Evaluation of Vitamin D Levels in the Course of Acute Rheumatic Fever with Active Carditis

Objective: Vitamin D is a hormone with immunomodulatory and anti-inflammatory effects besides calcium hemostasis. The present study aims to evaluate the relationship between acute rheumatic fever (ARF) attacks and vitamin D levels. Materials and Methods: Acute phase reactants, vitamin D levels and echocardiographic parameters of 25 patients with active carditis were evaluated at the time of the acute attack and in 1, 2 and 6 months of follow-up and compared to a control group of 25 age-and sex-matched healthy children. Results: At the time of diagnosis, WBC, ESR and CRP levels were significantly higher (p<0.05), and vitamin D levels were lower than the control group, not statistically significant (p=0.07). The mean vitamin D levels of the patients diagnosed in winter and spring-autumn seasons were 17.54 +/- 9.89 mu g/L, and the rate of vitamin D deficiency was 47.3%. The mean vitamin D levels of the control group, in the same seasons, were 23.97 +/- 9.48 mu g/L and the vitamin D deficiency rate was 19.1%. The vitamin D levels at the time of diagnosis of the ARF group were lower than the control group (p=0.038) and the attributed risk for vitamin D deficiency in ARF carditis in winter and spring seasons was found 3.46 (95% CI 1.1-5.14). Furthermore, cardiac parameters were significantly getting better, while vitamin D deficiency rates decreasing during the follow-up period. Conclusion: ARF attacks were found to be more frequent in non-summer seasons when vitamin D levels were lower. Echocardiographic and laboratory parameters improved with increasing vitamin D levels. These findings suggest that anti-inflammatory and immunomodulatory effects of vitamin D.