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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
  • alcoholism

Last reviewed 01/2018

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