Case Info - BotMed Application

CaseName

Presentation Case 2. Pellagra

CaseDescription

A 53-year-old woman with a history o carcinoid tumor o the appendix
(status post resection) presents to a local clinic with symmetric, dry,
hyperpigmented skin lesions and persistent diarrhea. Her husband
expresses concern that the patient does not seem to be herself anymore;
he reports that she has been irritable, confused, and forgetful. What is the
most likely diagnosis?

PhysicalExams

Labs

ImagingStudies

Comment

Pellagra, a deficiency o vitamin B3 (niacin), 2° to a recurrent carcinoid tumor. Carcinoid tumors produce serotonin, which is a derivative of tryptophan. However, tryptophan is also the precursor o niacin. In
patients with carcinoid tumors, the tumor can be so active that most
tryptophan is used or serotonin production, resulting in niacin
deficiency.