Background: Owing to high diarrhoea and protein malnutrition frequencies in pellagra, we hypothesised that pellagra patients would have higher electrolyte disturbances than non-pellagra alcoholics. Objective: To compare serum electrolytes of hospitalised alcoholics with or without pellagra. Design: Retrospective and descriptive case-control study. Setting: Internal Medicine wards at a University Hospital, Medical School of Uberaba, Brazil. Subjects: Medical records were reviewed to obtain relevant clinical details, main diagnosis and laboratory data, including serum electrolytes on hospital admission of pellagra patients (n 33) and a randomly chosen control group of alcoholics (n 37), matched in age, gender and socio-economic status. Anaemia was ascertained by haemoglobin`12.5 gadl (men) and 1.5 gadl (women), and hypoalbuminemia by serum albumin`3.3 gadl. Results: Pellagra and controls showed similar age (39.4 AE 13.1 vs 45.0 AE 11.4 years) and a male predominance of gender (69.7 vs 78.4%), and similar associated diagnoses, including high blood pressure (21.2 vs 16.2%), peripheral neuropathy (12.1 vs 13.5%), and pneumonia (9.1 vs 13.5%). Despite displaying similar serum sodium (136.6 AE 6.1 vs 137.8 AE 5.7 mEqaI), magnesium (1.72 AE 0.74 vs 1.62 AE 0.34 mgadl), phosphorus (3.79 AE 0.87 vs 3.87 AE 0.78 mEqa1) than controls,in addition to higher hypoalbuminemia (76.2 vs 33%) and anaemia (60.6 vs 35.1%) frequencies. Conclusions: Higher anaemia and hypoalbuminemia frequencies associated with lower serum potassium levels suggest increased protein malnutrition prevalence among pellagrins.