A Clinical Study of Serum Vitamin D Levels in Chronic Tonsillitis among Paediatric Age Group

Main Article Content

Sudhakar Rao M.S.
Deepak Karade

Abstract

Introduction


Infectious diseases of the faucial tonsils are most frequently encountered by Oto-rhino-laryngologists. Vitamin D has got an important role in the production of surface Anti-microbial peptides (AMPs). Overall, the active form of vitamin D plays a vital role in maintaining the immune system of the body. This study aims to evaluate the association of vitamin D deficiency in chronic tonsillitis among paediatric age group.


Materials and Methods


It is a clinical study carried out in the Department of Oto-rhino-laryngology and Head and Neck surgery at a medical college in Ballari, Karnataka, India from January 2018 to January 2019 for the time period of 12 months. Patients were evaluated with the relevant investigations and digital X-ray nasopharynx along with serum Vitamin D level assessment.


Results


A total of 60 children with chronic tonsillitis were enrolled in this study. There were 26(43.3%) male children and 34(56.7%) females, ranging in age group from 5 to15 years, mean age is 9.82. The common clinical presentation was recurrent episodes of throat pain seen in all the patients (100%). On serum 25-hydroxyvitamin D assessment, 40(66.7%) patients were found to have deficiency and 20(33.3%) patients were having insufficiency. Mean is 17.99ng/ml and ranging from 9.13-28.58ng/ml.


 


Conclusion


The study concludes that, the serum vitamin D levels in chronic tonsillitis among the paediatric age groups is found to be below normal levels and is unrelated to the socio demographic factors.

Article Details

How to Cite
1.
M.S. SR, Karade D. A Clinical Study of Serum Vitamin D Levels in Chronic Tonsillitis among Paediatric Age Group. BJOHNS [Internet]. 2020Apr.30 [cited 2024May7];28(1):23-9. Available from: https://bjohns.in/journal3/index.php/bjohns/article/view/21
Section
Main article
Author Biographies

Sudhakar Rao M.S., Vijayanagar Institute of Medical Sciences Ballari, Karnataka Rajiv Gandhi University of Health Sciences

Assistant professor, Department of otorhinolaryngology and head and neck surgery

Deepak Karade, Vijayanagar Institute of Medical Sciences Ballari, Karnataka Rajiv Gandhi University of Health Sciences

Junior resident, Department of otorhinolaryngology and head and neck surgery

 

References

Somuk BT, Sapmaz E, Soyaliç H, Yamanoğlu M, Mendil D, Arici A, et al. Evaluation of iron and zinc levels in recurrent tonsillitis and tonsillar hypertrophy. Am J Otolaryngol - Head Neck Med Surg [Internet]. 2016;37(2):116-9. Available from: http://dx.doi.org/10.1016/j.amjoto.2015.11.002

Paradise JL, Bluestone CD, Colborn DK, Bernard BS, Rockette HE, Kurs-Lasky M. Tonsillectomy and adenotonsillectomy for recurrent throat infection in moderately affected children. Pediatrics. 2002;Jul:110(1 Pt 1):7-15

Nseir W, Mograbi J, Abu-Rahmeh Z, Mahamid M, Abu-Elheja O, Shalata A. The association between vitamin D levels and recurrent group A streptococcal tonsillopharyngitis in adults. Int J Infect Dis [Internet]. 2012;16(10):e735-8. Available from: http://dx.doi.org/10.1016/j.ijid.2012.05.1036

Reid D, Morton R, Salkeld L, Bartley J. Vitamin D and tonsil disease - Preliminary observations. Int J Pediatr Otorhinolaryngol [Internet]. 2011;75(2):261-4. Available from: http://dx.doi.org/10.1016/j.ijporl.2010.11.012

Nave H, Gebert A, Pabst R. Morphology and immunology of the human palatine tonsil. Anat Embryol (Berl). 2001;Nov;204(5):367-73

Lange MJ, Lasiter JC, Misfeldt ML. Toll-like receptors in tonsillar epithelial cells. Int J Pediatr Otorhinolaryngol. 2009; 73(4):613-21

Mansson A, Adner M, Cardell LO. Toll-like receptors in cellular subsets of human tonsil T cells: Altered expression during recurrent tonsillitis. Respir Res. 2006; 27(7):36

Liu PT, Stenger S, Li H, Wenzel L, Tan BH, Krutzik SR, et al. Toll-like receptor triggering of a vitamin D-mediated human antimicrobial response. Science 2006;Mar 24; 311(5768):1770-3

Adams JS, Liu PT, Chun R, Modlin RL, Hewison M. Vitamin D in defense of the human immune response. Ann N Y Acad Sci. 2007; 1117:94-105

Uitterlinden AG, Fang Y, Van Meurs JBJ, Van Leeuwen H, Pols HAP. Vitamin D receptor gene polymorphisms in relation to Vitamin D related disease states. J Steroid Biochem Mol Biol. 2004; 89-90(1-5):187-93

Yildiz I, Unuvar E, Zeybek U, Toptas B, Cacina C, Toprak S, et al. The role of vitamin D in children with recurrent Tonsillopharyngitis. Ital J Pediatr. 2012; 38(1):25

Aydin S, Aslan I, Yildiz I, Aĝaçhan B, Toptaş B, Toprak S, et al. Vitamin D levels in children with recurrent tonsillitis. Int J Pediatr Otorhinolaryngol. 2011;75(3):364-7

Elbistanlı MS, Güneş S, Yegin Y, Çelik M, Koçak HE, Evren C, et al. Relationship Between Serum Vitamin D Levels and Childhood Recurrent Tonsillitis. Otolaryngol - Open J. 2017; 3(1):16-21

Canning MO, Grotenhuis K, de Wit H, Ruwholf C, Drexhage HA. 1-α,25-dihydroxyvitamin D3 (1,25(OH)2D3) hampers the maturation of fully active immature dendritic cells from monocytes. Eur J Endocrinol. 2001;145(3):351-7

Holick MF, Binkley NC, Bischoff-Ferrari HA, Gordon CM, Hanley DA, Heaney RP, et al. Evaluation, treatment, and prevention of vitamin D deficiency: An endocrine society clinical practice guideline. J Clin Endocrinol Metab. 2011; 96(7):1911-30

Selvarajan S, Gunaseelan V, Anandabaskar N, Alphienes Stanley Xavier SS et al. Systematic review on Vit D levels in apparently healthy indian population and analysis of its associated factors. Indian J Endocrinol Metab [Internet]. 2017;21(5):765-75. Available from: http://www.ijem.in

Powell S. Paeditric obstructive sleep apnoea. In: Watkinson John C, Editor. Scott-Brown’s Otorhinolaryngology Head & Neck Surgery. Eighth Ed. CRC; 2018. Vol. 2; p293-309

Kazi MY, Aamir K, Rana MN, Farooq MA. Frequency of Vitamin D3Deficiency in Children Presenting With Frequent Sino-Pulmonary Infections. Pakistan Paediatr J. 2013; 37(2):101-5

Asghari A, Bagheri Z, Jalessi M, Salem MM et al. Vitamin D levels in children with adenotonsillar hypertrophy and Otitis media with effusion. Iran J Otorhinolaryngol. 2017; 29(1):29-33

Collak A. Serum vitamin D levels in children with recurrent tonsillopharyngitis. North Clin Istanbul. 2014;1(1):13-8

Alladi YR, Gopal J. Vitamin D Deficiency and Relation to Recurrent Respiratory Tract Infection in children less than 5 years. J Dent Med Sci. 2017; 16(8):88-96

Albanna EA, Ali YF, Am R, Moneim EA. Vitamin D and LL-37 in children with pneumonia Correspondence. Egypt J Pediatr Allergy Immunology 2010; 8(2):81-6

Robertsen S, Grimnes G, Melbye H. Association between serum 25-hydroxyvitamin D concentration and symptoms of respiratory tract infection in a Norwegian population: The Tromso Study. Public Health Nutr. 2014; 17(4):780-6

Nair R, Maseeh A. Vitamin D: the sunshine vitamin. J Pharmacol Pharmacother [Internet] 2012; 3(2):118–26. Available from: http://www.ncbi.nlm.nih.gov/pubmed/22629085

Haider N, Nagi AG, Khan KM. Frequency nutritional rickets in children admitted with severe pneumonia. J Pak Med Assoc. 60(9):729-32.