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Pellagra is rare in the UK as niacin occurs in many plant and animal foods and can also be synthesised from tryptophan.
Causes of pellagra:
- a monotonous maize diet (maize is low in tryptophan)
- a very low protein diet
- conditions producing considerable loss of protein e.g. nephrotic syndrome
Other causes include:
- malabsorption e.g. coeliac disease
- isoniazid - isoniazid is a pyridoxine antagonist - this agent is essential for conversion of tryptophan to nicotinic acid
- Hartnup Disease
- carcinoid syndrome - consumption of tryptophan by serotonin producing tumour
Last reviewed 01/2018