Vitamin D deficiency and its correction in children with sickle cell anaemia

Clare Wykes, Anita Arasaretnam, Sandra O'Driscoll, Laura Farnham, Caje Moniz, David C. Rees*

*Corresponding author for this work

    Research output: Contribution to journalArticlepeer-review

    15 Citations (Scopus)

    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 mu g/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.

    Original languageEnglish
    Pages (from-to)2051-2056
    Number of pages6
    JournalAnnals of Hematology
    Volume93
    Issue number12
    DOIs
    Publication statusPublished - Dec 2014

    Keywords

    • Cholecalciferol
    • Ergocalciferol
    • Alkaline phosphatase
    • Serum calcium
    • Vitamin D
    • Sickle cell disease
    • CHRONIC PAIN
    • DISEASE
    • SUPPLEMENTATION
    • CHOLECALCIFEROL
    • TRIAL

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