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

Aim: Children with sickle cell disease (SCD) are at high risk of 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. Materials and Methods: Total 89 children who were attending a sickle cell clinic/admitted to paediatric wards of a Tertiary Care Centre were enrolled in this study. After their history, clinical examination and anthropometry were investigated, samples were taken for serum 25-hydroxy vitamin D ng/mL and calcium level assessment. The outcome was morbidity in sickle cell children in terms of 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 in vitamin D (<20 ng/dL), 22 (24.72%) cases had insufficiency (20-30 ng/dL) and 9 (10.11%) cases had normal vitamin D levels (>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 the number of pain episodes and the total number of hospital admissions but not in the number of admissions for acute febrile illness or the total number of blood transfusions. Conclusion: VDD was prevalent in 65.17% of children with SCD. Children between 4-12 years were more affected with a male predominance. As this study involved children with SCD alone, future studies need to be carried out involving children without SCD to establish a better possible link between vitamin-D and SCD morbidity.