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Kawasaki disease (strawberry tongue) associated with very low vitamin D – May 2015

Severe vitamin D deficiency in patients with Kawasaki disease: a potential role in the risk to develop heart vascular abnormalities?

Clinical Rheumatology, May 2015 https://doi.org/10.1007/s10067-015-2970-6
Stefano Stagi, Donato Rigante, Gemma Lepri, Marco Matucci Cerinic, Fernanda Falcini falcini at unifi.it

VitaminDWiki

(Note by VitaminDWiki: KD appears to be an orphan disease in US (but not in Japan 1 in 150)
Kawasaki disease (strawberry tongue) not treated by occasional 400 IU of Vitamin D – Feb 2019

Chart in the study
Image

Twenty-five-hydroxyvitamin D (25(OH)-vitamin D) is crucial in the regulation of immunologic processes, but—although its deficiency has been reported in patients with different rheumatological disorders—no data are available for Kawasaki disease (KD). The goals of this study were to assess the serum levels of 25(OH)-vitamin D in children with KD and evaluate the relationship with the eventual occurrence of KD-related vascular abnormalities. We evaluated serum 25(OH)-vitamin D levels in 79 children with KD (21 females, 58 males, median age 4.9 years, range 1.4–7.5 years) in comparison with healthy sex-/age-matched controls. A significantly higher percentage of KD patients (98.7 %) were shown to have reduced 25(OH)-vitamin D levels (<30 ng/mL) in comparison with controls (78.6 %, p < 0.0001). Furthermore, KD patients had severely low levels of 25(OH)-vitamin D than controls (9.17 ± 4.94 vs 23.3 ± 10.6 ng/mL, p < 0.0001), especially the subgroup who developed coronary artery abnormalities (4.92 ± 1.36 vs 9.41 ± 4.95 ng/mL, p < 0.0001).
In addition, serum 25(OH)-vitamin D levels correlated not only with

  • erythrosedimentation rate (p < 0.0001),
  • C-reactive protein (p < 0.0001),
  • hemoglobin level at KD diagnosis (p < 0.0001) but also with both
  • coronary artery aneurysms (p = 0.005) and
  • non-aneurysmatic cardiovascular lesions (p < 0.05).

Low serum concentrations of 25(OH)-vitamin D might have a contributive role in the development of coronary artery complications observed in children with KD.

PDF is available free at Sci-Hub   10.1007/s10067-015-2970-6

First 2 pages given by publisher a free preview - image only - no translation possible


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 Download the KD 2014 PDF from VitaminDWiki - noticed nothing about Vitamin D


KD has had a recent seasonal cycle

which has gotten worse as vitamin D levels have been dropping
Note:the KD season is now in Winter-Spring - when vitamin D levels are the lowest
Note: very little conection between the winds(mentioned below) and KD before vitamin D levels became very low
chart from http://www.nature.com/news/infectious-disease-blowing-in-the-wind-1.10374
Image
KD is the red line
Wonder if the winds cause such pollution that Japanese the children stay indoors and thus get less vitamin D?


VitaminDWiki reasons to suspect that KD can be prevented with Vitamin D supplementation

  1. KD increases during the season which has the lowest vitamin D levels
  2. KD affects those with dark skins more (dark skin carries a high risk of being vitamin D deficient when away from the tropics)
  3. KD is an automimmune disease - many of which can be prevented or treated by Vitamin D
  4. KD has increased 2X in a decade - like 30 other diseases associated with low vitamin D

See also Criteria to associate a health problem with low vitamin D


Snips from Wikipedia entry – with VitaminDWiki comments

  • Autoimmune inflammation of lymph nodes
  • Without treatment, mortality may approach 1%
  • It is difficult to establish the diagnosis, especially early in the course of the illness,
    and frequently children are not diagnosed until they have seen several health-care providers
  • May be associated with liver inflammation (which can be the cause of low vitamin D)
  • Kawasaki disease affects boys more than girls,
    with people of Asian ethnicity, particularly Japanese and Korean people, most susceptible,
    as well as people of Afro-Caribbean ethnicity. (darker skin ==> lower vitamin D)
  • The disease was rare in Caucasians until the last few decades,
    (perhaps increase with recent lower levels of vitamin D) and incidence rate fluctuates from country to country
  • more than one in 150 children in Japan will develop Kawasaki disease during their lifetimes.
  • 80% of patients younger than five years of age
  • US incidence of the disease doubled from 1991 to 2000
    which is yet another indication of vitamin D association:
    see VitaminDWiki Incidence of 30 health problems related to vitamin D has doubled in a decade
  • it appears to have replaced acute rheumatic fever as the most common cause of acquired heart disease in children
    More cases in winter in spring (times when vitamin D levels are the lowest)

References

  1. Jamieson, N, Singh-Grewal, D (2013) Kawasaki disease: a clinician’s update. Int J Pediatr 2013: pp. 645391 CrossRef
  2. Rosa, G, Pardeo, M, Rigante, D (2007) Current recommendations for the pharmacologic therapy in Kawasaki syndrome and management of its cardiovascular complications. Eur Rev Med Pharmacol Sci 11: pp. 301-308
  3. Falcini, F, Capannini, S, Rigante, D (2011) Kawasaki syndrome: an intriguing disease with numerous unsolved dilemmas. Pediatr Rheumatol 9: pp. 17 CrossRef
  4. Kato, H, Sugimura, T, Akagi, T (1996) Long-term consequences of Kawasaki disease. A 10- to 21-year follow-up study of 594 patients. Circulation 94: pp. 1379-1385 CrossRef
  5. Burns, JC, Glodé, MP (2004) Kawasaki syndrome. Lancet 364: pp. 533-544 CrossRef
  6. Rigante, D, Valentini, P, Rizzo, D (2010) Responsiveness to intravenous immunoglobulins and occurrence of coronary artery abnormalities in a single-center cohort of Italian patients with Kawasaki syndrome. Rheumatol Int 30: pp. 841-846 CrossRef
  7. Esposito, S, Rigante, D, Principi, N (2013) The role of infection in Kawasaki syndrome. J Infect 67: pp. 1-10 CrossRef
  8. Matsubara, T, Ichiyama, T, Furukawa, S (2005) Immunological profile of peripheral blood lymphocytes and monocytes/macrophages in Kawasaki disease. Clin Exp Immunol 141: pp. 381-387 CrossRef
  9. Lips, P, Duong, T, Oleksik, A (2001) A global study of vitamin D status and parathyroid function in postmenopausal women with osteoporosis: baseline data from the multiple outcomes of raloxifene evaluation clinical trial. J Clin Endocrinol Metab 86: pp. 1212-1221 CrossRef
  10. Spiro, A, Buttriss, JL (2014) Vitamin D: an overview of vitamin D status and intake in Europe. Nutr Bull 39: pp. 322-350 CrossRef
  11. Stagi, S, Pelosi, P, Strano, M (2014) Determinants of vitamin D levels in Italian children and adolescents: a longitudinal evaluation of cholecalciferol supplementation versus the improvement of factors influencing 25(OH) D status. Int J Endocrinol 2014: pp. 583039
  12. Outila, TA, Kärkkäinen, MU, Lamberg-Allardt, CJ (2001) Vitamin D status affects serum parathyroid hormone concentrations during winter in female adolescents: associations with forearm bone mineral density. Am J Clin Nutr 74: pp. 206-210
  13. Huh, SY, Gordon, CM (2008) Vitamin D deficiency in children and adolescents: epidemiology, impact and treatment. Rev Endocr Metab Disord 9: pp. 161-170 CrossRef
  14. Stagi, S, Bertini, F, Cavalli, L, Matucci-Cerinic, M, Brandi, ML, Falcini, F (2014) Determinants of vitamin D levels in children, adolescents, and young adults with juvenile idiopathic arthritis. J Rheumatol 41: pp. 1884-1892 CrossRef
  15. Stagi, S, Cavalli, L, Bertini, F (2014) Vitamin D levels in children, adolescents, and young adults with juvenile-onset systemic lupus erythematosus: a cross-sectional study. Lupus 23: pp. 1059-1065 CrossRef
  16. Holick, MF (2007) Vitamin D deficiency. N Engl J Med 357: pp. 266-281 CrossRef
  17. Adorini, L, Penna, G (2008) Control of autoimmune diseases by the vitamin D endocrine system. Nat Clin Pract Rheumatol 4: pp. 404-412 CrossRef
  18. Arnson, Y, Amital, H, Shoenfeld, Y (2007) Vitamin D and autoimmunity: new aetiological and therapeutic considerations. Ann Rheum Dis 66: pp. 1137-1142 CrossRef
  19. Szodoray, P, Nakken, B, Gaal, J (2008) The complex role of vitamin D in autoimmune diseases. Scand J Immunol 68: pp. 261-269 CrossRef
  20. Kudo, K, Hasegawa, S, Suzuki, Y (2012) 1α,25-Dihydroxyvitamin D (3) inhibits vascular cellular adhesion molecule-1 expression and interleukin-8 production in human coronary arterial endothelial cells. J Steroid Biochem Mol Biol 132: pp. 290-294 CrossRef
  21. Newburger, JW, Takahashi, M, Gerber, MA (2004) Diagnosis, treatment, and long-term management of Kawasaki disease: a statement for health professionals from the Committee on Rheumatic Fever, Endocarditis and Kawasaki Disease, Council on Cardiovascular Disease in the Young, American Heart Association. Circulation 110: pp. 2747-2771 CrossRef
  22. Falcini, F, Ozen, S, Magni-Manzoni, S (2012) Discrimination between incomplete and atypical Kawasaki syndrome versus other febrile diseases in childhood: results from an international registry-based study. Clin Exp Rheumatol 30: pp. 799-804
  23. Ozdemir, H, Ciftçi, A, Karbuz, A (2013) Incomplete Kawasaki disease in an infant presenting with only prolonged fever. Turk J Pediatr 55: pp. 529-532
  24. Stabile, A, Bertoni, B, Ansuini, V, Torraca, I, Salli, A, Rigante, D (2006) The clinical spectrum and treatment options of macrophage activation syndrome in the pediatric age. Eur Rev Med Pharmacol Sci 10: pp. 53-59
  25. Zorzi, A, Colan, SD, Gauvreau, K, Baker, AL, Sundel, RP, Newburger, JW (1998) Coronary artery dimensions may be misclassified as normal in Kawasaki disease. J Pediatr 133: pp. 254-258 CrossRef
  26. Webb, AR, Pilbeam, C, Hanafin, N, Holick, MF (1990) An evaluation of the relative contributions of exposure to sunlight and of diet to the circulating concentrations of 25-hydroxyvitamin D in an elderly nursing home population in Boston. Am J Clin Nutr 51: pp. 1075-1081
  27. Holick, MF (2007) Vitamin D deficiency. N Engl J Med 357: pp. 266-281 CrossRef
  28. Grant, WB, Holick, MF (2005) Benefits and requirements of vitamin D for optimal health: a review. Altern Med Rev 10: pp. 94-111
  29. Fitzpatrick, TB (1986) Ultraviolet-induced pigmentary changes: benefits and hazards. Curr Probl Dermatol 15: pp. 25-38
  30. Cacciari, E, Milani, S, Balsamo, A (2006) Italian cross-sectional growth charts for height, weight and BMI (2 to 20 yr). J Endocrinol Invest 29: pp. 581-593 CrossRef
  31. Stagi, S, Bertini, F, Rigante, D, Falcini, F (2014) Vitamin D levels and effects of vitamin D replacement in children with periodic fever, aphthous stomatitis, pharyngitis, and cervical adenitis (PFAPA) syndrome. Int J Pediatr Otorhinolaryngol 78: pp. 964-968 CrossRef
  32. Aydemir, G, Cekmez, F, Kalkan, G (2014) High serum 25-hydroxyvitamin D levels are associated with pediatric sepsis. Tohoku J Exp Med 234: pp. 295-298 CrossRef
  33. Haan, K, Groeneveld, A, Geus, H, Egal, M, Struijs, A (2014) Vitamin D deficiency as a risk factor for infection, sepsis and mortality in the critically ill: systematic review and meta-analysis. Crit Care 18: pp. 660 CrossRef
  34. Grzanka, A, Machura, E, Mazur, B (2014) Relationship between vitamin D status and the inflammatory state in patients with chronic spontaneous urticaria. J Inflamm (Lond) 11: pp. 2 CrossRef
  35. Patel, S, Farragher, T, Berry, J, Bunn, D, Silman, A, Symmons, D (2007) Association between serum vitamin D metabolite levels and disease activity in patients with early inflammatory polyarthritis. Arthritis Rheum 56: pp. 2143-2149 CrossRef
  36. Peterson, CA, Heffernan, ME (2008) Serum tumor necrosis factor-alpha concentrations are negatively correlated with serum 25(OH) D concentrations in healthy women. J Inflamm (Lond) 5: pp. 10 CrossRef
  37. Dean, DD, Schwartz, Z, Schmitz, J (1996) Vitamin D regulation of metalloproteinase activity in matrix vesicles. Connect Tissue Res 35: pp. 331-336 CrossRef
  38. Timms, PM, Mannan, N, Hitman, GA (2002) Circulating MMP9, vitamin D and variation in the TIMP-1 response with VDR genotype: mechanisms for inflammatory damage in chronic disorders?. QJM 95: pp. 787-796 CrossRef
  39. Kendrick, J, Targher, G, Smits, G, Chonchol, M (2009) 25-Hydroxyvitamin D deficiency is independently associated with cardiovascular disease in the Third National Health and Nutrition Examination Survey. Atherosclerosis 205: pp. 255-260 CrossRef
  40. Anagnostis, P, Athyros, VG, Adamidou, F, Florentin, M, Karagiannis, A (2010) Vitamin D and cardiovascular disease: a novel agent for reducing cardiovascular risk?. Curr Vasc Pharmacol 8: pp. 720-730 CrossRef
  41. Syal, SK, Kapoor, A, Bhatia, E (2012) Vitamin D deficiency, coronary artery disease, and endothelial dysfunction: observations from a coronary angiographic study in Indian patients. J Invasive Cardiol 24: pp. 385-389
  42. Klotz, B, Mentrup, B, Regensburger, M (2012) 1,25-Dihydroxyvitamin D3 treatment delays cellular aging in human mesenchymal stem cells while maintaining their multipotent capacity. PLoS One 7: pp. e29959 CrossRef
  43. Furigay, P, Swamy, N (2004) Anti-endothelial properties of 1,25-dihydroxy-3-epi-vitamin D3, a natural metabolite of calcitriol. J Steroid Biochem Mol Biol 89–90: pp. 427-431 CrossRef
  44. Nibbelink, KA, Tishkoff, DX, Hershey, SD, Rahman, A, Simpson, RU (2007) 1,25(OH)2-vitamin D3 actions on cell proliferation, size, gene expression, and receptor localization, in the HL-1 cardiac myocyte. J Steroid Biochem Mol Biol 103: pp. 533-537 CrossRef
  45. Tarcin, O, Yavuz, DG, Ozben, B (2009) Effect of vitamin D deficiency and replacement on endothelial function in asymptomatic subjects. J Clin Endocrinol Metab 94: pp. 4023-4030 CrossRef
  46. London, GM, Guérin, AP, Verbeke, FH (2007) Mineral metabolism and arterial functions in end-stage renal disease: potential role of 25-hydroxyvitamin D deficiency. J Am Soc Nephrol 18: pp. 613-620 CrossRef
  47. Targher, G, Bertolini, L, Padovani, R (2006) Serum 25-hydroxyvitamin D3 concentrations and carotid artery intima-media thickness among type 2 diabetic patients. Clin Endocrinol (Oxf) 65: pp. 593-597 CrossRef
  48. Suzuki, Y, Ichiyama, T, Ohsaki, A, Hasegawa, S, Shiraishi, M, Furukawa, S (2009) Anti-inflammatory effect of 1alpha,25-dihydroxyvitamin D (3) in human coronary arterial endothelial cells: implication for the treatment of Kawasaki disease. J Steroid Biochem Mol Biol 113: pp. 134-138 CrossRef

Attached files

ID Name Comment Uploaded Size Downloads
10434 KD chart.jpg admin 28 Aug, 2018 17:45 8.83 Kb 314
5511 KD Seasonal Cycle.jpg admin 26 May, 2015 02:48 103.65 Kb 1916
5510 KD.pdf PDF 2014 admin 26 May, 2015 01:31 1.27 Mb 595
5509 KD Child.jpg admin 26 May, 2015 01:16 29.29 Kb 1452
5508 KD3.jpg admin 26 May, 2015 00:53 148.87 Kb 1173
5507 KD2.jpg admin 26 May, 2015 00:53 179.80 Kb 1456
5506 KD1.jpg admin 26 May, 2015 00:52 87.51 Kb 1827
5505 Kawasaki manifestations.jpg admin 26 May, 2015 00:15 11.87 Kb 949
5504 Kawasaki disease.jpg admin 26 May, 2015 00:15 1.98 Kb 923
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