Abstract:
Two patients are described who developed pellagra during treatment with azathioprine for inflammatory bowel disease. Pellagra is a disease caused by a systemic deficiency of the water soluble vitamin niacin (nicotinic acid, vitamin B3) and may occur with disturbances of tryptophan metabolism, an unbalanced diet, malabsorption, certain drugs, and rarer conditions such as Hartnup disease; implicated drugs have included 6-mercaptopurine, 5- fluorouracil and isoniazid.