Title: Serum vitamin D profile in children with severe pneumonia: A prospective study in a rural institute

Authors: Loganathan Palanivel, Chidambaranathan Sivaprakasam, Logesvar Palanisamy

 DOI: https://dx.doi.org/10.18535/jmscr/v7i3.107

Abstract

Background: Vitamin D plays a vital role in the maturation of the skeletal system and immunological functions especially by receptor sensing and signaling. The stable form of vitamin D in the body is 25-hydroxycholecalciferol which is often used as its biomarker.

Methods: The study was done prospectively in the pediatric wards, Rajah Muthiah medical college, and hospital, Chidambaram from October 2016 to June 2018. Out of the 200 children with respiratory compliance, 46 children who fulfilled inclusion and exclusion criteria are included in our study. Using a pre-defined proforma, data were collected and the study population was categorized as children having broncho-pneumonia and lobar pneumonia. SPSS software was used for statistical analyses.

Results: Pneumonia was 1.8 times more common in male children than the female. Majority of children had bronchopneumonia (n=28) followed by lobar pneumonia (n=18) based on clinical examination, laboratory and imaging studies. The mean duration of stay in the hospital is 5.8±.51 days.

Conclusion: Prevalence of vitamin D insufficiency among children with pneumonia is 78.26%.

Keywords: Acute lower respiratory tract infection, 25-hydroxycholecalciferol, pneumonia, bronchiolitis.

References

  1. Hurwitz JL, Jones BG, Penkert RR, Gansebom S, Sun Y, Tang L, et al. Low Retinol-Binding Protein and Vitamin D Levels Are Associated with Severe Outcomes in Children Hospitalized with Lower Respiratory Tract Infection and Respiratory Syncytial Virus or Human Metapneumovirus Detection. J Pediatr. 2017;187:323–7.
  2. Jat KR. Vitamin D deficiency and lower respiratory tract infections in children: a systematic review and meta-analysis of observational studies. Trop Doct. 2017;47(1):77–84.
  3. Haugen J, Chandyo RK, Ulak M, Mathisen M, Basnet S, Brokstad KA, et al. 25-hydroxy-vitamin D concentration is not affected by severe or non-severe pneumonia, or inflammation, in young children. Nutrients. 2017;9(1).
  4. Morris SK, Pell LG, Rahman MZ, Dimitris MC, Mahmud A, Islam MM, et al. Maternal vitamin D supplementation during pregnancy and lactation to prevent acute respiratory infections in infancy in Dhaka, Bangladesh (MDARI trial): protocol for a prospective cohort study nested within a randomized controlled trial. BMC Pregnancy Childbirth. 2016; 16(1):309.
  5. Sismanlar T, Aslan AT, Gulbahar O, Ozkan S. The effect of vitamin D on lower respiratory tract infections in children. Türk Pediatr Arşivi. 2016;51(2):94–9.
  6. Beigelman A, Castro M, Schweiger TL, Wilson BS, Zheng J, Yin-DeClue H, et al. Vitamin D levels are unrelated to the severity of respiratory syncytial virus bronchiolitis among hospitalized infants. J Pediatric Infect Dis Soc. 2015;4(3):182–8.
  7. Ahmed P, Babaniyi IB, Yusuf KK, Dodd C, Langdon G, Steinhoff M, et al. Vitamin D status and hospitalisation for childhood acute lower respiratory tract infections in Nigeria. Paediatr Int Child Health. 2015;35(2):151–6.
  8. Baraldi E, Lanari M, Manzoni P, Rossi GA, Vandini S, Rimini A, et al. Inter-society consensus document on treatment and prevention of bronchiolitis in newborns and infants. Ital J Pediatr. 2014;40(1):1–13.
  9. McNally JD, Sampson M, Matheson LA, Hutton B, Little J. Vitamin D receptor (VDR) polymorphisms and severe RSV bronchiolitis: A systematic review and meta-analysis. Pediatr Pulmonol. 2014;49(8):790–9.
  10. Wahab Mohamed WA, Al-Shehri MA. Cord blood 25-Hydroxyvitamin D levels and the risk of acute lower respiratory tract infection in early Childhood. J Trop Pediatr. 2013; 59(1): 29–35.
  11. Magnus MC, Stene LC, Nafstad P, Stigum H, London SJ, Nystad W. Prospective study of maternal mid-pregnancy 25-hydroxyvitamin D level and early childhood respiratory disorders. Paediatr Perinat Epidemiol. 2013;27(6):532–41.
  12. Belderbos ME, Houben ML, Wilbrink B, Lentjes E, Bloemen EM, Kimpen JLL, et al. Cord Blood Vitamin D Deficiency Is Associated With Respiratory Syncytial Virus Bronchiolitis. 2011;127(6): e1513–20.
  13. Roth D, Shah R, Black R, Baqui A. Vitamin D status and acute lower respiratory infection in early childhood in Sylhet, Bangladesh. Acta Paediatr Int J Paediatr. 2010;99(3):389–93.
  14. Roth DE, Jones AB, Prosser C, Robinson JL, Vohra S. Vitamin D status is not associated with the risk of hospitalization for acute bronchiolitis in early childhood. Eur J Clin Nutr. 2009;63(2):297–9.
  15. Roth DE, Jones AB, Prosser C, Robinson JL, Vohra S. Vitamin D Receptor Polymorphisms and the Risk of Acute Lower Respiratory Tract Infection in Early Childhood. J Infect Dis. 2008;197(5):676–80.

Corresponding Author

Dr Chidambaranathan. S, M.D, (Paediatrics) Fellowship in Paediatric Neurology

Rajah Muthiah Medical College, Chidambaram, Tamilnadu, India

Phone (or Mobile) No.: +919444456056, Email: This email address is being protected from spambots. You need JavaScript enabled to view it.