抄録
We investigated a widow farmer, 39 years old, who had definite signs of symptomatic psychosis. Both her psychiatric and dermatological findings gave us the conclusion that the patient might be affected by a typical pellagra.
In order to eliminate her anxiety and excitement, chlorpromazine per os was applied totaling 600mg in 8 days, The medication was stopped when her body temperature went up to 38.0°C. The following day slight jaundice and symptoms of disturbances of consciousness occured. Death resulted on the s'xth day of the jaundice.
By autopsy we obtained several findings: acute yellow atrophy of the liver, severe haemorrhagic diathesis, cloudiness of the pia mater, dilatation of the lateral ventricles, dipigmentation of the nucleus nigra and calcification of the nucleus lentiformis.
It is known that disfunction of the liver in the pellagra patient is due to the deficit of nicotinic acid amide, however, we experienced a case of chlorpromazine's severe toxic action on the liver which had not been previously observed in our daily psychiatric practice.
The pathological and clinical changes of this case suggest to us that pellagra psychosis should be considered in the series of diseases with hepatDcerebral relationships.
