Serum vitamin D levels in children with newly diagnosed and chronic immune thrombocytopenia

Čulić, Srđana; Markić, Joško; Petrović, Davor; Konjevoda, Paško; Pavelić, Jasminka

doi:10.1053/j.seminhematol.2016.04.020

Cited by 10 publications

(18 citation statements)

References 17 publications

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“…Our patients come from the coastal Croatia region, with a high incidence of sunny days [58], and therefore they may have higher 25(OH)D values. The study by Culic et al had pediatric patients from a similar geographic region and also had lower 25(OH)D values, especially in the group of patients with chronic ITP (35 ± 20 nmol/L) probably due to ITP treatment which additionally lowered their 25(OH)D values [49].…”

Section: Discussionmentioning

confidence: 99%

“…To prove our first hypothesis, we used unpublished and published data from a pilot study of Culic et al [49] for calculating our minimal sample size. In that pilot study, 21 participants were included.…”

Section: Methodsmentioning

confidence: 99%

“…Deming’s methodology is a method of linear regression type 2 (Method II), using a Reduced Major Axis (RMA) variant [50]. In our pilot study [49], we obtained results that the 95% CI coefficient slope does not include 0, according to which we already have enough patients not to commit a type 2 error; so, our only concern is to keep the formal level of type 1 error at 5%. As there is no software to calculate the size of sample for the RMA variant of regression, we used network software to calculate the sample size (Soper DS, a priori sample size calculator for multiple regression, 2017) and concluded that the sample we can muster (30 patients) guarantees a margin of type 1 error of 5% and power of 80% to discover medium to large (Cohen f 2 = 0.29) differences between the null and alternative hypotheses.…”

Section: Methodsmentioning

confidence: 99%

See 2 more Smart Citations

Hypovitaminosis D Influences the Clinical Presentation of Immune Thrombocytopenia in Children with Newly Diagnosed Disease

Petrović

Benzon

Batinic

et al. 2019

JCM

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Immune thrombocytopenia (ITP) is an acquired autoimmune disorder characterized by isolated thrombocytopenia defined as platelet count in peripheral blood <100 × 109/L. Hypovitaminosis D is very common in children with autoimmune diseases. To analyze whether hypovitaminosis D is associated with the clinical presentation of ITP in children, medical records of 45 pediatric patients with newly diagnosed immune thrombocytopenia in the coastal region of Croatia were evaluated. The severity of bleeding was assessed using two bleeding scores. Children with lower 25-hydroxyvitamin D (25(OH)D) values had higher values of the skin-mucosa-organ-gradation (SMOG) bleeding score and respectively more severe bleeding on diagnosis of ITP. With further analysis of the main domains of that score, we found that patients with a lower 25(OH)D value had more severe bleeding in the skin and organs. When 25(OH)D and ITP Bleeding Scale (IBLS) score were analyzed, a negative correlation was found, but it was not significant. Our findings suggest that hypovitaminosis D influences the severity of the clinical presentation of ITP in children on initial diagnosis of the disease. Therefore, therapy with 25(OH)D could be a new potential option for treatment of ITP. To investigate the connection between 25(OH)D and the incidence and severity of ITP, further studies, especially randomized controlled studies, are needed.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

See 1 more Smart Citation

Hypovitaminosis D Influences the Clinical Presentation of Immune Thrombocytopenia in Children with Newly Diagnosed Disease

Petrović

Benzon

Batinic

et al. 2019

JCM

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“…To the best of our knowledge, this study constitutes the first investigation of the 25(OH)D levels specifically in preschool children in Croatia and the surrounding countries (the territory of the former Yugoslavia). Additionally, studies performed on other samples in Croatia (i.e., adults and adolescents) mostly focused on specific populations with severe health conditions, which makes comparison of the results additionally difficult [ 50 , 51 ]. Therefore, we could not specifically compare our results with those previously reported for children, and future studies are needed to confirm our results.…”

Section: Discussionmentioning

confidence: 99%

Vitamin D Status and Analysis of Specific Correlates in Preschool Children: A Cross-Sectional Study in Southern Croatia

Karin

Gilić

Domić

et al. 2018

IJERPH

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Vitamin D deficiency is a globally important problem, particularly in children, but there is a lack of information regarding this deficiency in preschool children from southeastern Europe. This study aimed to establish the levels of 25-hydroxyvitamin D (25(OH)D) and associations of gender, time spent outdoors, physical activity (PA), and body mass index (as predictors) with the 25(OH)D level (outcome) in healthy preschool children. The participants were preschoolers (all 5–6 years of age) from southern Croatia. All the participants were tested during their mandatory medical examination 6–7 months prior to school enrollment. The PA was obtained using the preschool-age physical activity questionnaire (Pre-PAQ), which categorizes PA into five levels (from sedentary to vigorous PA). The prevalence of 25(OH)D deficiency was high: 58% of the children had 25(OH)D levels of <50 nmol/L (deficiency), and an additional 29% had an insufficient level of 25(OH)D (50–75 nmol/L). Boys had higher levels of 25(OH)D than girls. A multinomial regression using 25(OH)D categories as the outcome and a sufficient level (>75 nmol/L) as the reference value identified gender as the only significant predictor of 25(OH)D status, with boys being at lower risk for 25(OH)D deficiency than girls. These results showed a high prevalence of 25(OH)D deficiency in preschoolers from the southern part of Croatia, which is additionally alarming based on the geographical position of the studied region (42° N) and its high number of sunshine hours (>2600 h per year). Future studies examining other potential correlates of 25(OH)D in the region are warranted.

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“…Mean serum 25 (OH) D3 (VD) levels have been determined to be significant lower in hematological disorders, such as ITP, AIHA, Evan’s syndrome, and chronic idiopathic neutropenia (CIN), than in controls 13. VD deficiency is very common in children with newly diagnosed or chronic ITP form 14…”

Section: Vitamin D (Vd) Deficiency – a Remarkable Pathophysiological mentioning

confidence: 99%

<p>Vitamin D supplementation for the prevention or depletion of side effects of therapy with alemtuzumab in multiple sclerosis</p>

Goischke¹

2019

TCRM

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Purpose of review: Not only the multiple sclerosis specialist but also the general neurologist and primary care practitioner are increasingly aware of possible adverse events (AEs) by treatment with alemtuzumab (over 47% risk of secondary autoimmune-mediated diseases). Vitamin D supplementation's effect (VDS) to reduce these autoimmune AEs is poorly performed in routine practice. This article seeks to justify why this simple, inexpensive, patient-friendly therapy should be seriously discussed. Recent findings: Patients who have developed autoimmunity also show a high basal level of IL-21, a cytokine which increases the growth of auto-reactive T-cells. For side effects such as thyroid dysfunction, autoimmune thrombocytopenia, autoimmune hemolytic anemia, autoimmune hepatitis, diabetes mellitus type 1, and alopecia areata/alopecia totalis, VDS may have an impact on the immunological mechanism, in particular lowering levels of IL-17 and IL-21. Summary: The potential role of vitamin D in influencing autoimmune diseases is evident. If a life-threatening side-effect can be prevented by high-dose VDS, it is ethical to initiate this add-on therapy despite contradictory results in studies on the effectiveness of VDS.

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Serum vitamin D levels in children with newly diagnosed and chronic immune thrombocytopenia

Cited by 10 publications

References 17 publications

Hypovitaminosis D Influences the Clinical Presentation of Immune Thrombocytopenia in Children with Newly Diagnosed Disease

Hypovitaminosis D Influences the Clinical Presentation of Immune Thrombocytopenia in Children with Newly Diagnosed Disease

Vitamin D Status and Analysis of Specific Correlates in Preschool Children: A Cross-Sectional Study in Southern Croatia

<p>Vitamin D supplementation for the prevention or depletion of side effects of therapy with alemtuzumab in multiple sclerosis</p>

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