Niacin deficiency [pellagra]
Chapter 4:Endocrine, nutritional and metabolic diseases
ICD-10 E52 is a billable code used to indicate a diagnosis of niacin deficiency [pellagra].
Niacin deficiency, also known as pellagra, is a nutritional disorder caused by a lack of niacin (vitamin B3) in the diet. It is characterized by the classic triad of symptoms: dermatitis, diarrhea, and dementia. Pellagra can occur in populations with limited access to diverse foods, particularly in areas where maize is a staple, as maize is low in niacin and tryptophan, the amino acid from which niacin is synthesized. The skin lesions associated with pellagra typically appear in sun-exposed areas and can be scaly and red. Gastrointestinal symptoms may include abdominal pain, vomiting, and diarrhea, while neurological symptoms can range from confusion to severe cognitive impairment. If left untreated, niacin deficiency can lead to severe complications and even death. Treatment involves dietary changes to include niacin-rich foods such as meat, fish, and fortified cereals, as well as niacin supplementation when necessary. Early diagnosis and intervention are crucial to prevent irreversible damage.
Detailed dietary assessments and patient history.
Patients presenting with skin lesions, gastrointestinal issues, or cognitive decline.
Ensure comprehensive documentation of dietary intake and any supplementation provided.
Thorough clinical evaluations and lab results to rule out other causes.
Patients with chronic gastrointestinal disorders leading to malabsorption.
Document any co-existing conditions that may contribute to niacin deficiency.
Used when a patient is assessed for dietary deficiencies.
Document the patient's dietary history and the plan for nutritional intervention.
Nutrition specialists should ensure comprehensive dietary assessments are included.
The primary symptoms include dermatitis, diarrhea, and dementia, often referred to as the 'three D's' of pellagra.
Diagnosis is typically based on clinical symptoms, dietary history, and response to niacin supplementation.
Rich sources of niacin include meat, fish, poultry, fortified cereals, and legumes.
Yes, by ensuring a balanced diet that includes adequate sources of niacin and considering supplementation in at-risk populations.
