Insufficiency of nicotinic acid (vitamins PP, B3, etc.) is due to insufficient intake of this vitamin with food (for example, with preferential feeding by corn), inadequate absorption of it in the intestine (various diseases of the stomach and small intestine, accompanied by a syndrome of insufficiency of absorption) or increased need for (Pregnancy, hard physical work, etc.). The severe degree of nicotinic acid deficiency is manifested by the clinical symptoms of pellagra, which occurs in some countries of Africa and Asia. Nicotinic acid and its amide are effective anti-pellagra agents, participate in cellular respiration, being prosthetic groups of enzymes of codohydrazines I and II. With their deficiency in the body, there are significant metabolic and functional disorders of many organs, degenerative and degenerative changes in organs and tissues, most pronounced in the skin, nervous and digestive systems. Usually, with Pellargue, there are signs of deficiency in other B vitamins, as well as amino acids of tryptophan (contained in high-grade proteins).

In many foods of animal and vegetable origin, nicotinic acid is available in sufficient quantities. The daily requirement of adults in nicotinic acid and its amide is 20-25 mg.

The clinical picture is due to the predominant lesion of the digestive, nervous systems and skin. Appearance of loss of appetite, dryness and burning sensation in the mouth, vomiting, diarrhea, alternating with constipation, general progressive weakness. The tongue is bright red with edema, with painful ulceration, and later lax. Atrophic and erosive changes are found in other parts of the digestive tract, the secretion of the digestive glands is suppressed, and achillia appears. The defeat of the nervous system manifests itself as general irritability, symptoms of polyneuritis, and sometimes signs of spinal cord injury (often posterolateral columns). In severe cases, convulsions, ataxia occur, and sometimes dementia develops. Skin lesions are manifested by pellagricocular erythema, accompanied by skin itching, hyperpigmentation (mainly on open areas of the body and limbs), skin flaking, the appearance of follicular papules. The functions of the endocrine system are violated, hypoproteinemia develops.

The diagnosis is based on the characteristic clinical manifestations of the disease, given biochemical studies: the N1-methyl nicotinamide content in daily urine is lower than 4 mg, in the urine hour - or 0.3 mg; The content of nicotine puss. Below 0.2 mg. Reduces the blood and urine content of other B vitamins.

Treatment in moderate and severe cases is stationary: complete fractional nutrition with a gradual increase in calorie, nicotinic acid or nicotinamide inside 25-100 mg / day for 2-3 weeks in combination with other vitamins of group B. In endogenous forms - parenteral administration of nicotinic acid And its amide.

Prevention: a varied balanced diet with sufficient content in the diet of foods rich in nicotinic acid. With endogenous form - timely diagnosis and treatment of bowel diseases, preventive administration of nicotinic acid and its amide; Additional introduction of vitamin PP to people with increased need for it.