Vitamin B3 deficiency leads to Pellagra; which of the following is part of its four D's?

• A. Diarrhea, Dermatitis, Dementia, Death
• B. Diarrhea, Dermatitis, Dehydration, Drowsiness
• C. Digestion issues, Dermatitis, Depression, Death
• D. Dermatitis, Dementia, Depression, Death

Answer: (A)

Pellagra is caused by niacin (Vitamin B3) deficiency, which disrupts the formation of NAD/NADP and leads to damage in skin, GI tract, and nervous system. The classic clinical picture consists of four D’s: diarrhea from GI mucosal injury, dermatitis (often a symmetric, sun-exposed, pigmented rash), dementia (neuropsychiatric symptoms such as confusion and memory loss), and, if untreated, death. The option listing diarrhea, dermatitis, dementia, and death matches these hallmark manifestations exactly. The other choices mix in symptoms like dehydration, drowsiness, digestion issues, or depression, which are not the established four D’s of Pellagra.