title: Severe vitamin D deficiency in patients with Kawasaki disease: a potential role in the risk to develop heart vascular abnormalities?
abstract: Twenty-five-hydroxyvitamin D (25(OH)-vitamin D) is crucial in the regulation of immunologic processes, but-although its deficiency has been reported in patients with different rheumatological disorders-no data are available for Kawasaki disease (KD). The goals of this study were to assess the serum levels of 25(OH)-vitamin D in children with KD and evaluate the relationship with the eventual occurrence of KD-related vascular abnormalities. We evaluated serum 25(OH)-vitamin D levels in 79 children with KD (21 females, 58 males, median age 4.9 years, range 1.4-7.5 years) in comparison with healthy sex-/age-matched controls. A significantly higher percentage of KD patients (98.7 %) were shown to have reduced 25(OH)-vitamin D levels (<30 ng/mL) in comparison with controls (78.6 %, p < 0.0001). Furthermore, KD patients had severely low levels of 25(OH)-vitamin D than controls (9.17 ± 4.94 vs 23.3 ± 10.6 ng/mL, p < 0.0001), especially the subgroup who developed coronary artery abnormalities (4.92 ± 1.36 vs 9.41 ± 4.95 ng/mL, p < 0.0001). In addition, serum 25(OH)-vitamin D levels correlated not only with erythrosedimentation rate (p < 0.0001), C-reactive protein (p < 0.0001), hemoglobin level at KD diagnosis (p < 0.0001) but also with both coronary artery aneurysms (p = 0.005) and non-aneurysmatic cardiovascular lesions (p < 0.05). Low serum concentrations of 25(OH)-vitamin D might have a contributive role in the development of coronary artery complications observed in children with KD.
authors.affiliation: Health Sciences Department, University of Florence, Anna Meyer Children's University Hospital, Florence, Italy.
authors.forename: Stefano
authors.initials: S
authors.lastname: Stagi
authors.affiliation: Institute of Pediatrics, Università Cattolica Sacro Cuore, Fondazione Policlinico Universitario Agostino Gemelli, Rome, Italy.
authors.forename: Donato
authors.initials: D
authors.lastname: Rigante
authors.affiliation: Department of Experimental and Clinical Medicine and Department of Biomedicine, Division of Rheumatology, Transition Clinic, University of Florence, Viale Pieraccini 18, 50139, Florence, Italy.
authors.forename: Gemma
authors.initials: G
authors.lastname: Lepri
authors.affiliation: Department of Experimental and Clinical Medicine and Department of Biomedicine, Division of Rheumatology, Transition Clinic, University of Florence, Viale Pieraccini 18, 50139, Florence, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Matucci Cerinic
authors.affiliation: Department of Experimental and Clinical Medicine and Department of Biomedicine, Division of Rheumatology, Transition Clinic, University of Florence, Viale Pieraccini 18, 50139, Florence, Italy. falcini@unifi.it.
authors.forename: Fernanda
authors.initials: F
authors.lastname: Falcini
mesh_terms: D002097:C-Reactive Protein / Q000737:chemistry; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D003330:Coronary Vessel Anomalies / Q000453:epidemiology*; D005260:Female; D006801:Humans; D007223:Infant; D007558:Italy; D016014:Linear Models; D008297:Male; D009080:Mucocutaneous Lymph Node Syndrome / Q000150:complications*; D015999:Multivariate Analysis; D012307:Risk Factors; D014807:Vitamin D / Q000097:blood*; D014808:Vitamin D Deficiency / Q000453:epidemiology*
chemical_list: D014807:Vitamin D; D002097:C-Reactive Protein
keywords: 25(OH)-vitamin D; Coronary artery aneurysms; Kawasaki disease