Association of Vitamin D Status with Morbidity in Children with Sickle Cell Disease in Tertiary Care Hospital

INTRODUCTION: Children with sickle cell disease (SCD) are at high risk for vitamin D deficiency (VDD). The prevalence of VDD in different countries is between 65-100% in these patients. The present study was undertaken to find the prevalence of VDD among sickle cell children and to assess the association of co-morbidities with VDD.
METHODS: Total 89 children who were attending sickle cell clinic /admitted in pediatric wards of Tertiary Care Centre were enrolled for the study. After history, clinical examination and anthropometry, samples were taken for serum 25-OH vitamin D and calcium level assessment. Outcome was morbidity in sickle cell children in terms frequency of pain episodes, number of febrile episodes, number of blood transfusions and total number of admissions.
RESULTS: Out of 89 cases, 58(65.17 %) cases were deficient for vitamin D (<20ng/dl), 22(24.72%) cases had insufficiency (20-30 ng/dl) and 9(10.11%) cases had normal vitamin D level (>30 ng/dl). The mean vitamin D level was 19.42ng/dl. Morbidity in SCD was more in VDD children compared to vitamin D sufficient children with significance in number of pain episodes and total number of hospital admissions but not in number of admissions for acute febrile illness or total number blood transfused.
DISCUSSION AND CONCLUSION: VDD was prevalent in 65.17% of children with SCD. Children between 4-12 years were more affected with male predominance. As this study involved children with SCD alone, a future study need to be carried out involving children without SCD to establish better possible link between vitamin-D and SCD morbidity.