A Case of Pellagra Induced by Isoniazid during Treatment of Pulmonary Tuberculosis.

Jeon, Ho Seok; Han, Min Soo; Ahn, Ju Eui; Lee, Yang Deok; Cho, Yongseon

doi:2004.57.2.180

Tuberc Respir Dis > Volume 57(2); 2004 > Article

Case Report

Tuberculosis and Respiratory Diseases 2004;57(2):180-182.
DOI: https://doi.org/10.4046/trd.2004.57.2.180 Published online August 1, 2004.

A Case of Pellagra Induced by Isoniazid during Treatment of Pulmonary Tuberculosis.

Ho Seok Jeon, Min Soo Han, Ju Eui Ahn, Yang Deok Lee, Yongseon Cho

Department of Internal Medicine, Eulji University School of Medicine, Daejeon, Korea. hms43@freechal.com

Abstract

A Case of Pellagra Induced by Isoniazid during Treatment of Pulmonary Tuberculosis Pellagra is a disease caused by a deficiency of nicotinic acid or niacin. It is mostly found among people eating corn-based diets in parts of China, Africa and India. It is also induced by drugs, such as isoniazid or 5-fluorouracil. Isoniazid inhibits the conversion of tryptophan to niacin and may induce pellagra, particularly in poorly nourished patients. Pellagra should be suspected whenever tuberculous patients under the treatment with isoniazid develop mental, neurological or gastrointestinal symptoms, even in the absence of typical skin changes. Herein, our experienced of a case of pellagra induced by isoniazid during treatment of pulmonary tuberculosis is reported. The patient was referred due to a skin rash and drowsy mental status. Her skin lesion developed during treatment for pulmonary tuberculosis. Her symptoms were improved after discontinuation of antituberculous agents and on the administration of nicotinamide.

Key Words: Pellagra, Isoniazid, Pulmonary tuberculosis