Evaluation of vitamin D levels in patients with acute rheumatic fever

Acute rheumatic fever (ARF) is a nonsuppurative complication of pharyngitis caused by group A beta-hemolytic streptococcus (GAS) whose underlying pathological mechanisms have not yet been fully elucidated (1). Vitamin D deficiency is a global health problem, particularly in the pediatric age group. Some immunomodulator and anti-inflammatory effects of vitamin D on various infectious and autoimmune diseases have also been reported. In limited number of pediatric studies low serum 25(OH)D levels have been reported in children with autoimmune diseases (2). Incidences of GAS infection and ARF make a seasonal peak at winter and spring months when 25(OH)D levels are expected to be lowest because of the lack of exposure to sunlight (3, 4). In addition to the high risk of developing ARF, children in the age group of 5–15 years are growing up rapidly, with increased vitamin D requirement. In present study, we evaluated the 25(OH) D levels in children with ARF in comparison with age-matched healthy controls to investigate the relationship between vitamin D deficiency and disease phenotype. Thirty patients admitted to our pediatric cardiology clinic and diagnosed with ARF using modified Jones criteria and 16 age-matched and sex-matched healthy controls evaluated for innocent murmur between December 2011 and March 2013 were prospectively recruited. Participants from the study and control groups were evaluated in the same seasonal period