Relationship between vitamin d levels and outcome of pneumonia in children

Abstract

BACKGROUND: Pneumonia, a common childhood infection in Nigerian children with a number of debilitating complications such as empyema thoracis, has been linked to vitamin D deficiency due to its ability to modulate the T lymphocyte of the immune system. OBJECTIVE: To determine the relationship between vitamin D and outcome of pneumonia in children. METHODS: This was a case-control study involving 24 children, admitted for pneumonia as subjects and 10 children without pneumonia as controls. Pre-formatted questionnaire was utilized to obtain background information, anthropometric measurements were made to determine nutritional status and estimation of 25-hydroxy cholecalciferol (25OHD) done for all those studied. RESULTS: The mean (SD) serum 25OHD concentration was 104 (59) nmol/L and 130 (107) nmol/L for subjects and controls respectively. Amongst the subjects 15 (54%) had serum 25OHD less than 70nmol/L and 11 (46%) serum 25OHD greater than70nmol/L. Hypocalcaemia was present in 15 (54%) of the subjects. Further analysis of hypocalcaemia with regards to the concentration of serum 25OHD showed that 2 (13%) had levels below 40nmol/L, 10 (67%) had levels below 70nmol/L and 3 (20%) above 70nmol/L. Hypocalcaemia was more frequent among subjects with 25OHD below 70nmol/L compared with those above70nmol/L, (p = 0.01). Empyema thoracis and death occurred amongst the two subjects with 25OHD between 27.5 and 40nmol/L. Anaemia was more frequent among subjects with 25OHD below 70nmol/L compared with those above70nmol/L (p = 0.03). CONCLUSION: The study showed that Vitamin D insufficiency, and not solely its deficiency, may have an important role to play in the immune and haemopoetic system. It may therefore affect the response of a child to infections especially pneumonia.