Children with periodic fevers (PFAPA) have half the vitamin D levels of others – June 2019

Vitamin D deficiency as a risk factor for PFAPA syndrome.

Int J Pediatr Otorhinolaryngol. 2019 Jun;121:55-57. doi: 10.1016/j.ijporl.2019.02.047
Nalbantoğlu A1, Nalbantoğlu B2.

  • 1 Namık Kemal University Department of Pediatrics, Tekirdağ, Turkey. Electronic address: analbantoglu@nku.edu.tr.
  • 2 Namık Kemal University Department of Pediatrics, Tekirdağ, Turkey. Electronic address: bnalbantoglu@nku.edu.tr.


OBJECTIVE:
The periodic fever, aphthous stomatitis, pharangytis and cervical adenitis (PFAPA) syndrome, is an idiopathic chronic disease of non-hereditary origin, primarily affecting pre-school children and is the most common periodic fever disorder in children. Rapid response to corticosteroid treatment suggest an immune dysregulation. Recently, emerging evidence suggest that vitamin D plays an important role in immunity regulation. The aim of our study was to assess the vitamin D levels in children with PFAPA syndrome.

METHODS:
This study was conducted prospectively. We have consecutively evaluated 50 patients after having excluded other causes of recurrent fever between May 2017 and May 2018 in addition to age-matched 50 patients as control group. All patients has complete physical examination and laboratory tests. Laboratory tests included complete blood count, C-reactive protein (CRP), and vitamin D levels. Serum 25 (OH) vitamin D levels were measured in all patients twice yearly.

RESULTS:
Vitamin D levels was 18 ± 10 ng/ml in the patient group and 35 ± 13 ng/ml in the control group. There was statistically significant difference between the groups (p < 0.001). 38 patients from the PFAPA group and 20 patients from the control group had low vitamin D levels. Multivariate logistic regression analysis showed that CRP (odd ratio (OR) = 2.7, 95% confidence interval (CI) = 2.4-4.1) and serum 25 (OH) vitamin D levels <30 ng/ml OR = 2.1, 95% CI = 1.8-2.5) were associated with PFAPA occurrence.

CONCLUSION:
We found strong correlation between PFAPA and vitamin D insufficiency. Hypovitaminosis D can be a significant risk factor for PFAPA episode recurrence.

980 visitors, last modified 14 Jun, 2019,
Printer Friendly Follow this page for updates