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PELLAGRA WITH PSYCHOSIS AND MINIMAL PHYSICAL SYMPTOMS

Vernon L. Evans, M.D.
JAMA. 1939;112(13):1249-1250. doi:10.1001/jama.1939.62800130005010d.
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The prompt response of pellagra to nicotinic acid therapy, as recently reported by a number of writers,1 affords an excellent therapeutic test and may show the presence of pellagra in many cases of hitherto undiagnosed disease. The following case is believed to bear this out:

REPORT OF CASE  A single woman aged 38 had been unable to work for eleven years owing to weakness, headaches, undernourishment and anorexia. There had been no ingestion of drugs. The patient had believed herself subject to disease of the stomach and gallbladder, and there were numerous physical complaints.Aug. 1, 1938, she entered a general hospital for study and treatment. There were no "mental" symptoms at that time. While she was there, complete anorexia developed, and the patient became suspicious, hostile, disoriented and violent. When members of her immediate family came to see her she did not recognize them.August 12 the patient

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