Tohoku J. Exp. Med., 2014 December, 234(4)

High Serum 25-Hydroxyvitamin D Levels Are Associated with Pediatric Sepsis

GOKHAN AYDEMIR,¹ FERHAT CEKMEZ,¹ GOKHAN KALKAN,² M.KURSAT FIDANCI,¹ GUVEN KAYA,¹ ABDULBAKI KARAOGLU,³ CIHAN MERAL,¹ IBRAHIM ARZIMAN,⁴ FERHAN KARADEMIR,¹ GANIME AYAR,⁵ RAMIZ COSKUN GUNDUZ⁵ and SELAMI SULEYMANOGLU¹

¹Department of Pediatrics, GMMA Medical Faculty, Istanbul, Turkey
²Department of Pediatrics, Gazi University, Ankara, Turkey
³Department of Pediatrics, GMMA Medical Faculty, Ankara, Turkey
⁴Department of Emergency Medicine, GMMA Medical Faculty, Ankara, Turkey
⁵Pediatric Service, Ankara Childrens Hematology Oncology Education and Research Hospital, Pediatric Intensive Care Unit, Ankara, Turkey

Despite major advances in intensive care, sepsis continues to be a major cause of morbidity and mortality. Vitamin D is involved in various physiologic functions, including cellular responses during infection and inflammation. The aim of this study was to evaluate diagnostic value of 25-hydroxyvitamin D in childhood sepsis because it can be fatal if diagnosis delayed. The study included 40 children with sepsis and 20 children without sepsis (control group). We included only the patients with high probable sepsis, judged by clinical and laboratory findings, including positive blood culture. Blood samples were collected from patients with sepsis before treatment (pre-treatment group) and 48-72 hours later (post-treatment group). Treatment varied from ampicillin-sulbactam to cephalosporin. Blood samples were collected from control group once on admission. Serum 25-hydroxyvitamin D levels were significantly higher in sepsis (pre-treatment group) than control group (74 ± 8 ng/ml vs. 28 ± 12 ng/ml, p = 0.01) and the serum 25-hydroxyvitamin D levels were decreased to 44 ± 5 ng/ml (p = 0.01) after treatment. Moreover, we found significant positive correlation between 25-hydroxyvitamin D and each of well-know sepsis markers, C-reactive protein, tumor necrosis factor-α and interleukin-6. A cut-off point of 20 ng/mL for serum 25-hydroxyvitamin D showed 84% sensitivity and 76% specificity for sepsis diagnosis. This is the first study evaluating the diagnostic role of vitamin D in pediatric sepsis, thereby suggesting that serum 25-hydroxyvitamin D level can be used as a diagnostic marker for sepsis with high sensitivity and specificity.

keywords —— acute phase reactant; child; diagnosis; hydroxyvitamin D; sepsis

© 2014 Tohoku University Medical Press

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Tohoku J. Exp. Med., 2014, 234, 295-298

Correspondence: Ferhat Cekmez, M.D., GMMA Medical Faculty, Department of Pediatrics, Division of Neonatology, 06018 Ankara, Turkey.

e-mail: ferhat_cocuk@hotmail.com