Katılma Nöbeti ile Başvuran Çocuklarda Vitamin D Düzeyleri: Bir Üniversite Hastanesi Örneği

Amaç: Bu çalışmanın amacı, katılma nöbetleri ile başvuran çocuklarda vitamin D düzeylerini araştırmak, bunları sağlıklı kontrol grubu ile karşılaştırmak ve nefes tutma nöbetleri ile vitamin D düzeyleri arasındaki ilişkiyi ortaya koymaktır. Yöntem: Aralık 2019 ile Ekim 2022 tarihleri arasında Adıyaman Üniversitesi Eğitim ve Araştırma Hastanesi Çocuk Nöroloji ve Çocuk Kardiyoloji polikliniklerine başvuran 98 hastanın dosyaları retrospektif olarak incelendi. Dahil etme kriterlerini karşılamayan 52 hasta çalışma dışı bırakıldı. Kırk altı çocuk katılma nöbeti grubu, 53 sağlıklı çocuk kontrol grubu olarak çalışmaya dahil edilmiştir. Tüm hastalarda Fe, serum demir bağlama kapasitesi, ferritin, vitamin B12 ve vitamin D düzeyleri ölçüldü. Bulgular: Çalışma grubu 27 kız (%58,6), 19 erkek (%41,3) olmak üzere 46 hastadan (K/E=1,4) oluşuyordu. Hasta grubumuzun 39’u (%84,8) siyanotik tip, 3’ü (%6,5) soluk tip ve 4’ü (%8,7) karışık tip katılma nöbeti tanısı almıştı. Katılma nöbetiyle başvuran hastaların özellikle tam kan sayımı, demir seviyeleri, demir bağlama kapasitesi, ferritin seviyeleri, vitamin B12 ve vitamin D seviyeleri gibi parametreler üzerinden kapsamlı bir analiz yapıldı. Bu çalışmada vitamin D seviyeleri ile anlamlı bir ilişki tespit edilmemiş olsa da düşük hemoglobin seviyeleri, azalmış B12 vitamini seviyeleri ve azalmış ferritin seviyeleri ile kayda değer bağlantılar kuruldu. Ayrıca B12 vitamini değerleri düşük olan hastaların analiz dışı bırakılmasıyla demir eksikliği anemisi ile katılma nöbetleri arasında istatistiksel olarak anlamlı bir ilişki ortaya çıktı (p<0,05). Sonuç: Çalışma sonuçları, düşük D vitamini düzeyleri ile genellikle olumlu prognoza sahip olan BHS arasında anlamlı bir ilişki olmadığını göstermektedir. Bununla birlikte, demir eksikliği anemisi ve vitamin B12 seviyeleri arasındaki potansiyel bağlantılar göz önünde bulundurulduğunda, bu faktörlerin rutin olarak değerlendirilmesi tavsiye edilmektedir.

Anahtar Kelimeler:

Katılma nöbeti, Çocuk, Vitamin D

Vitamin D Levels in Children Presenting with Breath-Holding Spells: An Example of A University Hospital

Aim: This study aimed to examine the vitamin D levels in children who experience breath-holding spells (BHS) and to compare these levels with those of a healthy control group. The goal was to establish a connection between BHS and vitamin D levels. Method: The records of 98 patients, who presented to the Pediatric Neurology and Pediatric Cardiology polyclinics of Adıyaman University Training and Research Hospital between December 2019 and October 2022, were retrospectively reviewed. Fifty-two patients who did not meet the inclusion criteria were excluded. The study included forty-six patients with BHS whose laboratory results were assessed and a healthy control group of fifty-three individuals. Fe, serum iron binding capacity, ferritin, vitamin B12, and vitamin D levels were measured in all patients. Results: The study group comprised 46 patients (female/male ratio = 1.4), consisting of 27 girls (58.6%) and 19 boys (41.3%). Within our patient cohort, 39 individuals (84.8%) were diagnosed with cyanotic-type spells, three (6.5%) with pallid-type spells, and four (8.7%) with mixed-type spells. For patients experiencing BHS, a comprehensive analysis was conducted on parameters including complete blood count, iron levels, iron-binding capacity, ferritin levels, vitamin B12, and vitamin D levels. Although no significant correlation was identified with vitamin D levels in this study, noteworthy connections were established with lower hemoglobin levels, decreased vitamin B12 levels, and reduced ferritin levels. Moreover, upon exclusion of patients exhibiting low vitamin B12 values from the analysis, a statistically significant relationship emerged between iron deficiency anemia and the occurrence of BHS (p<0.05). Conclusion: The study results suggest no significant correlation between low vitamin D levels and BHS, which generally have a favorable prognosis. However, considering the potential connections between iron deficiency anemia and vitamin B2 levels, it is advisable to assess these factors routinely.

Keywords:

Breath-holding spell, Child, Vitamin D,

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