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All Journal CRJIM (Clinical and Research Journal in Internal Medicine)
Adriansyah, Vito
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Education Health Professions Immunology & microbiology Medicine & Pharmacology Nursing Public Health Other

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Pellagra Syndrome in Geriatric Patient: Insights from Pathogenesis and Diagnosis Raharjo, Fajar Maulana; Soenarti, Sri; Winoto, Eden Suryoiman; Adriansyah, Vito; Aditya, Muhammad Reva
Clinical and Research Journal in Internal Medicine Vol. 7 No. 1: Volume 7 No 1, May 2026
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.crjim.2026.007.01.14

Abstract

Pellagra syndrome is a chronic niacin deficiency disease that is often underdiagnosed. We report a case of an 83-year-old woman presenting with the four classic symptoms (4D) of pellagra: dermatitis (Casal’s necklace), diarrhea, dementia, and a risk of death if left untreated. The patient also had severe malnutrition, multiple infections, and a history of stroke for five years. The diagnosis was established based on clinical findings and a history of inadequate nutritional intake. Management included fluid therapy, antibiotics, medical rehabilitation, enteral and parenteral nutrition, as well as niacin supplementation. Following treatment, the patient showed clinical improvement, including stabilization of hemoglobin levels. This case highlights the importance of early detection and understanding the pathogenesis of Pellagra syndrome to improve patient outcomes and quality of life. Keywords: Casal’s Necklace, Dementia, Malnutrition, Niacin, Pellagra syndrome
Co-Authors Aditya, Muhammad Reva Raharjo, Fajar Maulana Sri Soenarti Winoto, Eden Suryoiman