title: Vitamin D levels among pediatric tuberculosis patients - Does it alter following antitubercular treatment? A prospective study in 19 children.
abstract: OBJECTIVE
  It is still unknown whether altered vitamin D levels observed with osteoarticular tuberculosis change during treatment in a child or modify the disease course. To find a possible answer to the above query, we investigated serial serum 25 hydroxy vitamin D concentrations in children suffering from osteoarticular tuberculosis treated with multidrug antitubercular drugs.
  
  
  METHODS
  The prospective study enrolled 19 untreated immunocompetent children with an established diagnosis of osteoarticular tuberculosis. None of the patients were offered any therapeutic vitamin D supplementation at initiation or during the treatment. The patients were followed for response to multidrug antitubercular therapy (DOTS) at 2 months interval. Mean values of vitamin D were calculated at 0, 2, and 6 months and statistically compared. The following laboratory references for defining the vitamin D status were used: <30 nmol/L = deficiency; 30-75 nmol/L = insufficiency; >75 nmol/L = sufficiency.
  
  
  RESULTS
  All the patients responded to antitubercular therapy. Out of the enrolled children, 73.67% had low vitamin D levels at initial presentation. There was no statistically significant difference in vitamin D levels in affected children at either 0-2 (p= 0.452), 2-6 (p= 0.240), or 0-6 months (p= 0.854) following antitubercular treatment. Although the mean vitamin D levels were higher in male patients when compared to female patients at all times, there was no statistically significant difference in vitamin D levels during treatment stages in either sex.
  
  
  CONCLUSIONS
  Vitamin D levels were low at initiation of treatment and did not significantly improve during multidrug antitubercular treatment. Further, tuberculosis healed well with antitubercular therapy despite persistence of low serum levels of vitamin D.
authors.affiliation: Department of Pediatric Orthopaedics, Chacha Nehru Bal Chikitsalaya, Geeta Colony, Delhi 110031, India.
authors.forename: Anil
authors.initials: A
authors.lastname: Agarwal
authors.affiliation: Department of Biochemistry, Chacha Nehru Bal Chikitsalaya, Geeta Colony, Delhi 110031, India.
authors.forename: Pradeep Kumar
authors.initials: PK
authors.lastname: Dabla
authors.affiliation: Department of Pediatric Orthopaedics, Chacha Nehru Bal Chikitsalaya, Geeta Colony, Delhi 110031, India.
authors.forename: Madhusudan
authors.initials: M
authors.lastname: Mishra
authors.affiliation: Department of Pediatric Orthopaedics, Chacha Nehru Bal Chikitsalaya, Geeta Colony, Delhi 110031, India.
authors.forename: Anubrat
authors.initials: A
authors.lastname: Kumar
authors.affiliation: Department of Pediatric Orthopaedics, Chacha Nehru Bal Chikitsalaya, Geeta Colony, Delhi 110031, India.
authors.forename: Abbas
authors.initials: A
authors.lastname: Shaharyar
keywords: Bone and joint; Child; Osteoarticular; Pediatric; Tuberculosis; Vitamin D