Pellagra: a rare complication of anorexia nervosa


Pellagra is a potentially fatal, nutritional disease with cutaneous, gastrointestinal, and neuropsychiatric manifestations. Because of the diversity of pellagra’s signs and symptoms, diagnosis is difficult without an appropriate index of suspicion. A case of pellagra in a 14-year-old girl with anorexia nervosa is presented. Signs and symptoms of pellagra were resolved after niacin therapy and dietary treatment.

This is a preview of subscription content, log in to check access.

Fig. 1


  1. 1.

    Cleary MJ, Cleary JP (1989) Anorexia nervosa: a form of subclinical pellagra. Int Clin Nutr Rev 9:137–143

    Google Scholar 

  2. 2.

    Comerci GD (1990) Medical complications of anorexia nervosa and bulimia nervosa. Med Clin North Am 74(5):1293–1309

    PubMed  CAS  Google Scholar 

  3. 3.

    Evans VL (1939) Pellagra with psychosis and minimal physical symptoms. JAMA 112:1249–1250

    Google Scholar 

  4. 4.

    Judd LE, Poskitt BL (1991) Pellagra in a patent with eating disorder. Brit J Dermatol 125:71–72

    Article  CAS  Google Scholar 

  5. 5.

    Palla B, Litt I (1991) Medical complications of eating disorders in adolescents. Pediatrics 81(5):613–623

    Google Scholar 

  6. 6.

    Rapaport MJ (1985) Pellagra in patient with anorexia nervosa. Arch Dermatol 121:255–257

    PubMed  Article  CAS  Google Scholar 

  7. 7.

    Sauberlich HE (1984) Newer laboratory methods for assessing nutriture of selected B-complex vitamins. Annu Rev Nutr. 4:377–407

    PubMed  Article  CAS  Google Scholar 

  8. 8.

    Steinhausen HCh, Glanville K (1983) A long term follow-up of adolescent anorexia nervosa. Acta Psychiatr Scand 68(1):1–10

    PubMed  Article  CAS  Google Scholar 

  9. 9.

    Strumia R (2005) Dermatologic signs in patients with eating disorders. Am J Clin Dermatol 6(3):165–173

    PubMed  Article  Google Scholar 

  10. 10.

    Wilson JD (1985) Vitamin deficiency and excess. In: Fauci AS, Braunwald E, Isselbacher KJ, et al. (eds) Harrison’s principles of internal medicine, vol 1,14th edn. McGraw-ill Co, Inc, New York, NY, pp 480–489

    Google Scholar 

Download references


This work was supported by grant 2M7/N/2005 from The Medical University of Warszaw.

Author information



Corresponding author

Correspondence to Gabriela Jagielska MD, PhD.

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Jagielska, G., Tomaszewicz-Libudzic, C. & Brzozowska, A. Pellagra: a rare complication of anorexia nervosa. Eur Child Adolesc Psychiatry 16, 417–420 (2007).

Download citation


  • anorexia nervosa
  • pellagra
  • niacin