Biochemistry: Important deficiency manifestations of Niacin – Pellagra.

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Deficiency of Niacin

Deficiency of Niacin leads to a disease called Pellagra meaning “rough skin”.

Pellagra

  • Niacin is synthesized from tryptophan. Quinolinate phosphoribosyl transferase is the rate limiting enzyme. 
  • Apart from the deficiency of Niacin, Pellagra can also be caused by the deficiency of Tryptophan.
  • Pellagra is seen more in women; this may be because tryptophan metabolism is inhibited by estrogen metabolites.
  • The symptoms of pellagra are:
Dermatitis
  • In early stages, bright red erythema occurs, especially in the feet, ankles and face.
  • Increased pigmentation around the neck is known as Casal’s necklace.
  • The dermatitis is precipitated by exposure to sunlight
Diarrhea
  • The diarrhea may be mild or severe with blood and mucus.
  • This may lead to weight loss.
  • Nausea and vomiting may also be present.
Dementia
  • It is frequently seen in chronic cases.
  • Delerium is common in acute pellagra.
  • Irritability, inability to concentrate and poor memory are more common in mild cases.
  • Ataxia, and spasticity are also seen.

Causes of Niacin Deficiency

1. Dietary deficiency of tryptophan
  • Pellagra is seen among people whose staple diet is maize (South and Central America).
  • In maize, niacin is present; but it is in a bound form, and is unavailable.
  • Pellagra is also seen when staple diet is sorghum (jowar or guinea corn) as in Central and Western India.
  • Sorghum, contains leucine in high quantities.
  • Leucine inhibits the QPRT enzyme …

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