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ORIGINAL ARTICLE
Year : 2019  |  Volume : 44  |  Issue : 4  |  Page : 246-253

Reduced serum vitamin D levels in Egyptian adults with chronic primary immune thrombocytopenia (responders and nonresponders): an Egyptian single-center study


1 Department of Internal Medicine, Hematology and Clinical Oncology Division, Faculty of Medicine, Ain Shams University, Cairo, Egypt
2 Department of General Internal Medicine, Faculty of Medicine, Misurata Univeristy, Misurata, Libya

Correspondence Address:
Walaa A Esalakawy
Abbassia, Cairo 11241
Egypt
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ejh.ejh_34_19

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Introduction Immune thrombocytopenia (ITP) is a disorder characterized by immune-mediated accelerated platelet destruction and suppressed platelet production. Low vitamin D levels have been found in several autoimmune diseases, such as rheumatoid arthritis, systemic lupus erythematosus, systemic sclerosis, type 1 diabetes mellitus, multiple sclerosis, inflammatory bowel diseases, and autoimmune gastritis. The mechanisms underlying the link between vitamin D and autoimmunity are not completely understood but probably are associated with its anti-inflammatory and immunomodulatory functions. Patients and methods The study included 80 adult participants, comprising 40 patients with primary ITP (they were divided into 20 responders and 20 nonresponders), 20 cases of thrombocytopenia owing to non-ITP causes (eight acute myeloid leukemia, five myelodysplastic syndrome, and seven with aplastic anemia), and 20 healthy controls. All were subjected to measurement of serum 25-monohydroxyvitamin D level with ELISA. Results We found that vitamin D levels were significantly lower in patients with ITP (range=2–40 ng/ml; mean±SD=17.29±10.96 ng/ml) and thrombocytopenia owing to non-ITP causes (range=10–40 ng/ml; mean±SD=21.05±8.31 ng/ml) in comparison with normal healthy controls (range=10–65 ng/ml; mean±SD=36.70±16.30 ng/ml) (P=0.000), but there was no statistically significant difference between levels in ITP vs non-ITP thrombocytopenia (P=0.225). When comparing vitamin D levels in patients with ITP in relation to response to first-line treatment with corticosteroids, there was no statistical significant difference regarding vitamin D levels (mean±SD=15.73±10.00 ng/ml in responders and mean±SD=18.85±11.89 ng/ml in nonresponders), with a P value of 0.374. Conclusion Vitamin D levels are lower among patients with ITP in relation to healthy controls. Vitamin D may play a role in the pathogenesis of ITP.


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