Vitamin D3 Deficiency in Children with Chronic Rhinosinusitis with Nasal Polyps

Abstract

Objective: Vitamin D3 (VD3) is a steroid hormone that acts on the immune system similar to oral steroids. In asthmatics VD3 deficiency contributes to increased Th2 skewing and steroid use. We examined if children with allergic fungal rhinosinusitis (AFRS) or chronic rhinosinusitis with nasal polyposis (CRSwNP) were VD3 deficient. Method: Plasma levels of 25-hydroxyvitamin D3 were measured by ELISA in children (<21 years old) with AFRS (n = 9), CRSwNP (n = 4), CRS without nasal polyposis (CRSsNP) (n = 10), and controls undergoing surgery for adenotonsillar hypertrophy (n = 10). Levels were confirmed for patients being examined in clinic in CRSwNP (n = 4) and AFRS (n = 15). Results: There was no difference in mean plasma 25-OH VD3 between control and CRSsNP at time of surgery, 36.2 and 36.3 ng/ml respectively. Mean CRSwNP levels were 22.1 ng/ml and AFRS 17.7 ng/ml, both well below the minimum recommended level of 32 ng/ml and significantly lower than control and CRSsNP levels (p3 levels clinically confirmed that children with CRSwNP and AFRS were deficient (26 and 16.9 ng/ml, respectively). Presence of asthma did not appear to be associated with lower VD3, compared with nonasthmatic disease-matched children. VD3 deficiencies were independent of race and gender. Conclusion: Children with AFRS and CRSwNP were VD3 deficient and had levels significantly lower than the recommended level 32/ng mL. These results were confirmed clinically by mass spectrometry. Supplementation of VD3 deficient children may improve symptoms and reduce steroid use.