEs induced by pirfenidone. Conclusions: The utility of BB536 in pirfenidone-related pellagra from the viewpoint of reducing AEs was indicated. Importantly, further research is needed prior to clinical use of BB536 because its safety has not yet been evaluated in patients with IPF.
2023-03-08 | Protective effect of <i>Bifidobacterium longum</i> BB536 against nausea caused by pirfenidone in a mouse model of pellagra
Pellagra is caused by abnormal intake and/or use of nicotinic acid and is known in part to be induced by the use of medications such as isoniazid or pirfenidone. We previously investigated atypical phenotypes of pellagra, such as nausea, using a mouse model of pellagra and found that gut microbiota play an important role in the development of these phenotypes. Here, we investigated the effect of Bifidobacterium longum BB536 on pellagra-related nausea caused by pirfenidone in our mouse model. Our pharmacological data indicated that pirfenidone (PFD) causes modulation of the gut microbiota profile, which appeared to play an important role in the development of pellagra-related nausea. A gut microbiota-mediated protective effect of B. longum BB536 against nausea caused by PFD was also identified. Finally, the urinary ratio of nicotinamide/N-methylnicotinamide was shown to be a biomarker of pellagra-like adverse effects induced by PFD, and it may contribute to the prevention of these effects in patients with idiopathic pulmonary fibrosis.
2022-02-19 | The Combination of In Vitro Assessment of Stress Tolerance Ability, Autoaggregation, and Vitamin B-Producing Ability for New Probiotic Strain Introduction
The health benefits of probiotics are beyond doubt. The positive effects of lactobacilli and bifidobacteria on the function of many body systems have been repeatedly proven by various studies. To completely realize the potential of probiotic microorganisms, the strains should be tested by the greatest combination of characteristics that contribute to the wellness of the host. In this work, for the first time, a combined assessment of the probiotic properties and vitamin B-producing potential of various species and strains of bifidobacteria and lactobacilli was carried out. The presence of an additional advantage, such as vitamin-producing ability, can prevent vitamin deficiency both at the level of the consumption of fermented foods, when the enrichment will occur naturally on the spot, and during colonization by these intestinal strains, when synthesis will occur in vivo. To select potential probiotics, the stress tolerance ability of 16 lactic acid bacteria and bifidobacteria strains to low pH values, bile, and proteolytic enzymes, as well as their ability to autoaggregate, were studied under conditions of modeling the gastrointestinal tract in vitro. The ability of the strains to extracellularly accumulate water-soluble B vitamins was evaluated by capillary electrophoresis. Among the tested strains of bifidobacteria, B. adolescentis VKPM AC-1662 is of interest; it was characterized by the greatest stress tolerance ability and the ability to autoaggregate, in addition to the extracellular synthesis of riboflavin and pyridoxine. Among lactic acid bacteria, L. sakei VKPM B-8936 demonstrated the greatest tolerance to low pH, L. plantarum VKPM B-11007 to duodenal conditions, L. acidophilus VKPM B-2213 to pepsin, and L. salivarius VKPM B-2214 to pancreatin. The highest percentage of autoaggregation was observed in L. salivarius VKPM B-2214, which also accumulated the largest amount of pantothenic acid, but it was sensitive to stress conditions. The obtained results could be used to create new products enriched with probiotics and B vitamins.
2020-05-07 | Strange Blood
In the mid-1870s, the experimental therapy of lamb blood transfusion spread like an epidemic across Europe and the USA. Doctors tried it as a cure for tuberculosis, pellagra and anemia; proposed it as a means to reanimate seemingly dead soldiers on the battlefield. It was a contested therapy because it meant crossing boundaries and challenging taboos. Was the transfusion of lamb blood into desperately sick humans really defensible? The book takes the reader on a journey into hospital wards and lunatic asylums, physiological laboratories and 19th century wars. It presents a fascinating story of medical knowledge, ambitions and concerns - a story that provides lessons for current debates on the morality of medical experimentation and care.
1989-12-01 | Conversion of 3-cyanopyridine to nicotinic acid by Nocardia rhodochrous LL100-21
3-Cyanopyridinase activity, i.e. the ability to convert 3-cyanopyridine to nicotinic acid plus ammonia, was induced in stationary phase cultures of Nocardia rhodochrous LL100-21 by the addition of 2-, 3-, or 4-cyanopyridine or benzonitrile; the latter nitrile gave maximum induction. Harvested bacteria possessing 3-cyanopyridinase activity could stoichiometrically convert 3-cyanopyridine at concentrations of up to 0.5 m to nicotinic acid. Both 3-cyanopyridine and nicotinic acid inhibited the hydrolysis of 3-cyanopyridine by intact bacteria. Bacteria immobilized in calcium alginate beads and used in column bioreactors retained 3-cyanopyridinase activity for over 150 h when continuously supplied with 0.3 m 3-cyanopyridine.
small molecules
2026-06-16 | Pruritic rash and diarrhoea in a man with chronic alcohol use disorder
This report describes a 62-year-old man with long-term heavy alcohol consumption, who presented with pruritic, hyperpigmented scaly plaques on sun-exposed skin and recent nonbloody diarrhoea. Skin histopathology showed psoriasiform hyperplasia and superficial perivascular lymphocytic infiltration, supporting the diagnosis of pellagra. The patient responded well to oral nicotinamide supplementation, with gradual and complete resolution of skin lesions within 3 months. This case emphasizes that alcoholic pellagra should be considered in patients with chronic alcoholism and typical photosensitive dermatitis.
2026-04-20 | Pellagra From Tryptophan Depletion in Carcinoid Syndrome due to a Pulmonary Atypical Carcinoid Neuroendocrine Tumor.
Pellagra may complicate functioning pulmonary atypical carcinoid and present as a subtle acral dermatosis rather than the classical photo-distributed rash. In neuroendocrine tumor patients with chronic diarrhea and new skin changes, clinicians should suspect niacin deficiency and consider empiric nicotinamide, even when niacin assays are unavailable.
2026-04-08 | Pellagra presenting as Casal’s necklace dermatitis and upper limbs dermatitis in a person with chronic alcohol dependence: A rare case report
Abstract Chronic alcohol dependence can lead to a deficiency of Vitamin B3 (niacin). Niacin deficiency secondary to chronic alcoholism can present with a triad of three Ds in the form of dermatitis, diarrhea, and dementia. If not recognized early and treated promptly, it can lead to the fourth D, known as death. In the present case report, we have highlighted a clinical picture of a 34-year-old male who had chronic alcohol dependence who presented with Casal’s necklace dermatitis and both upper limb dermatitis characteristic of pellagra. Early diagnosis and proper intervention led to his complete recovery.
2026-02-26 | Molecular Level Study Through Thermodynamic and Acoustic Properties of Vitamin B 3 in Two Different Electrolyte Salt Solutions
ABSTRACT Treatment for pellagra depends on knowing the nature of biological processes and how bio‐physical qualities affect structural aspects of bodily systems. To circumvent this issue, an attempt was made in this study to provide a picture of the chemical interactions that took place in the solutions, which may be able to assist in choosing a suitable salt for preserving healthy blood pressure. Under circumstances of ambient temperature. Experimental measurements were made of the density and ultrasonic velocity of vitamin B 3 at concentrations of 0.02, 0.04, 0.06, 0.08, 0.1, 0.12, 0.14, 0.16, 0.18, and 0.2 mol/kg in 0.1 mol/kg electrolyte salt solutions (NaCl and KCl) at two distinct temperatures (i.e., 283 and 293 K). The different thermo‐acoustic characteristics have been investigated based on the aforementioned experimental findings. Because of this, the present study's goal is to employ electrolytic (NaCl and KCl) techniques for arriving at how salts, water, and vitamin B 3 interact molecularly. It is evident from the whole study that vitamin B 3 interacts with KCl salt ions more than NaCl salt ions. This leads to vitamin B 3 forging a stronger interaction with a K + containing solvent and impacting hypertension more quickly than a Na + containing one.
2026-02-24 | Marchiafava-Bignami Disease and Pellagra in a Chronic Alcohol User: A Reversible Case of Cognitive Impairment.
Marchiafava-Bignami disease (MBD) is a rare complication of chronic alcoholism characterized by demyelination of the corpus callosum. Pellagra, resulting from niacin (vitamin B3) deficiency, typically presents with dermatitis, diarrhea, and dementia. Both MBD and pellagra are often associated with severe nutritional deficiencies. We describe the case of a 56-year-old man with alcohol use disorder admitted after a syncopal episode, presenting with disorientation, apathy, and photosensitive desquamative lesions on sun-exposed skin. Brain MRI revealed T2 hyperintensity in the splenium and body of the corpus callosum, compatible with subacute MBS. Laboratory tests confirmed niacin deficiency, establishing concomitant pellagra. The patient received B-complex vitamin supplementation and was maintained in alcohol abstinence. His cognitive and dermatologic condition improved markedly, with near-complete recovery after six months. This case underlines the importance of recognizing nutritional deficiencies in alcohol-related neuropsychiatric presentations.
cell therapies
2023-09-09 | Impact of Bifidobacterium longum BB536 on nausea caused by pirfenidone in a mouse model of pellagra
Introduction: Pirfenidone is used for anti-fibrotic therapy of idiopathic pulmonary fibrosis (IPF). Pirfenidone causes some adverse effects (AEs) such as photosensitivity and nausea, which appear pellagra-like. Our pharmacological studies using mice had indicated that gut microbiota might play an important role in the development of these phenotypes. Here, we investigated the effect of Bifidobacterium longum BB536 on pellagra-related nausea caused by pirfenidone in our mouse model. Aims: We investigated the role of BB536 in the development of pellagra-related nausea. Methods: Mice kept under low-niacin diets were administered vehicle or pirfenidone (1,0 or 3.0 mg/mg/animal, twice daily, 5 days) and some mice were treated with BB536using HydroGel (a non-wetting water gel for animal hydration). The resulting nausea was evaluated based on their pica behavior and the urinary metabolite levels were analyzed using liquid chromatography coupled with mass spectrometry. Furthermore, the profiles of gut microbiota were investigated. Results: A modulation of the gut microbiota profile caused by pirfenidone were observed, which appeared to play an important role in the development of pellagra-related nausea. A therapeutic effect of BB536 against nausea caused by pirfenidone was also identified. Finally, the urinary ratio of nicotinamide / N-methylnicotinamide was shown to be a biomarker of pellagra-like AEs induced by pirfenidone. Conclusions: The utility of BB536 in pirfenidone-related pellagra from the viewpoint of reducing AEs was indicated. Importantly, further research is needed prior to clinical use of BB536 because its safety has not yet been evaluated in patients with IPF.
2023-03-08 | Protective effect of <i>Bifidobacterium longum</i> BB536 against nausea caused by pirfenidone in a mouse model of pellagra
Pellagra is caused by abnormal intake and/or use of nicotinic acid and is known in part to be induced by the use of medications such as isoniazid or pirfenidone. We previously investigated atypical phenotypes of pellagra, such as nausea, using a mouse model of pellagra and found that gut microbiota play an important role in the development of these phenotypes. Here, we investigated the effect of Bifidobacterium longum BB536 on pellagra-related nausea caused by pirfenidone in our mouse model. Our pharmacological data indicated that pirfenidone (PFD) causes modulation of the gut microbiota profile, which appeared to play an important role in the development of pellagra-related nausea. A gut microbiota-mediated protective effect of B. longum BB536 against nausea caused by PFD was also identified. Finally, the urinary ratio of nicotinamide/N-methylnicotinamide was shown to be a biomarker of pellagra-like adverse effects induced by PFD, and it may contribute to the prevention of these effects in patients with idiopathic pulmonary fibrosis.
2022-02-19 | The Combination of In Vitro Assessment of Stress Tolerance Ability, Autoaggregation, and Vitamin B-Producing Ability for New Probiotic Strain Introduction
The health benefits of probiotics are beyond doubt. The positive effects of lactobacilli and bifidobacteria on the function of many body systems have been repeatedly proven by various studies. To completely realize the potential of probiotic microorganisms, the strains should be tested by the greatest combination of characteristics that contribute to the wellness of the host. In this work, for the first time, a combined assessment of the probiotic properties and vitamin B-producing potential of various species and strains of bifidobacteria and lactobacilli was carried out. The presence of an additional advantage, such as vitamin-producing ability, can prevent vitamin deficiency both at the level of the consumption of fermented foods, when the enrichment will occur naturally on the spot, and during colonization by these intestinal strains, when synthesis will occur in vivo. To select potential probiotics, the stress tolerance ability of 16 lactic acid bacteria and bifidobacteria strains to low pH values, bile, and proteolytic enzymes, as well as their ability to autoaggregate, were studied under conditions of modeling the gastrointestinal tract in vitro. The ability of the strains to extracellularly accumulate water-soluble B vitamins was evaluated by capillary electrophoresis. Among the tested strains of bifidobacteria, B. adolescentis VKPM AC-1662 is of interest; it was characterized by the greatest stress tolerance ability and the ability to autoaggregate, in addition to the extracellular synthesis of riboflavin and pyridoxine. Among lactic acid bacteria, L. sakei VKPM B-8936 demonstrated the greatest tolerance to low pH, L. plantarum VKPM B-11007 to duodenal conditions, L. acidophilus VKPM B-2213 to pepsin, and L. salivarius VKPM B-2214 to pancreatin. The highest percentage of autoaggregation was observed in L. salivarius VKPM B-2214, which also accumulated the largest amount of pantothenic acid, but it was sensitive to stress conditions. The obtained results could be used to create new products enriched with probiotics and B vitamins.
2020-05-07 | Strange Blood
In the mid-1870s, the experimental therapy of lamb blood transfusion spread like an epidemic across Europe and the USA. Doctors tried it as a cure for tuberculosis, pellagra and anemia; proposed it as a means to reanimate seemingly dead soldiers on the battlefield. It was a contested therapy because it meant crossing boundaries and challenging taboos. Was the transfusion of lamb blood into desperately sick humans really defensible? The book takes the reader on a journey into hospital wards and lunatic asylums, physiological laboratories and 19th century wars. It presents a fascinating story of medical knowledge, ambitions and concerns - a story that provides lessons for current debates on the morality of medical experimentation and care.
1989-12-01 | Conversion of 3-cyanopyridine to nicotinic acid by Nocardia rhodochrous LL100-21
3-Cyanopyridinase activity, i.e. the ability to convert 3-cyanopyridine to nicotinic acid plus ammonia, was induced in stationary phase cultures of Nocardia rhodochrous LL100-21 by the addition of 2-, 3-, or 4-cyanopyridine or benzonitrile; the latter nitrile gave maximum induction. Harvested bacteria possessing 3-cyanopyridinase activity could stoichiometrically convert 3-cyanopyridine at concentrations of up to 0.5 m to nicotinic acid. Both 3-cyanopyridine and nicotinic acid inhibited the hydrolysis of 3-cyanopyridine by intact bacteria. Bacteria immobilized in calcium alginate beads and used in column bioreactors retained 3-cyanopyridinase activity for over 150 h when continuously supplied with 0.3 m 3-cyanopyridine.
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