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Vitamin D deficiency may be relevant to childhood asthma infections, infant fractures
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Postmortem vitamin D results could offer a deeper understanding of the pathophysiological mechanisms behind certain diseases causing child deaths and inform further research, according to findings published in Pediatric and Developmental Pathology.
“Measuring serum vitamin D levels postmortem may provide invaluable information on sudden unexplained death in children, in children dying from asthma, and in babies with fractures,” researchers in the United Kingdom wrote.
Irene Scheimberg, MD, and Leslie Perry, PhD, both of Barts Health NHS Trust, London, conducted a retrospective review of data on infants and children from the pediatric autopsy files (July 2009-April 2012) at The Royal London Hospital, North East London.
Vitamin D status was available for 51 cases in children aged 2 days to 10 years; data on one child with known vitamin D deficiency who died in 2002 was also considered.
Postmortem examinations showed 17 children had vitamin D deficiency (<25 nmol/L), 24 vitamin D insufficiency (25–49 nmol/L), 10 suboptimal vitamin D levels (50–79 nmol/L) and only 1 adequate vitamin D levels (≥80 nmol/L). Fractures were seen in three infants.
Abnormal growth plate histology was seen in 10 children who had vitamin D deficiency (59%), but abnormal radiology was seen in only three. Among the infants, eight (33%) with vitamin D insufficiency had abnormal histology, and all had normal radiology.
Hypocalcemia resulting from vitamin D deficiency was determined to be the cause of death for three children. Each showed radiological and histological rickets; two babies had cardiomyopathy and a 3-year-old hypocalcemic seizures.
The high proportion of low vitamin D levels was seen across all ethnic groups.
The researchers underscored that vitamin D deficiency, the most common form of pediatric metabolic bone disease, is both preventable and treatable; further, the levels are neither difficult nor expensive to measure.
“The information obtained may assist in establishing the cause of death,” the researchers wrote. “Low vitamin D may prove to be a significant risk factor in various morbidities.”
Disclosure: The researchers report no relevant disclosures.
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