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"Child`s Health" 8 (51) 2013

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The Use of Vitamin D in the Complex Treatment of Children with Allergic Diseases and its Quantitative Dynamics in the Blood in Different Periods of the Disease

Authors: Tyazhka O.V., Selska Z.V. - National Medical University named after O.O. Bogomolets, Kyiv; Central Children’s Polyclinic of Desnyansky District of Kyiv, Ukraine

Categories: Pediatrics/Neonatology

Sections: Clinical researches

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Introduction. In recent years the statistical information about extension of allergic diseases among the population as a whole is disconsolate. Comparing with the previous years the allergic disease frequency increases eight times faster. From 20 to 40 % of the World population is suffering from these diseases.

It is known nowadays, the lack of vitamin D in blood serum may stimulate the progression of different diseases in human body in which allergic ones are. It is already found that participation of vitamin D in contraction of allergic diseases is through its effect on immune system. It is also known, that the mechanism of the allergic disease progression is bacause of the response of immune system to antigen.

According to P. Pludovsky recommendations for the Central Europe, the preventive and curative doses of the vitamin D are put for the general population on, not taking into account existing diseases in adults and children what’s development, in part, may be related to insufficiency of vitamin D in human body.

It is evidently, that for patients whom vitamin D may help in their curing it is very handy to prevent the individual measures and include vitamin D in the complex therapy. Paying attention to this, patients with allergic diseases may form a group of suffering from such ones and they are needed to be put vitamin D medication on with preventive and treatment goals in complex therapy.

Methods and materials. The research was carried out on the base of the Children’s Central Polyclinic of the Desnyansky district of Kyiv City. There were examined 53 children with allergic diseases from which 17 were in exacerbation of disease and the rest 36 — in remission.

By clinical entity, patients were subdivided in such way: bronchial asthma was found in 23 patients, in 5 was atopic eczema, in 2 patients was allergic rhinitis, 10 ones were diagnosed with the bronchial asthma and atopic eczema. The children were examined in the age from 3 to 16. In the patients were studied in detail the medical and life history, the clinical trial was carried out, detected the level of vitamin D in blood serum. Identifying the 25-hydroxyvitamin D was carried out with the help of the ECL method on Elecsys 2010 analyzer (Roche Diagnostics, Germany), the test of Cobas-system in State Institute of Gerontology AMS of Ukraine named after D.F. Chebotaryov. Assessing the vitamin D supporting was carried out according to M.F. Holick et al. (2011) classification, according to which, the vitamin D deficiency is fixed by the level of 25-hydroxyvitamin D lower than 50 nM/l; vitamin D shortage is diagnosed by a norm of 25-hydroxyvitamin D between 75 and 50 nM/l; concentration of the 25-hydroxyvitamin D from 75 to 150 nM/l is considered to be a norm.

Investigation results. In 53 children (they are 100%) in whom was detected the vitamin D level in blood serum, it was fixed the 25-hydroxyvitamin D deficiency, the index of vitamin D in blood serum ranged from 37.68 nM/l to 8.69 nM/l; the average index was 22.54 nM/l. 31 children with allergic diseases were treated with vitamin D. During the vitamin D administration period the 13 children were in remission, 18 had exacerbation disease episodes. Patients got 2000 international water-soluble vitamin D3 units every day during 2 months. Level of vitamin D was fixed before and after the course of treatment by its medication.

The diseased children, which were administrated of vitamin D the average index of this vitamin in blood serum before treatment was 21.51 nM/l. Children in remission of disease were put monotherapy on with vitamin D medication or in complex with background therapy by topical glucocorticoid medication, if children were in exacerbation period of disease, the given complex therapy included the medication of vitamin D. After 2-months course of vitamin D administration the average index this vitamin in blood serum was 36.54 nM/l, in 27 children the level of vitamin D was in the range of deficiency index, in 4 children was established shortage of vitamin D, it was not come up to the normal level of vitamin D in blood serum in any child. The total increase of vitamin D was 15 nM/l. It should be noted that vitamin D increase was lower in children with exacerbation of disease during the initial examination or they had episodes of disease exacerbation during the administration of vitamin D medication. The total increase of vitamin D level in blood serum in children in remission of disease and those who was in exacerbation period of disease accordingly was 26.24 and 6.93 nM/l. At the same time the survey of patients revealed that during the led therapy with vitamin D medication the exacerbation of disease proceeded in milder case and less long than before prescription of this vitamin in the complex therapy.

Conclusions. Administration of water-soluble vitamin D medication for children with allergic diseases such as bronchial asthma, atopic eczema and allergic rhinitis at a dose of 2000 international units during 2 months period is insufficient for coming up to the normal level of vitamin D in blood serum, which is used for human body needs.

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