ENT - September 2020 - 508

Clinical Study

Vitamin D Status in Egyptian Children
With Allergic Rhinitis

Ear, Nose & Throat Journal
2020, Vol. 99(8) 508-512
ª The Author(s) 2019
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DOI: 10.1177/0145561319850814
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Khaled Saad, MD1 , Abobakr Abdelmoghny, MD2,
Mohamed Diab Aboul-Khair, MD3, Yasser Farouk Abdel-Raheem, MD1,
Eman Fathalla Gad, MD1, Ahmed El-Sayed Hammour, MD3, Bahaa Hawary, MD4,
Asmaa M. Zahran, MD5, Mohamd A. Alblihed, MD6, and Amira Elhoufey, PhD7,8

Abstract
Objective: This study aimed to assess the serum levels of vitamin D in an Egyptian cohort of children with allergic rhinitis (AR)
and to evaluate any correlation of vitamin D status with the disease severity. Patient and methods: One hundred twenty
children with AR and 100 healthy children were included in our study. We studied the serum levels of vitamin D 25(OH)D and
1,25(OH)2D in all participants. The associations between vitamin D levels and clinical characteristics of AR were examined.
Results: In AR group, the serum levels of calcium, (25(OH)D and 1,25(OH)2D levels were significantly lower (p < .0001, p < .001,
and p < .0001, respectively) in AR children than in controls. Furthermore, the mean 25-OHD3 levels in patients with moderate/
severe AR were significantly lower than those with mild AR ( p < .001). We found significant negative correlations between mean
25(OH)D levels and total nasal symptom score (r ¼ À.62, p ¼ .002) and total immunoglobulin E levels (r ¼ À.27, p ¼ .013) in AR
group. Conclusions: Vitamin D deficiency is a frequent finding among Egyptian children with AR when compared to the healthy
group. A significant inverse association was observed between vitamin D levels and AR disease severity.
Keywords
allergic rhinitis, vitamin D, children

Introduction

Materials and Methods

Allergic rhinitis (AR) is one of the most important allergic airway diseases in children. It is an allergic disorder of the mucous
membranes of the nasal passages. Allergic rhinitis is caused by
an immune-mediated inflammatory reaction characterized by
raised serum immunoglobulin E (IgE), mucus hypersecretion,
and eosinophilic cell infiltration.1,2 Patients usually presented
with paroxysmal sneezing, watery rhinorrhea, and nasal blockage.3 At present, AR is considered a major health problem
affecting up to 40% of children worldwide, which may interfere
with sleep and quality of life in AR children and impose a
considerable burden on public health in economic terms.1,3 The
exact etiology of AR remains poorly understood, and it is an
active area of research.2 Vitamin D deficiency is progressively
documented as a possible etiologic or disease-modifying factor
in many allergic disorders, including asthma,4 eczema,5 and food
allergy.6 However, a few pieces of research have studied the
relationship between vitamin D status and AR in children, especially in the Middle East. The epidemiologic pattern for the
deficiency of vitamin D is coupled with the rising epidemic of
atopic and allergic diseases in the developed countries so raises
the likelihood of an association between the 2 variables.2 This
study aimed to assess the serum levels of vitamin D in a large
Egyptian cohort of children with AR and to evaluate any correlation of vitamin D status with the disease severity.

Compliance With Ethical Standards
The procedures of our study were following the regulations of
the relevant clinical research Ethics Committee and with
those of the code of ethics of the world medical association
Declaration of Helsinki). Written informed consents of parents
of all children were taken after explanation of the study

1

Faculty of Medicine, Department of Pediatrics, Assiut University, Assiut, Egypt
Faculty of Medicine, Department of ENT, Al-Azhar University, Assiut, Egypt
3
Faculty of Medicine, Department of Pediatrics, Al-Azhar University, Cairo, Egypt
4
Faculty of Medicine, Department of Pediatrics, Aswan University, Aswan,
Egypt
5
Department of Clinical Pathology, South Egypt Cancer Institute, Assiut, Egypt
6
Department of Medical Biochemistry, School of Medicine Taif University, Taif,
Saudi Arabia
7
Faculty of Nursing, Department of Community Health Nursing, Assiut
University, Assiut, Egypt
8
Department of Community Health Nursing, Sabia University College, Jazan
University, Kingdom of Saudi Arabia
2

Received: April 9, 2019; accepted: April 22, 2019
Corresponding Author:
Khaled Saad, Faculty of Medicine, Pediatric Department, Assiut University,
Assiut 71516, Egypt.
Emails: ksaad8@yahoo.com; khaled.ali@med.au.edu.eg
https://www.sagepub.com/journals-permissions https://www.doi.org/10.1177/0145561319850814 http://journals.sagepub.com/home/ear https://www.orcid.org/0000-0002-8473-6116 https://www.orcid.org/0000-0002-8473-6116
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