Pellagra as a potential complication of anorexia nervosa: A comprehensive literature review

Pellagra, a deficiency of niacin (Vitamin B3), is a potential secondary complication of anorexia nervosa (AN) resulting from restricted nutrient consumption. Symptoms observed in patients with pellagra (such as diarrhea, dermatitis, dementia, and death) can often overlap with or be affected by AN status. This article presents the largest literature review to date on symptoms observed with AN-induced pellagra, treatment regimens, and patient outcomes. An English literature search was performed using the keywords “pellagra” and “anorexia”, yielding seven female case reports. The most prevalent symptom (100%) reported was erythema of the face, neck, and arm regions. Symptoms traditionally associated with pellagra were not identified as frequently, such as diarrhea (29%). The most common treatment regime included both Vitamin B supplementation and dietary advice (83%), with all patients recorded recovering from pellagra. AN and pellagra may affect the symptomatic presentation of its counterpart disease, providing a challenge to practitioners tasked with diagnosing patients. Future studies are needed to clarify the symptomatic development of the diseases concurrently, and best practices in treatment and diagnosis.