Vitamina D em crianças e adolescentes com doença falciforme: uma revisão integrativa

Abstract

Objective:To review the literature about the prevalence of vitamin D deficiency and its consequences in children and adolescents with sickle-cell disease.Data sources:The literature survey was performed through the bibliographic databases MEDLINE; U.S. National Library of Medicine and National Institutes of Health (PubMed); Literatura Latino-Americana e do Caribe em Ciências da Saúde (Lilacs), and the Cochrane Library. The keywords were selected using Medical Heading Terms (MeSH): “vitamin D” OR “vitamin D deficiency” AND “anemia, sickle cell” AND “child” AND “adolescent”. The search was limited to articles in English, Spanish and Portuguese, published until April 2014.Data synthesis:Eleven articles were selected among the 18 found. In 6 of the 11 studies, serum levels of vitamin D in children and/or adolescents with sickle-cell anemia were low. The prevalence of vitamin D deficiency in patients with sickle-cell anemia exceeded that of the comparison group. The low intake of vitamin D, seasonality, exposure to sun, increased metabolism associated with the hemoglobinopathy, and age increase were factors associated with the deficiency. There was an association between a significant vitamin D deficiency and bone weakness and painful crises. There was a positive correlation between increased levels of vitamin D by supplementation and functional, physical capacity.Conclusions:The vitamin D deficiency in children and adolescents with sickle-cell disease is prevalent and requires further studies to demonstrate its association with comorbidities and possible benefits of vitamin D supplementation.

Vitamin D deficiency in sickle cell disease patients in the Eastern Province of Saudi Arabia

“… 26 Many studies have reported a high frequency of VDD in the SCD population of different haplotypes as opposed to the non-SCD population, in study specific control groups. 13 – 16 Nevertheless, when compared to the healthy general population of the same ethnic group, the frequency was not much different in the SCD population. 14 This explanation is consistent with the finding in the present study, as SCD in the Eastern Province of Saudi Arabia is of the Arab-Indian haplotype, 20 whilst being of the same ethnicity.…”

“…The present study showed a high frequency of suboptimal 25(OH)D (insufficiency and deficiency) in SCD patients, reaching 82%, which is comparable to other studies where the frequency reached up to 96%. 13 – 16 …”

“…Among sickle cell disease (SCD) patients, VDD is also highly prevalent. 13 – 16 VDD in SCD presents a challenge to the caring physician as it can cause confusion in the clinical presentation. Muscle and bone pain may mimic acute sickle cell pain or chronic pain syndrome.…”

Deficiency of vitamin D (250H) and its impact on the quality of life: a literature review

“…Com isso, os novos valores de referência laboratorial para os níveis de vitamina D 25 (OH) sugerem que acima de 20 ng/mL é o valor desejável para população saudável (até 60 anos), e entre 30 ng/mL e 60 ng/mL é o valor recomendado para grupos de risco como: idosos, gestantes, lactantes, pacientes com raquitismo/osteomalácia, osteoporose, pacientes com história de quedas e fraturas, causas secundárias de osteoporose (doenças e medicações), hiperparatiroidismo, doenças infamatórias, doenças autoimunes, doença renal crônica e síndromes de má absorção (clínicas ou pós-cirúrgicas) e acima de 100 ng/mL: risco de toxicidade e hipercalcemia (13) Como citado anteriormente, a vitamina D está presente na maioria das células e tecidos do corpo, sen-do uma das mais potentes reguladoras de crescimento celular tanto em células normais como em cancerosas. (14) Na Tabela 1 estão as principais causas da hipovitaminose D. (14) Tabela 1 -Principais causas da hipovitaminose D (14) Causas Exemplo…”

Patient with sickle cell anemia

“…Under low oxygen pressure, polymerization occurs, causing the normal shape of the RBCs to change to a scythe/middle moon shape, decreasing the life span of the RBCs [3]. This modification (HbS) causes molecules to organize into polymeric bundles when deoxygenated, giving the red blood cell an elongated and rigid form, called "scythe form" or "half-moon" [4].…”