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