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The Role of Vitamin D in

Children with RecurrentTonsillopharyngitis

Canan Cacina

Sadk Toprak

Ayse Kilic

Salih Aydin

Frisca Finlania Agan !"#$!!%!!#%&em'im'ing( dr) *) Agus+ Sp)T,T+ *)Kes

Yildiz et al. Italian Journal of Pediatrics 2012, 38:25

http://.i!ponline.net/content/38/1/25

-smail .ildi/

0min 1nu2ar1mit 3ey'ek4ahar Toptas


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I"#$%&'(#I%"


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#%")I*%P+$Y"-I#I)

#onsillopharnitis : acute infection of

tonsil and pharn, characterized

erthea, eudation, ulceration or

erane.

tiolo : 4irus and -roup eta6

haeoltic streptococci


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$ecurrent tonsillopharnitis :

7 episodes of tonsillopharnitis in

a ear %$7 5 episodes of acute tonsillitis in a

ear for to conse9uetie ears %$

7 3 episodes of acute tonsillitis in aear for three conse9uetie ears


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$is; factors : #he enironental

conditions, the child


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Pathophsiolo


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4I#=I" &

4itain & has a preentie role for inhiition

of acterial iofil

$ole of itain & : aintainin of innate

iunitdendritic cells, lphoctes, #lphoctes, "> cells

4itain & receptors ?4&$@ in an tissues

Ao; I, s, pa and #a9 polorphissdescried reardin 4&$ ene affected

itain &.


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4itain & =etaolis


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P'$P%)

to deterine the role of the

polorphis characteristics of

itain & and 4&$ receptors in

children dianosed ith recurrent

tonsillopharnitis.


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*AT0R-A5 A6D *0T,7DS


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)tud desin

=etode : retrospectie stud

2B2 children eteen 2 and 10 ears

of ae Perfored in Istanul 'niersit,

Istanul =edical Aacult, &epartent

of Pediatrics, %utpatient (linic of

-eneral Pediatrics

eteen pril 2008 and pril 200C.


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the total nuer of access to the

outpatient clinic as 58C33

B,D ?280@

acute tonsillopharitis 115/280 ?B,1D@ et the eliililit

criteria

12

control roup


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(onducted ostl in autun and inter

seasons ecause of the increased fre9uenc

of tonsillopharnitis durin those seasons

and seasonal ariailit of the itain & leels lood saples ere collected fro oth

roups and ere studied in the sae season.

)eru 25?%+@ itain & and 1,256?%+@2itain & leels ere easured *I)

ethod


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Aiure 1 Alo chart of the stud.pril 1st, 2008 E pril 1st, 200C

"uer of isits to the outpatient clinic?58C33@

"uer of cases dianosed ith acute tonsillopharnitis

?280@

"uer of cases included to the stud

?155@

12 of CF E *I) ;it ere

used durin the preparation

phase

&" could not isolated fro 15

saples in #a9 and pa

polorphiss and 1B saples

in Ao; 1 polorphis

"uer of cases

ith easured

)eru 25?%+@

itain & leel8B ?3D@

"uer of cases

ith easured

)eru 1,25?%+@2

itain & leel8B ?3D@

"uer of cases ith studied

4&$ ene polorphisG

#a9 polorphis 100 ?D8F,C@

pa polorphis 100 ?D8F,C@Ao; 1 polorphis 101 ?D8,8@


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#he liiilit (riteria Aor Participants

Inclusion criteria for the stud roup:

a@ +ain tonsillopharnitis H ties a ear,

@ +ain sptos of tonsillopharnitis

deeloped ithin last das,

c@ "o conditions re9uirin to e hospitalized,

d@ -ien parental consent,

e@ "o ;non chronic diseases,f @ "ot hain an suppleentation of itain

& durin the last 3 onth.


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#onsillopharnitis

&ianosed : phsical eaination perfored aphsician and su!ects included to the the stud

reardless of the etiolo

#he su!ects : dianosed as tonsillopharnitis

ore than ties in a ear are considered asfre9uent tonsillopharnitis. #he fre9uenc :

inestiated reiein the hospital records and

referrin the feedac; of parents if the patient

is dianosed ith tonsillopharnitis in a differentinstitution or a prescription for tonsillopharnitis

as ien another phsician preiousl.


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=easureent of seru itain & leel and

deterination of itain & receptor ?4&$@ ene

polorphis

)tud seru 25?%+@ and 1,256?%+@ itain &

leels ere easured sandich nze

*in;ed Iunosorent ssa ?*I)@

ethod &" of the su!ects as isolated fro the

lood saples otained and 4&$


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Interpretation of seru itain & leels

)eru 25?%+@ itain & leel as interpreted :

Insufficient : 50E80 nol/*

)ufficient :80E250 nol/*

cess :250E325 nol/* Intoication : H 325 nol

)eru 25?%+@ itain & leel

pperent deficienc : 50 nol/*


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Aactors affectin seru itain & leel

&ail eposure to sunliht

-ender

e

Keiht

#he aount of tie spent ith outdoor

actiities and at seaside


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thical coittee approal and support

Istanul 'niersit, Istanul )chool of

=edicine ethical coittee approal as

ta;en in Januar 2008 ith the file

nuered 2008/35 efore the stud asperfored.

#his stud as supported Istanul

'niersit )cientific $esearch Pro!ects

?Pro!ect "o: 200F@.


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)tatistical analsis

)tudent


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$)'*#)


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&I)('))I%"

#he eistence of 4&$s in iune sste cells a

#he est paraeter for the ealuation of itain & :

- od itain & storae : seru 25 ?%+@ itain &

leels ?half life : 20 das@- ioloicall actie for : 1,256?%+@2 itain & ?half

life : 3 to F hours@, circulatin lood leel is er lo

)eru 25?%+@ itain & and 1,256?%+@2 itain &

leels ere easured *I) ethod


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erae seru 256?%+@ itain & leels

ere in the noral rane in oth roups, it

as sinificantl loer in the children ith

fre9uent tonsillopharnitis ?p 0.01@ #o randoized controlled trails reported

that, itain & suppleentation is effectie

for preention of upper respirator tract

infections


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din and colleaues prospectie

research seru 256?%+@ itain &

leels in tonsillecto patients ith

recurrent tonsillitis N no statistical

differencesith the control roup.


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(%"(*')I%"

*o seru itain & leel can e a ris; factor for

recurrent tonsillopharnitis.

In children hain recurrent tonsillopharnitis,

seru 25?%+@ itain leels ere loer thanthose of health children.

"o difference in itain & receptor ene

polorphis.


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In the future,

iin itain & support to the children ithrecurrent tonsillopharnitis, then

easurin their seru itain & leels and

oserin the decrease in annual disease

fre9uenc after the supportie treatentould eactl eplain the relation eteen

itain & and hain recurrent

tonsillopharnitis.


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T,A6K .71

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