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Title: Children With Cystic Fibrosis Not Well Covered by Guidelines for Vitamin D Needs
URL: http://www.pslgroup.com/dg/22E792.htm
Doctor's Guide
October 9, 2008

BALTIMORE, Md -- October 9, 2008 -- Existing recommendations for treating vitamin D deficiency in children with cystic fibrosis (CF) are too low to cover the serious need, leaving most at high risk for bone loss and rickets, according to a study published in the October issue of The Journal of Pediatrics.

"These findings are a big wake-up call, not only because they show that many children with CF are lacking vitamin D, but also because the deficiency persists even in those children who are treated with weekly doses 2 or 3 times as high as the current recommendations," said lead author Deanna Green, MD, Johns Hopkins Children's Center, Baltimore, Maryland. "Clearly there is an urgent need to find more effective ways to restore healthy vitamin D levels."

Researchers found that nearly half of the 262 children with CF in the study were vitamin D deficient, and the majority of these remained persistently so, despite getting restorative doses equal to or higher than the recommendations set by the Cystic Fibrosis Foundation.

The study looked at children with CF who were treated at the Johns Hopkins Children's Center between 2003 and 2006. The researchers found that 86% were vitamin D deficient in 2003, 50% in 2004, 54% in 2005, and 46% were deficient in 2006.

Comparing different weekly intakes of ergocalciferol, researchers found that the currently recommended 50,000 IU per week for 8 weeks was effective in only 33% of children with vitamin D deficiency, while increasing the therapy to twice a week was effective in 26%.

Delivering the same dose 3 times a week corrected the deficiency in just 43% of children. Vitamin D levels appeared to follow fluctuations in seasonal sun exposure, dropping sharply in the fall and winter and peaking during spring and summer.

"Clearly we haven't established an optimal dose for treating vitamin D deficiency and more research is needed to do so," said senior researcher Peter Mogayzel, MD, Johns Hopkins Children's Cystic Fibrosis Center. "But what we know for sure is that the current recommendations are too low."

The authors suggest, based on the results of the study, that physicians consider increasing the vitamin D intake for patients with CF beyond the current recommendations in those who are vitamin D deficient. Vitamin D levels should be checked at least once a year in all CF patients and more frequently in those with abnormally low levels.


SOURCE: Johns Hopkins Medical Institutions

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