Hematology Xagena

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Children with sickle cell disease: vitamin D deficiency is associated with acute pain

Vitamin D is increasingly recognized for its roles in non-skeletal disorders. Patients with sickle cell disease ( SCD ) have a high prevalence of vitamin D deficiency but data are limited with respect to possible associations between low vitamin D and acute vaso-occlusive complications.

Researchers have examined whether vitamin D deficiency is associated with acute pain and acute chest syndrome ( ACS ) in children with sickle cell disease.

A cross-sectional study was conducted in 95 children with sickle cell disease who had serum 25-hydroxyvitamin D ( 25-OHD ) measured during comprehensive care examinations.

History of acute pain and sickle cell disease within two years of obtaining 25-OHD was collected.

Associations between 25-OHD levels and acute vaso-occlusive events were analyzed by logistic regression. Odds ratios and 95% confidence intervals were calculated for the risk of pain and acute chest syndrome associated with vitamin D deficiency ( 25-OHD less than 20 ng/ml ).

Subjects were 3-20 years old ( median 10.6 ); 48 males, 47 females; 46 African, 49 Hispanic; 72 SS, 20 SC, 1 S/beta(0) Thalassemia, and 2 S/beta(+) Thalassemia.

Median 25-OHD was 16 ng/ml. Fifty-six ( 59% ) were vitamin D-deficient. Thirty-one ( 33% ) and 29 ( 31% ) had at least one episode of pain and acute chest syndrome, respectively.

Serum 25-OHD was significantly associated with pain ( P = 0.0121 ) but not with acute chest syndrome ( P = 0.628 ).
Of those with pain, 73% ( 23/31 ) were vitamin D-deficient while 26% ( 8/31 ) had 25-OHD greater than or equal to 20 ng/ml ( P = 0.04, OR = 2.7, 95%CI = 1.05-6.94 ).

In conclusion, the findings emphasize the high prevalence of vitamin D deficiency and its potential association with acute pain in sickle cell disease.
Correcting low vitamin D may offer a simple, low-cost intervention to help reduce acute vaso-occlusive complications. ( Xagena )

Lee MT et al, Pediatr Blood Cancer 2015; 62: 643-647