ISSN: 2149-2247 | E-ISSN: 2149-2549
Evaluation of Vitamin D Levels in the Course of Acute Rheumatic Fever with Active Carditis [Erciyes Med J]
Erciyes Med J. 2020; 42(3): 312-316 | DOI: 10.14744/etd.2020.26429

Evaluation of Vitamin D Levels in the Course of Acute Rheumatic Fever with Active Carditis

Serkan Türkuçar1, Özge Pamukçu2, Mustafa Argun3, Abdullah Özyurt4, Nazmi Narin4
1Department of Pediatric Rheumatology, Dokuz Eylül University Faculty of Medicine Children’s Hospital, İzmir, Turkey
2Erciyes University Faculty of Medicine, Kayseri, Turkey
3Department of Pediatric Cardiology, Kahramanmaraş City Hospital, Kahramanmaraş, Turkey
4Pediatric Cardiology Erciyes University Faculty of Medicine, Kayseri, Turkey

Objective: Vitamin D is a hormone with immunomodulatory and anti-inflammatory effects besides calcium hemostasis. The present study aims to evaluate the relationship between acute rheumatic fever (ARF) attacks and vitamin D levels.
Materials and Methods: Acute phase reactants, vitamin D levels and echocardiographic parameters of 25 patients with active carditis were evaluated at the time of the acute attack and in 1, 2 and 6 months of follow-up and compared to a control group of 25 age-and sex-matched healthy children.
Results: At the time of diagnosis, WBC, ESR and CRP levels were significantly higher (p<0.05), and vitamin D levels were lower than the control group, not statistically significant (p=0.07). The mean vitamin D levels of the patients diagnosed in winter and spring-autumn seasons were 17.54±9.89 μg/L, and the rate of vitamin D deficiency was 47.3%. The mean vitamin D levels of the control group, in the same seasons, were 23.97±9.48 μg/L and the vitamin D deficiency rate was 19.1%. The vitamin D levels at the time of diagnosis of the ARF group were lower than the control group (p=0.038) and the attributed risk for vitamin D deficiency in ARF carditis in winter and spring seasons was found 3.46 (95% CI 1.1–5.14). Furthermore, cardiac parameters were significantly getting better, while vitamin D deficiency rates decreasing during the follow-up period.
Conclusion: ARF attacks were found to be more frequent in non-summer seasons when vitamin D levels were lower. Echocardiographic and laboratory parameters improved with increasing vitamin D levels. These findings suggest that anti-inflammatory and immunomodulatory effects of vitamin D.

Keywords: Rheumatic fever, vitamin D, carditis

Serkan Türkuçar, Özge Pamukçu, Mustafa Argun, Abdullah Özyurt, Nazmi Narin. Evaluation of Vitamin D Levels in the Course of Acute Rheumatic Fever with Active Carditis. Erciyes Med J. 2020; 42(3): 312-316

Corresponding Author: Serkan Türkuçar, Türkiye
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