Pelagra e o alcoolismo

O alcoolismo está bastante relacionado coma pelagra, pois o álcool além de não fornecer aminoácido essenciais, sais minerais e vitaminas; ainda reduz a disponibilidade das vitaminas B2, B6, e B12. Estas duas primeiras são muito importantes para o metabolismo, já que são imprescindíveis em reações enzimáticas que transformam o aminoácido triptofano em ácido niconítico. A sua deficiência leva, então, ao surgimento de casos de pelagra como abordado nos artigos abaixo.

The diagnostic importance of photosensitivity dermatoses in chronic alcoholism: report of two cases.

Many of the vitamin deficiency diseases have been almost completely eliminated in developed countries. Niacin deficiency is considered one of them. However, cases of pellagra are recently reported in West Europe, USA, Australia, and Japan in connection with chronic alcoholism, gastrointestinal malabsorption, and some medications. We report two cases of pellagra, manifesting as photosensitivity dermatoses with mental deterioration in chronic alcoholic abusers in the Mediterranean basin, the island of Crete in Greece. The report highlights the fact that all physicians should be alerted to photosensitivity dermatoses in alcoholics; early treatment with multiple vitamin therapy, including nicotinic acid should be initiated in these patients.
Pipili C, Cholongitas E, Ioannidou D.
Department of Internal Medicine, General Hospital of Sitia, GR 72300, Greece.

B Vitamin deficiency and neuropsychiatric syndromes in alcohol misuse.

Alcohol misuse and alcohol withdrawal are associated with a variety of neuropsychiatric syndromes, some of which are associated with significant morbidity and mortality. B vitamin deficiency is known to contribute to the aetiology of a number of these syndromes, and B vitamin supplementation thus plays a significant part in prophylaxis and treatment. In particular, the Wernicke Korsakoff syndrome (WKS). due to thiamine deficiency, is a common condition in association with alcohol misuse, and is associated with high morbidity and mortality. Nicotinamide deficiency may result in a rarer condition, alcoholic pellagra encephalopathy, which often has a similar clinical presentation to WKS. This review considers the role of B vitamins in the aetiology and treatment of neuropsychiatric syndromes associated with alcohol misuse, with particular emphasis on WKS.
Cook CC, Hallwood PM, Thomson AD.
Kent Institute of Medicine and Health Sciences, University of Kent at Canterbury, UK.