TY  - JOUR
PY  - 2020//
TI  - Pellagra Disease in a Hemodialysis Patient
JO  - Saudi journal of kidney diseases and transplantation
A1  - Barrah, Sana
A1  - Jebali, Hela
A1  - Kheder, Rania
A1  - Krid, Madiha
A1  - Smaoui, Wided
A1  - Beji, Soumaya
A1  - Hmida, Fathi Ben
A1  - Fatma, Lilia Ben
A1  - Rais, Lamia
A1  - Zouaghi, Mohamed Karim
SP  - 874
EP  - 876
VL  - 31
IS  - 4
N2  - Pellagra usually results from niacin deficiency and presents with the classic triad of dermatitis, diarrhea, and dementia. It is most commonly associated with malnutrition and poverty. We report a case of pellagra in a hemodialysis (HD) patient with breast neoplasia, aged 68-years, female, on HD unit for seven years. Her original nephropathy was indeterminate. The patient was followed up for homozygous beta-thalassemia and breast neoplasia with hepatic metastases on chemotherapy. The body mass index of the patient was 18.5 kg/m2. Physical examination showed a thickening of the epidermis with a scaly surface, pigmented, and atrophied areas. We noted neuropsychiatric signs (apathy, irritability, anorexia, and depression) and digestive symptomatology (diarrhea). The laboratory tests revealed hypoproteinemia at 55 g/L, hypoalbuminemia at 21 g/L, and hypocholesterolemia at 0.8 g/L. The diagnosis of pellagra disease was made. Vitamin and protein supplementation was initiated, but the patient committed suicide by puncture of her arteriovenous fistula, causing hemorrhagic shock. Pellagra is usually reported to be associated with malnutrition, chronic alcoholism, and some chemotherapeutic agents. In our patient, pellagra was caused by malnutrition and co-morbidities. Pellagra disease requires multidisciplinary care and can be frequently seen in HD patients due to the associated malnutrition.<p /> <p>Language: en</p>
LA  - en
SN  - 1319-2442
UR  - http://dx.doi.org/10.4103/1319-2442.292325
ID  - ref1
ER  -