Saving a Life by Recognizing the Rash: Niacin (Vitamin B3) Deficiency in Hartnup Disease With a Clinical Debut in Adulthood

Tryptophan deficiency can lead to a critical shortness of niacin (vitamin B3), causing photosensitive dermatitis and a range of neurologic symptoms. The most common cause is severe protein malnutrition. However, in the case we present here, it is caused by a rare genetic disorder (Hartnup disease)....

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Main Authors: Melanie Hafdi, Inge C.M. Hoogland, Arne A. Meesters, Mirjam Langeveld, Diederik van de Beek
Format: Article
Language:English
Published: American College of Physicians 2024-12-01
Series:Annals of Internal Medicine: Clinical Cases
Online Access:https://www.acpjournals.org/doi/10.7326/aimcc.2024.0137
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author Melanie Hafdi
Inge C.M. Hoogland
Arne A. Meesters
Mirjam Langeveld
Diederik van de Beek
author_facet Melanie Hafdi
Inge C.M. Hoogland
Arne A. Meesters
Mirjam Langeveld
Diederik van de Beek
author_sort Melanie Hafdi
collection DOAJ
description Tryptophan deficiency can lead to a critical shortness of niacin (vitamin B3), causing photosensitive dermatitis and a range of neurologic symptoms. The most common cause is severe protein malnutrition. However, in the case we present here, it is caused by a rare genetic disorder (Hartnup disease). A previously healthy 26-year-old woman presented with a photosensitive skin rash, myoclonic twitching of hands and mouth, and, ultimately, coma and status epilepticus. Starting treatment with high-dose niacin, even before the suspected diagnosis was confirmed, turned out to be a lifesaving intervention.
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series Annals of Internal Medicine: Clinical Cases
spelling doaj-art-1790d468dcae40938d9d2d01d8237fc02025-08-20T02:11:43ZengAmerican College of PhysiciansAnnals of Internal Medicine: Clinical Cases2767-76642024-12-0131210.7326/aimcc.2024.0137Saving a Life by Recognizing the Rash: Niacin (Vitamin B3) Deficiency in Hartnup Disease With a Clinical Debut in AdulthoodMelanie Hafdi0Inge C.M. Hoogland1Arne A. Meesters2Mirjam Langeveld3Diederik van de Beek41Department of Neurology, Amsterdam University Medical Center, Amsterdam Neuroscience, University of Amsterdam, Amsterdam, The Netherlands1Department of Neurology, Amsterdam University Medical Center, Amsterdam Neuroscience, University of Amsterdam, Amsterdam, The Netherlands3Department of Dermatology, Amsterdam University Medical Center, University of Amsterdam, Amsterdam, The Netherlands5Department of Internal Medicine, Division of Endocrinology and Metabolism, Amsterdam University Medical Center, University of Amsterdam and Amsterdam Gastroenterology Endocrinology and Metabolism, Inborn Errors of Metabolism, Amsterdam, The Netherlands1Department of Neurology, Amsterdam University Medical Center, Amsterdam Neuroscience, University of Amsterdam, Amsterdam, The NetherlandsTryptophan deficiency can lead to a critical shortness of niacin (vitamin B3), causing photosensitive dermatitis and a range of neurologic symptoms. The most common cause is severe protein malnutrition. However, in the case we present here, it is caused by a rare genetic disorder (Hartnup disease). A previously healthy 26-year-old woman presented with a photosensitive skin rash, myoclonic twitching of hands and mouth, and, ultimately, coma and status epilepticus. Starting treatment with high-dose niacin, even before the suspected diagnosis was confirmed, turned out to be a lifesaving intervention.https://www.acpjournals.org/doi/10.7326/aimcc.2024.0137
spellingShingle Melanie Hafdi
Inge C.M. Hoogland
Arne A. Meesters
Mirjam Langeveld
Diederik van de Beek
Saving a Life by Recognizing the Rash: Niacin (Vitamin B3) Deficiency in Hartnup Disease With a Clinical Debut in Adulthood
Annals of Internal Medicine: Clinical Cases
title Saving a Life by Recognizing the Rash: Niacin (Vitamin B3) Deficiency in Hartnup Disease With a Clinical Debut in Adulthood
title_full Saving a Life by Recognizing the Rash: Niacin (Vitamin B3) Deficiency in Hartnup Disease With a Clinical Debut in Adulthood
title_fullStr Saving a Life by Recognizing the Rash: Niacin (Vitamin B3) Deficiency in Hartnup Disease With a Clinical Debut in Adulthood
title_full_unstemmed Saving a Life by Recognizing the Rash: Niacin (Vitamin B3) Deficiency in Hartnup Disease With a Clinical Debut in Adulthood
title_short Saving a Life by Recognizing the Rash: Niacin (Vitamin B3) Deficiency in Hartnup Disease With a Clinical Debut in Adulthood
title_sort saving a life by recognizing the rash niacin vitamin b3 deficiency in hartnup disease with a clinical debut in adulthood
url https://www.acpjournals.org/doi/10.7326/aimcc.2024.0137
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