1. Vitamin D deficiency as a risk factor of acute constrictive
laryngotracheitis in young children
Berezhny VV, Mamenko MYe, Romanko MR, Romankevych IV, Glyadelova NP
Shupyk National Medical Academy of Postgraduate Education, Kyiv, Ukraine
PO.ID
1446
Results
Abstracts
Vitamin D deficiency as a risk factor of viral croup
Respiratory tract infections (RTIs) are important causes of morbidity and mortality in young children. Acute constrictive laryngotracheitis (viral croup) is one of the most common syndromes in pediatric practice associated with viral respiratory infection. Croup remains the commonest reason for acute upper airway obstruction in children, but little is known about risk factors or its recurrence rate.
Vitamin D is a regulator of calcium and phosphate homeostasis, and also has numerous extra-skeletal effects. These include effects on the cardiovascular system, central nervous system, endocrine system, and immune system, modulating the innate and adaptive system, influencing the production of endogenous antimicrobial peptides, and regulating the inflammatory cascade.
The connection between vitamin D, calcium homeostasis, infections and immune function in the pediatric population indicates a possible role of vitamin D deficiency in viral croup occurrence.
Variable
Serum 25-OHD concentration
<20ng/mL
(n=26)
20-40ng/mL (n=26)
40-60ng/mL
(n=18)
>60ng/mL
(n=10) n %
Moderate croup 23
88,5 19
73,1 8
44,5* 2
20,0*
Recurrent croup (>2 episode/yr)
30,8
Recurrent RTIs (>6 episode/yr ) 14
53,8 12
46,2 6
33,3 3
30,0
History of allergies 7
26,9
53,8*
18,0 1
10,0
*-the difference with children who had serum 25-OHD concentration, significant value, p<0,05
Serum 25(OH)D levels in young children at the age of 1-36 months with acute constrictive laryngotracheitis ranged from ng/ml (median 31.81ng/ml).
Only 33.8% of patients had sufficient serum 25(OH)D levels (>40ng/ml).
In 16.3% cases critically low levels of 25(OH)D (<15ng/ml) were detected.
The median of serum 25(OH)D levels in children of the first year of life was 43.8 ng/ ml (QR: 35.0; 61.1) and in children aged months it was 37.4ng/ml (QR: 26.0; 57.6; p=0.21).
In patients aged months the level of serum 25(OH)D was the lowest: 18.4ng/ml (QR: 13.3; 28.1, p<0.001) with the rate of vitamin D deficiency of 70.8%.
Serum 25(OH)D levels <40 ng/mL were associated with an recurrent croup risk (χ²=6,5, p=0,011).
Serum 25(OH)D levels <20 ng/mL were associated with moderate croup (88,5%, χ²=7,9, p=0,005).
Objectives
To evaluate the nutritional vitamin D status of young children with acute constrictive laryngotracheitis.
Methods
Conclusions
Vitamin D deficiency can result in increased risks for recurrent episodes of viral croup.
Hospital-based survey included 80 children aged 1-36 months with viral croup.
Evaluation included clinical data, serum 25-hydroxyvitamin D (25(OH)D) level, serum calcium (mg/dl), phosphorous (mg/dl) and alkaline phosphatase (IU/L).
The level of vitamin D above 40 ng/mL was considered as sufficient.
66.2% of young children with acute constrictive laryngotracheitis have low levels of serum 25(OH)D.
References
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Contacts:
EAPS 2016
Geneva, Switzerland