Vitamin D level in preschool children with recurrent wheezy chest, and its relation to the severity of the wheezing episodes

Document Type : Original Article

Authors

1 Department of Pediatrics, Faculty of Medicine, Assiut University, Assiut, Egypt.

2 Department of Pediatrics Faculty of Medicine, Assiut University, Assiut, Egypt.

3 Department of Clinical Pathology, Faculty of Medicine, Assiut University, Assiut, Egypt.

Abstract

Background: Recurrent wheezy chest is a common complaint in pediatric
practice. Vitamin D is a potent immunomodulator in allergic diseases as wheezy
chest and asthma. The prevalence of vitamin D deficiency has been increasing
in Egypt leading to significant morbidities. Objectives: This study aimed to
assess serum 25 hydroxy (OH) Vitamin D level in preschool children with
recurrent wheezy chest, and to assess its relation to the recurrence, severity,
and level of control of the wheezing episodes. Methods: The study included 100
preschool children (aged 2 to 5 years), of both sexes, recruited from the
Emergency department, Allergy and Pulmonology units at Assiut University
Children Hospital, Egypt. They should have at least 3 documented episodes of
wheeze, cough, and difficulty breathing in the last year with clinical
improvement on inhaled short-acting beta 2 agonists. Patients were subjected to
questionnaire-based history, clinical examination, and laboratory investigations
(complete blood count (CBC) with the absolute eosinophil count, serum total
IgE level, and serum 25 hydroxy (OH) Vitamin D level). Pediatric Respiratory
Assessment Measure (PRAM score) for assessment of the severity of the
wheezing episodes and Global Initiative for Asthma (GINA) based level of
asthma control for children 5 years and younger were applied. The patients
were grouped according to PRAM score to mild, moderate and severe episodes
and according to vitamin D level as sufficient and below-sufficient groups
(including deficient and insufficient patients). Results: 25(OH) Vitamin D level
was below-sufficient in 53% of the studied patients (deficient in 32% and
insufficient in 21%). PRAM score was significantly lower in patients with
sufficient 25(OH) Vitamin D level versus those with below-sufficient level (p <
0.025). There was a significant negative correlation between PRAM score and
25 (OH) Vitamin D level (r = -0.334, p = 0.001). Conclusion: There is an
inverse relationship between 25(OH)vitamin D level and parameters of asthma
severity, as well as with the level of asthma control in preschool children with
recurrent wheezy chest.

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