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Vitamin D deficiency and its correction in children with sickle cell anaemia.
Ann Hematol 2014; 93(12):2051-6AH

Abstract

Vitamin D deficiency is common in sickle cell anaemia (SCA, HbSS), although its significance and optimal means of correction are unknown. We conducted an audit to assess the clinical significance of 25-hydroxy vitamin D (25-OHD) deficiency in children with SCA and to evaluate two methods of vitamin D supplementation. We audited 25-OHD levels in 81 children with SCA and looked for statistical associations with biochemical, haematological and clinical parameters. In a separate group of regularly transfused children with SCA, we compared changes in 25-OHD blood concentrations following treatment with either high-dose intramuscular ergocalciferol (n = 15) or 4 days of high-dose oral cholecalciferol (n = 64). Ninety-one percent of children with SCA had 25-OHD levels <20 μg/L. The 25-OHD levels were negatively correlated with increasing age (P < 0.001) but showed no significant relationship to laboratory measurements, transcranial Doppler velocities or hospital attendance. Both intramuscular ergocalciferol and oral cholecalciferol supplementations resulted in increases of 25-OHD blood concentration to normal levels. The mean dose of ergocalciferol was greater than that of cholecalciferol (7,729 versus 5,234 international units (IU)/kg, P < 0.001), but the increment in 25-OHD levels was significantly greater in the oral cholecalciferol group (6.44 versus 2.82 (ng/L)/(IU/kg), P < 0.001). Both approaches resulted in vitamin D sufficiency for about 120 days. Increased 25-OHD concentration was significantly associated with increased serum calcium concentration. Vitamin D deficiency is very common in SCA and can be effectively corrected with high-dose intramuscular ergocalciferol or 4 days of high-dose oral cholecalciferol. Prospective, randomised studies are needed to assess the clinical value of vitamin D supplementation.

Authors+Show Affiliations

Department of Paediatric Haematology, King's College Hospital, King's College London, Denmark Hill, London, SE5 9RS, UK.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

24981689

Citation

Wykes, Clare, et al. "Vitamin D Deficiency and Its Correction in Children With Sickle Cell Anaemia." Annals of Hematology, vol. 93, no. 12, 2014, pp. 2051-6.
Wykes C, Arasaretnam A, O'Driscoll S, et al. Vitamin D deficiency and its correction in children with sickle cell anaemia. Ann Hematol. 2014;93(12):2051-6.
Wykes, C., Arasaretnam, A., O'Driscoll, S., Farnham, L., Moniz, C., & Rees, D. C. (2014). Vitamin D deficiency and its correction in children with sickle cell anaemia. Annals of Hematology, 93(12), pp. 2051-6. doi:10.1007/s00277-014-2144-7.
Wykes C, et al. Vitamin D Deficiency and Its Correction in Children With Sickle Cell Anaemia. Ann Hematol. 2014;93(12):2051-6. PubMed PMID: 24981689.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Vitamin D deficiency and its correction in children with sickle cell anaemia. AU - Wykes,Clare, AU - Arasaretnam,Anita, AU - O'Driscoll,Sandra, AU - Farnham,Laura, AU - Moniz,Caje, AU - Rees,David C, Y1 - 2014/07/02/ PY - 2014/04/14/received PY - 2014/06/19/accepted PY - 2014/7/2/entrez PY - 2014/7/2/pubmed PY - 2015/1/3/medline SP - 2051 EP - 6 JF - Annals of hematology JO - Ann. Hematol. VL - 93 IS - 12 N2 - Vitamin D deficiency is common in sickle cell anaemia (SCA, HbSS), although its significance and optimal means of correction are unknown. We conducted an audit to assess the clinical significance of 25-hydroxy vitamin D (25-OHD) deficiency in children with SCA and to evaluate two methods of vitamin D supplementation. We audited 25-OHD levels in 81 children with SCA and looked for statistical associations with biochemical, haematological and clinical parameters. In a separate group of regularly transfused children with SCA, we compared changes in 25-OHD blood concentrations following treatment with either high-dose intramuscular ergocalciferol (n = 15) or 4 days of high-dose oral cholecalciferol (n = 64). Ninety-one percent of children with SCA had 25-OHD levels <20 μg/L. The 25-OHD levels were negatively correlated with increasing age (P < 0.001) but showed no significant relationship to laboratory measurements, transcranial Doppler velocities or hospital attendance. Both intramuscular ergocalciferol and oral cholecalciferol supplementations resulted in increases of 25-OHD blood concentration to normal levels. The mean dose of ergocalciferol was greater than that of cholecalciferol (7,729 versus 5,234 international units (IU)/kg, P < 0.001), but the increment in 25-OHD levels was significantly greater in the oral cholecalciferol group (6.44 versus 2.82 (ng/L)/(IU/kg), P < 0.001). Both approaches resulted in vitamin D sufficiency for about 120 days. Increased 25-OHD concentration was significantly associated with increased serum calcium concentration. Vitamin D deficiency is very common in SCA and can be effectively corrected with high-dose intramuscular ergocalciferol or 4 days of high-dose oral cholecalciferol. Prospective, randomised studies are needed to assess the clinical value of vitamin D supplementation. SN - 1432-0584 UR - https://www.unboundmedicine.com/medline/citation/24981689/Vitamin_D_deficiency_and_its_correction_in_children_with_sickle_cell_anaemia_ L2 - https://dx.doi.org/10.1007/s00277-014-2144-7 DB - PRIME DP - Unbound Medicine ER -