PNEUMONIA AND ROLE OF VITAMIN D IN CHILDREN

Abstract

INTRODUCTION: And vitamin D deficiency might substantially increase the risk of severe pneumonia in children of under 5 years age group. Vitamin D has important role in development and maintenance of the skeleton, it has been shown there is increasing evidence that vitamin D has a beneficial effect on extraskeletal tissues such as the brain, heart, stomach, pancreas, lymphatics, skin, gonads, and prostrate tissue are composed of cells, including T and B lymphocytes, that express the vitamin D receptor (VDR). In these tissues, vitamin D is thought to have roles in the improvement of immune function and the reduction of inflammation. The consumption of vitamin D may reduce respiratory tract infection (RTI) susceptibility in children such as acute otitis media (AOM), pharyngotonsillitis, rhinosinusitis, bronchiolitis and pneumonia.

MATERIAL AND METHODS: Children between 6 months to 5 years with a clinical diagnosis of severe pneumonia were included in the study. Children having a history or clinical features suggestive of rickets, malnutrition, asthma, hypertension, tuberculosis complicated pneumonia such as lung abscess, pleural effusion, empyema or illness severe enough to require ventilation, chronic respiratory disease, heart disease, renal or hepatic diseases, neurological diseases resulting in abnormalities of muscle tone/power were excluded. Eligible candidates for the study were given 100,000 IU of vitamin D i.e. cholecalciferol. At home, participants were followed for 180 days (from day of enrolment) to document the recurrence of episodes of pneumonia. Serum 25(OH)D of each patient was  estimated:

RESULTS: 117 participants were included in the study. Mean age of the study group was 17.2 ±16.4monthts ranging from 8 months to 49 months. There was higher percentage of male children (60.7%) as compared to female (39.3%). Mean weight of the children was 8.2±3.4. Mean duration of illness in days was 3.2±1.1. oxygen saturation in percentage was 95±3.1. After vitamin D supplementation in all 117 subjects 22 (18.8%) children had single episode of pneumonia. In 7 (5.9%) of cases there were 2 episodes in six months and in 1 (0.9%) case there was more than 2 episodes of pneumonia it was found that serum vitamin D levels were higher in patients with no episodes of pneumonia as compared to patients with 2 or more episodes of pneumonia.

CONCLUSION:  It was found that patients with higher serum vitamin D levels had less recurrence of pneumonia episodes and vitamin D supplementation can reduce the recurrence episodes of pneumonia in children.

Keywords: Vit D, pharyngotonsillitis, rhinosinusitis, bronchiolitis and pneumonia