Possible Coexistence of Pellagra in a Malnourished Patient with Seizure and Multiple Cerebrovascular Foci: A Case Report

Background and Clinical Significance: Pellagra is caused by a chronic deficiency of niacin (vitamin B3 or nicotinic acid): it is rare in developed countries, where the major risk factors are chronic alcoholism and intestinal malabsorption. Although it typically presents three main symptoms, dermatitis, diarrhea, and dementia, some cases do not show these classic symptoms. Case Presentation: We report a case of a malnourished patient with seizure and multiple cerebrovascular foci, in whom a postmortem autopsy revealed the findings of pellagra. The patient had atypical symptoms of seizure as pellagra and the multiple cerebrovascular lesions, which made the diagnosis difficult. Conclusions: The aim of this paper is to recognize the importance of suspecting pellagra as a treatable disease, especially when patients with eating disorder present atypical symptoms.