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Pellagra Associated with Organic Disease of the Gastro-Intestinal Tract¹

1. The literature is briefly reviewed.

2. The findings in a group of 16 patients are presented in the form of a table. They all had pellagra and with it some organic disease of the gastro-intestinal tract. They represent 20 per cent of the patients studied.

3. Symptoms of pellagra may obscure those of serious organic disease.

4. The death rate in the group was very high; 50 per cent dying in the hospital in spite of dietary treatment along most modern lines, as compared with 25 per cent in the control group.

5. Two of the patients, one without diarrhea until after dermatitis had appeared, had been on an excellent diet throughout. The diet of four others was good up to the appearance of the diarrhea.

6. The effect of such lesions on bacterial growth in, and absorption of harmful substances from the intestinal lumen, is discussed. It is suggested that this may be an important factor in production of the pellagra.

¹ Aided by grants from the Committee on Scientific Research of the American Medical Association.