Pellagra is ... The cause and symptoms of pellagra

Pellagra is a disease manifested due to a lack of vitamins or malnutrition with a lack or deficiency in the diet of proteins, nicotinic acid and the amino acid tryptophan.

The disease is exposed in equal parts to both adults and children. Poverty is mainly affecting the poor. Pellagra can be described with certainty as a disease of three d - dermatitis, diarrhea, dementia, in English-language reference books often called a disease of 4 d and add death in the end.

Nicotinic acid and pellagra

After reading this, most people can misunderstand what has the nicotine, which is quite a dangerous poison. But, in fact, nicotinic acid is one of the most important vitamins, which plays a huge role in the functioning of the human body. In the nervous system, there are special receptors, the effect of which begins only if the body has a sufficient amount of nicotinic acid, which is produced by specific bacteria in the human intestine. But, despite the fact that niacin (nicotinic acid) is contained in tobacco smoke, there are completely different compounds and therefore are sufficiently poisonous. Internal organs suffer from it, there may be various pathologies in pregnant women, manifestations of various diseases. The disease of pellagra can manifest itself in smokers - they practically do not have their own synthesis.

History of the disease

The meaning of the word "pellagra" in translation means rough skin. Particularly widespread in the XIX century in almost all countries of Europe. At the end of the same century, the disease itself disappeared in France.

In one of the found case histories, the pellagra is described as follows: the patients have "glass" eyes with a fixed gaze, a pale face. Hands like after a vast burn or wound - all in cracks and scars. Uncertain walking with a shaking head creates the appearance of a person with alcoholic intoxication. There is a feeling that they are being led by some force - they go one way, then they start running out of the last forces quite directly, or they suddenly fall with hysterical laughter or strong sobs.

The bulk of the disease occurred in the villages and semi-isolated groups (orphanages, prisons, mental hospitals).

The main outbreaks occurred in the spring-summer period, so specialists concluded that the pellagra has an infectious nature. In another country, this disease has been registered for generations in one family, hence the conclusion that the pellagra is hereditary.

After long observations, Dr. Goldberg found that in semi-closed groups with numerous pellagra diseases, there have never been registrations about the defeat of attendants by this illness. Therefore, the experience, carried out in 1916 by Professor D. Goldberg together with 15 colleagues, proved that pellagra is a non-infectious disease. And after a time, a substance was found that successfully cures this disease - pellagra prevention factor or PP. But in fact this substance was found in 1873 by the scientist Weiner, but only after many years it became clear that PP and nicotinic acid are the same substance.

Vitamins in the human body

Vitamin B takes a serious step among all the necessary microelements for humans. But the most significant is the help in the formation of ATP and various reactions. This vitamin lowers the level of harmful cholesterol in the blood, thereby significantly reducing the risk of cardiovascular disease.

Nicotinic acid is the only vitamin that recognizes traditional medicine as an independent drug and is used in the treatment of various serious diseases.

The lack of vitamins of group B can provoke beriberi, it is promoted by:

• Low content of nicotinic acid or nicotinamide with ingested food.

• Violation of the function of absorption of the vitamin in the violation of the gastrointestinal tract at retirement age.

• Lack of amino acid tryptophan in an unbalanced diet - without it, intestinal bacteria do not synthesize nicotinic acid.

• Alcohol addiction.

• Various malignant formations.

• Constant fatigue and stress.

The role of microelements in the human body

The lack of vitamin D reduces appetite, unstable mood, digestive disorder and so on. A small amount of ultraviolet causes a lack of vitamin D in the body, which is fraught with serious consequences. Contained in fish oil, butter.

The lack of vitamin E in the first place affects the general condition of the skin, hair, nails. But also without it, the synthesis of all tissues of the human body does not do - improves the transport of oxygen in the blood, prevents the onset of atherosclerosis, promotes the normal functioning of the genital organs.

The lack of vitamin E is a rarity. This antioxidant is in sufficient quantities in vegetable oils, cereals, by-products and greens. Nevertheless, if the liver does not function well, it is necessary to stimulate the secretion of bile for the normal assimilation of vitamins.

The lack of vitamin K leads to a violation of blood coagulability and often there is increased bleeding. You can restore the balance by including liver, spinach, leafy or cabbage, tomatoes and carrots.

Lack of vitamin A. Symptoms of deficiency are manifested in the form of "night blindness", people suffering from this disease, cease to see at dusk, but at the same time they are perfectly seen in the daytime. If the deficit occurs sharply, then dryness in the eyes is felt. Sometimes the peeling or keratinizing of not only cutaneous but also mucous membranes may occur, glands of internal secretion may fail - this is also affected by a lack of vitamin A. Symptoms pass quickly enough with food regulation. Contained in oils of animal origin, liver, fish oil, yolks, in red carrots, tomatoes, fresh apricots. When cooking or souring vitamins are preserved, while drying is a rapid destruction.

To date, several stages of vitamin A deficiency are known, the symptoms of which are described below:

1. General disorder of internal organs, both all together, and some. This is due to a decrease in efficiency and resilience.

2. The deficit gradually begins to manifest itself. At clinical researches it is already possible to define with accuracy the lack of deficiency of substances in an organism.

3. Insufficient or complete absence of the vitamin or a violation of its digestibility.

Different types of hypovitaminosis nowadays occur quite often, mainly in elderly people, pregnant or lactating women, athletes, children, workers in physically hard work.

The role of vitamins in the human body is quite obvious, and neglecting these substances is dangerous for health.

Factors provoking the disease

• Skin burns with sunburn.

• Alcoholism.

• Various diseases of the gastrointestinal tract.

• Pregnancy or lactation.

• Various infectious diseases.

• Imbalance in the power supply.

Diagnosis and Clinic of the disease

The lack of vitamins in the body is formed over the years, all this time masking for various diseases - from the mental to the nervous. With a shortage of nicotinic acid, a person has a syndrome of chronic fatigue, lack of appetite, a decrease in working capacity, a sharp decrease in body weight.

And only after the time has passed, the patient begins to complain of insomnia, irritability, migraine and forgetfulness, there is a negative reaction to loud music, bright colors and light. Rushing from extreme to extreme - from melancholic to aggressive state.

All these abrupt mood changes often lead others to think about mental ill health, and they try to force the patient to visit a psychiatrist.

In this case, it will be good if the disease reaches the stage of extensive clinical manifestations, and the doctor will perform a thorough examination, which will reveal symmetrical red spots with a flaky surface on the body and a bright crimson tongue with a shiny surface, with toothmarks at the edges, various neuritis and " Lumbago, loss of sensitivity of any parts of the face.

Symptoms

In principle, a patient can turn absolutely to any specialist, because there is a different pellagra. The symptoms are as follows:

- A dermatologist will detect a swollen and itchy epithelium of a dark red color, on which blisters are periodically formed, which in time burst and become wet, look like a pityriasis in a couple of days. But over time, the skin is sloughed, and deeper layers of the epithelium become visible, or completely discolored and resembles vitiligo. In our country, pellagra is a fairly rare disease.

- When examined by a gastroenterologist of a patient with this disease, he will find minor sores in the mouth, bright tongue coloring, weight loss. And complaints of excessive salivation, a loose stool with putrefactive odor, nausea, a decrease or lack of appetite, discomfort in the throat or esophagus will prompt experts to conduct additional studies - sigmoidoscopy and / or fibrogastroduodeniya. By results of analyzes, atrophy of the mucous membrane of the gastrointestinal tract will be visible, sometimes on the walls small bleeding sores can be seen.

- At the final stage of the disease, patients are visited by a neurologist or psychiatrist. At this moment, dementia begins to progress, accompanied by encephalopathy or psychosis, which is manifested by various hallucinations, delusions with paranoid tendencies and psychomotor agitation. Encephalopathic syndrome is accompanied by a clouding of consciousness, the emergence of an uncontrolled sucking or grasping reflex, increased muscle tone.

Symptoms of pellagra will depend on the stage at which the victim addresses, and which specialist will find it - the case.

The clinical picture of the disease is quite diverse and can be combined with the symptoms of other hypovitaminosis.

Pellagra, a photo of common symptoms slightly lower, is characterized by various ulcers in the oral cavity, dermatitis, stool disorder and mental disorders of a different nature. That is, the symptoms are quite diverse. In adults with pellagra, the symptoms are due to weakness, apathy, a decrease or a complete lack of appetite and, as a consequence, a decrease in body weight, irritability, rapid fatigue.

Stool disorder, changes in the mucosa and epidermis are manifested by the end of winter. After a while, in the absence of treatment after the manifestation of symptoms, burning in the oral cavity begins and excessive salivation. After this, there is a swelling of the lips, mainly the lower one, with painful cracks. The mucosa of the oral cavity is hyperemic, and the gums and tongue are covered with small ulcers. The tongue is covered with a black-brown coating, but the tip and edges have a bright red color. Over time, the language becomes completely red, lacquered luster appears. In the puffy tongue, the papillae are hypertrophied and visible in the form of red dots; along the edges, the teeth are visible. After that, the sharp signs gradually go to decline, the mucous pale, atrophy papillae, but deep furrows may appear on the surface of the tongue. Skin lesion is manifested primarily in open areas.

Chronic Pellagra: Symptoms of this disease

Blisters, a thickening of the epidermis with a scaly surface, which then begins to pigment, thin out and, eventually, atrophy. In some cases, the manifestation of spinal poliradiculoneuritic, cerebrospinal or polyneuric syndrome.

With this disease, often there is depression, gradually turning into psychosis. This condition can last for years, with annual spring exacerbations that can occur with various complications in the form of symptoms of typhoid or dysentery, in rare cases develops scurvy.

Today in highly developed countries this is a rather rare phenomenon. But in some regions of Africa or Asia, pellagra is a serious problem, yet local doctors find it at an early stage. To do this, it will be sufficient to pass a urine test to determine the level of methyl nicotinamide, as well as the amount in the blood of nicotinic acid and the content of vitamins of the b-group.

Treatment

Patients need to be in the hospital, where they are prescribed a certain table with the following content:

1. Protein diet with high content of low-fat products, meat broths, chicken or quail eggs, as well as dairy or sour-milk products.

2. Preparations containing nicotinic acid. The method and dose depend on the severity of the disease and the concomitant pathology.

3. In severe cases, strict adherence to bed rest is required.

4. Various drugs in which vitamin B is present in the required amount.

5. In severe cases, it is recommended that blood transfusion be performed.

6. With current mental disorders, according to the expert, various tranquilizers, antidepressants, are used primarily.

7. The patient should avoid a long pastime in the open sun before recovery.

If you do not pay attention to the signs of the disease and do not follow the treatment, then the pellagra can kill a person in about five years.

Prevention

For preventive purposes, a balanced diet with the necessary amount of antipellagric factor in the food consumed is necessary. The daily need for an adult in vitamin PP is about 15-25 mg.

A sufficient amount of this vitamin is found in wheat, yeast, by-products. Milk contains a lot of tryptophan, which in the body is easily synthesized into nicotinic acid.

For the prevention of chronic pellagra, parenteral administration of significant doses of vitamins required in the body is required if there are a history of diseases that prevent the body from absorbing nutrients normally, or if there are chronic or acute infections. Therefore, the role of vitamins in the human body is quite important.

It follows that such a disease is easier to prevent than diagnose and cure in time.