Serum 25-hydroxy vitamin D level in patients with pemphigus andits association with disease severity

BackgroundThere is a growing number of studies suggesting a key role for vitamin D in the pathogenesis and progression of autoimmune disorders. AimTo determine the serum levels of 25-hydroxy vitamin D [25(OH)D] in patients with pemphigus and association of 25(OH)D with clinical features. MethodsWe enrolled 52 patients with pemphigus and 56 age- and sex-matched healthy controls (HCs). Only patients newly diagnosed with pemphigus or patients who had relapsed after discontinuing their treatment for >6months were included. Serum 25(OH)D and parathyroid hormone (PTH) levels were measured. Data on demographics, body mass index (BMI), disease severity (based on Pemphigus Area and Activity Score; PAAS) and involved surface body area (BSA) were obtained. ResultsSuboptimal levels of vitamin D (<30ng/mL) were observed in 78.8% and 91.0% of patients and HCs, respectively (P=0.13). Univariate and multivariate ordinal logistic regression models showed that low vitamin D status was more likely to occur in patients with higher BSA (OR=1.07, 95% CI 1.01-1.13) and those with higher cutaneous (OR=1.36, 95% CI 1.11-1.66) and total (OR=1.24, 95% CI 1.08-1.41) PAAS. However, there was no significant association between vitamin D levels and presence of pemphigus, season of sampling, age, BMI or smoking habit. ConclusionVitamin D deficiency is common both in patients with pemphigus and in HCs. Patients with more severe disease (higher PAAS) are likely to have lower vitamin D levels.