الفهرس 
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Abstract
Asthma is also known as bronchial asthma, basically it is a chronic airway inflammation with a very high incidence in children. Asthma symptoms in children are more significantly noticed at night or early morning. The symptom can be relieved by the appropriate treatment therapy.
Previous studies have shown that children with mild to moderate asthma who also had low serum vitamin D levels had poor asthma control, more exacerbations, more hospitalizations in the previous year, decreased lung function, reduced responses to inhaled corticosteroids (ICS), and consequently, increased ICS use.
The work aimed to study any possible beneficial effect of Vitamin D supplementation on control of pediatric asthma.
This prospective controlled study was conducted on Sixty asthmatic children of both sexes divided into three equal groups according to asthma control test score.
group I: Twenty asthmatic children with controlled asthma.
group II: Twenty asthmatic children with partially controlled asthma. group III: Twenty asthmatic children with uncontrolled asthma.
This study performed in Pediatric Department in Menoufia University Hospital on asthmatic children attending to pediatric chest clinic and pediatric emergency room after obtaining Institutional ethical committee approval and informed consents from children’s parents.
Inclusion Criteria: Asthmatic children aged between 3 and 15y, both sexes and diagnosed by the history and clinical examination (coughing, particularly at night, wheezing, difficulty breathing, chest pain, tightness or discomfort, challenge testing and chest X-ray was included in the study).
Exclusion Criteria: Patients on immunotherapy or anti IgE, those on drugs which might affect vit D like phenytoin and phenobarbitone. Also, impaired renal function and chronic liver disease, Obesity, Disease of calcium or bone metabolism. Additionally, respiratory tract infection within past 4 weeks and Parenchymal or pleural disease, finally, those on vitamin D supplementation.
All Patients were subjected to:
- Detailed history such as age, onset of disease, progression, duration of illness, symptoms, aggravating factors…. etc.
- Clinical examination including their weight, height, and signs of vit D deficiency.
- Complete blood count including Hb, platelet, WBCs, RBCs, Eosinophil.
- Liver function including AST and ALT
- Renal function including urea and creatinine - Serum 25(OH)D3 measured before its supplementation and two months after by ELISA reader-TECAN Infinite F50
Results of the current study could be summarized as follow:
There was significant male predominance in group II compared with group III and group I (P<0.05).
Summary
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There was statistically significant increase in group III than the other groups regarding weight and height percentile (P<0.05).
Vitamin D level was significantly improved after supplementation in group I, group II and group III with mean (32.9±2.57, 24.39±3.28, 22.8±3.14 ng/ml) respectively then before supplementation with mean (17.02±2.067, 14.75±3.49, 14.56±5.23 ng/ml) in group I, group II and group III respectively.
A high statistically significant increase was observed in mean scores of ACT (Asthma Control Test) after supplementation of Vitamin D with mean (23.3±1.22 and 18.6±3.38) in group II and group III respectively than before with mean (20.1 ±0.986 and 11.2±2.19) respectively.
A high statistically significant increase was observed among asthmatic children in group III regarding levels of ACT (Asthma Control Test) after supplementation of Vitamin D than before.
There was a statistically significant difference regarding level of reliever medication per week among asthmatic children in group II and group III after supplementation of Vitamin D compared to before.
There were significant negative correlations between vitamin D level change after supplementation regarding all variables of study except for age at onset and number of hospital admissions revealed no significant correlation.
Also, there was a significant positive correlation between vitamin D level change after supplementation and ACT.
Vit D level, had sensitivity of 94.7% and specificity of 100% in diagnosing of asthma in children.