RUHS Journal of Health Sciences (Sep 2023)

Evaluation of Clinical Significance of Vitamin D3 Status in Hospitalized Cases of Acute Febrile Illness with Thrombocytopenia in North-West Zone of Rajasthan

  • Bal Kishan Gupta , Nitesh Kumar Garwa , Shyam Lal Meena , Jigyasa Gupta , Gurmeet Singh , Suryalakshmi Kala C Thankom

DOI
https://doi.org/10.37821/ruhsjhs.8.3.2023.612

Abstract

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Introduction: Thrombocytopenia is an important haematological manifestation of acute febrile illness caused by a variety of infections. Besides the role of vitamin D3 in bone homeostasis, its significance in infections, inflammation, and immune response has also been documented. This study aimed to evaluate clinical significance of vitamin D3 status in patients of acute febrile illness with thrombocytopenia. Methodology: The present cross-sectional study was conducted on 400 patients of fever with thrombocytopenia admitted between May 2022 to October 2022. Laboratory evaluation including vitamin D3, complete blood count (CBC), renal function test (RFT), liver function test ( LFT), blood sugar, lactate dehydragenase (LDH), rapid diagnostic test for malaria, peripheral blood smear (PBS) for malaria parasite (MP), test for dengue, HBsAg, HCV, HIV, blood culture, D dimer, test for scrub typhus and leptospirosis, ultrasonography, and chest X-ray was also done in all the cases. Results: Out of 400 patients, 227 were males (mean age 5.46±15.63 years) and 173 females (mean age 39.75±17.36 years). Dengue fever was found to be the commonest cause (29.5%) followed by malaria, COVID-19 infection (0.75%), and one case each of HIV and Hepatitis B. Low level of vitamin D3 was found in 73.5% cases as compared to 17.5% in control subjects (p 0.2089), residence (p>0.97), comorbidities (p>0.248), and etiology (27.70±14.0, 27.45±11.96, 34.13±6.36, 28.79±26.04, respectively for dengue, malaria, COVID-19, and undiagnosed; p>0.609). Longer duration of illness at the time of hospitalization (p<0.02) and longer duration of hospital stay (p<0.04) was associated with lower vitamin D3 status. Low D3 status was associated with increased incidence of bleeding manifestations (p <0.05) and more requirement of platelet transfusion (p <0.017).

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