Assessment of micronutrients in pediatric vertigo

Year 2024, Volume: 10 Issue: 2, 140 - 147, 30.08.2024

Hilal Aydın , İbrahim Bucak , Mehmet Geyik

https://doi.org/10.30569/adiyamansaglik.1441127

Abstract

Aim: This study aimed to evaluate the clinical characteristics of patients admitted to the pediatric neurology outpatient clinic with the complaint of vertigo and to investigate the role of micronutrients in the etiology of vertigo
Materials and Methods: This study retrospectively evaluated the patients aged four to 18 years who were admitted to the pediatric neurology outpatient clinic with the complaint of vertigo to evaluate the clinical characteristics and the role of micronutrients in the etiology of vertigo. Patients, for whom the Z00.1 code, the routine child health examination code, was entered in the pediatric outpatient clinic in the same period when the patients presented with the complaint of vertigo were included as the healthy control group. Hemogram and hormone profiles [25(OH)D, FT4, TSH, vitamin B12, folic acid and ferritin] of the groups were compared.
Results: There was no statistically significant difference between the study group and healthy controls in terms of age and gender. Hematocrit (p<0.001), platelet (p<0.001), vitamin B12 (p=0.015), vitamin D (p=0.043) and TSH (p=0.013) levels were found to be significantly lower in the vertigo group compared to the control group.
Conclusion: The importance of micronutritional deficiencies cannot be denied in patients presenting with vertigo symptoms. Main point that makes our study valuable is that there are limited number of studies in the literature comparing laboratory parameters of pediatric patients with vertigo symptoms and healthy controls. There is a need for prospective studies, involving more cases and awareness on this issue.

Keywords

Children, Deficiency, Micronutrient, Vertigo, Vitamin

Ethical Statement

Ethics committee approval was obtained with the decision of the Ethics Committee for Non-Interventional Procedures of Adiyaman University, numbered no.:2021/02-30. The principles of the Declaration of Helsinki conducted the research.

Supporting Institution

The authors received no financial support for the research, authorship, and/or publication of this article.

Thanks

None.

Pediatrik baş dönmesinde mikronutrisyon değerlerinin değerlendirilmesi

Abstract

Amaç: Bu çalışmada çocuk nörolojisi polikliniğine baş dönmesi şikâyeti ile başvuran hastaların klinik özelliklerinin değerlendirilmesi ve mikro besinlerin baş dönmesi etiyolojisindeki rolünün araştırılması amaçlandı.
Gereç ve Yöntem: Bu çalışma, çocuk nörolojisi polikliniğine vertigo şikayeti ile başvuran 4-18 yaş arası hastaların klinik özelliklerini ve vertigo etiyolojisinde mikro besinlerin rolünü değerlendirmek amacıyla retrospektif olarak değerlendirildi. Çocuk polikliniğine rutin çocuk sağlığı muayene kodu olan Z00.1 kodu girilen olgular sağlıklı kontrol grubu, vertigo şikâyeti ile başvuran hastalar çalışma grubu olarak kabul edildi. Grupların hemogram ve hormon profilleri [25(OH)D, FT4, TSH, B12 vitamini, folik asit ve ferritin] karşılaştırıldı.
Bulgular: Çalışma grubu ile sağlıklı kontroller arasında yaş ve cinsiyet açısından istatistiksel olarak anlamlı bir fark yoktu. Hematokrit (p<0,001), trombosit (p<0,001), B12 vitamini (p=0,015), D vitamini (p=0,043) ve TSH (p=0,013) düzeylerinin vertigo grubunda kontrol grubuna göre anlamlı derecede düşük olduğu görüldü.
Sonuç: Vertigo semptomlarıyla başvuran hastalarda mikronütrisyonel eksikliklerin önemi inkâr edilemez. Çalışmamızı değerli kılan en önemli nokta ise literatürde vertigo semptomlu çocuk hastalar ile sağlıklı kontrollerin laboratuvar parametrelerini karşılaştıran çalışmaların sınırlı sayıda olmasıdır. Bu konuda daha fazla olgu içeren ve farkındalığın arttığı prospektif çalışmalara ihtiyaç vardır.

Keywords

Vertigo, Vitamin, Mikrobesin, Çocuklar, Eksiklik

References

• Joseph M, Furman L CM. Vertigo. In: Swainman KF, Ashwal S, Ferriero DM SN, ed. Swaiman’s Pediatric Neurology Elsevier Saunders 2012:118-126.
• Niemensivu R, Pyykkö I, Wiener-Vacher SR, Kentala E. Vertigo and balance problems in children - An epidemiologic study in Finland. Int. J. Pediatr. Otorhinolaryngol. 2006; 70(2):259-265 https://doi.org/10.1016/j.ijporl.2005.06.015
• Harrison MS. Vertigo in childhood. J. Laryngol. Otol. 1962;76(8): 601-616 https://doi.org/10.1017/s0022215100059776
• Gruber M, Cohen-Kerem R, Kaminer M, Shupak A. Vertigo in children and adolescents: Characteristics and outcome. Scientific World Journal 2012;1-6 https://doi.org/10.1100/2012/109624
• Walls T, Teach SJ. Evaluation of dizziness and vertigo in children and adolescents. Uptodate. Published online 2020:1-29.
• Swain S, Munjal S, Shajahan N. Vertigo in children: Our experiences at a tertiary care teaching hospital of eastern India. J. Sci. Soc. 2020;47(2): 74 https://doi.org/10.4103/jss.JSS_20_20
• Bailey RL, West KP, Black RE. The epidemiology of global micronutrient deficiencies. Ann. Nut. Metab. 2015;66:22-33 https://doi.org/10.1159/000371618.
• Tulchinsky TH. Micronutrient Deficiency Conditions:Global Health Issues. Public Health Rev. 2010;32:243–255 https://doi.org/10.1186/s40985-017-0071-6
• Mahajan S, Aundhakar S. A study of the prevalence of serum vitamin B12 and folic acid deficiency in Western Maharashtra. J. Fam. Med. Prim Care 2015;4(1):64 https://doi.org/10.4103/2249-4863.152255.
• Langan RC, Zawistoski KJ. Update on vitamin B12 deficiency. Am Fam Physician 2011;83(12):1425-30.
• World Health Organization‎. Haemoglobin concentrations for the diagnosis of anaemia and assessment of severity. 2011.
• Holick MF, Binkley NC, Bischoff-Ferrari HA, et al. Evaluation, treatment, and prevention of vitamin D deficiency: An endocrine society clinical practice guideline. J. Clin. Endocrinol. Metab. 2011; 96(7):1911-1930 https://doi.org/10.1210/jc.2011-0385.
• Kennel KA, Drake MT, Hurley DL. Vitamin D deficiency in adults: When to test and how to treat. Mayo Clin. Proc. 2010; 85(8): 752-758 https://doi.org/10.4065/mcp.2010.0138.
• Zhang X, Liu Z, Xia L, Gao J, Xu F, Chen H, et al. Clinical features of vitamin D deficiency in children: A retrospective analysis. J Steroid Biochem. Mol. Biol. 2020;196 https://doi.org/10.1016/j.jsbmb.2019.105491.
• Georgieff MK, Ramel SE, Cusick SE. Nutritional influences on brain development. Acta Paediatr Int. J. Paediatr 2018;107(8):1310-1321 https://doi.org/10.1111/apa.14287.
• Serin HM, Arslan EA. Neurological symptoms of vitamin b12 deficiency: Analysis of pediatric patients. Acta Clin. Croat. 2019;58(2):295-302 https://doi.org/10.20471/acc.2019.58.02.13.
• Arıcan P, Bozkurt O, Cavusoglu D, Gencpınar P, Haspolat S, Duman O, et al. Various neurological symptoms with vitamin b12 deficiency and posttreatment evaluation. J Pediatr. Neurosci. 2020;15(4):365-369 https://doi.org/10.4103/jpn.JPN_130_19.
• Lee JH. Iron-deficiency anemia in children: From diagnosis to treatment. J. Korean Med. Assoc. 2016;59(9):678-682 https://doi.org/10.5124/jkma.2016.59.9.678.
• Mattiello V, Schmugge M, Hengartner H, von der Weid N, Renella R. Diagnosis and management of iron deficiency in children with or without anemia: consensus recommendations of the SPOG Pediatric Hematology Working Group. Eur J Pediatr 2020;179(4):527-545 https://doi.org/10.1007/s00431-020-03597-5.
• Erdoǧan E, Güzel Nur B, Olgac Dundar N. Vertigo in childhood: Evaluation of clinical and laboratory findings. Turkiye Klin. J. Med. Sci. 2012;32(6):1601-1606 https://doi.org/10.5336/medsci.2011-27059
• Yıldırım M, Doğan MT, Keçeli AM. Retrospective evaluation of patients consulted to the pediatric neurology department with dizziness/vertigo. Ege Journal of Medicine 2020;59(2):119-126 https://doi.org/10.19161/etd.756284
• Korkmaz MF, Ekici A. Retrospective review of children with vertigo: a 3-year experience. Eur. Res. J. 2020;6(5):449-456. https://doi.org/10.18621/eurj.630613
• Gülaçtı U, Lok U, Hatipoğlu S, et al. Assessment of vitamin B12 and folic acid deficiency in emergency department as a cause of acute presentation of dizziness. Acta Medica Mediterranea 2014;30:771.
• Dugeroglu H, Kaya Y. Evaluation of Vitamin B12 Deficiency in Patients with Dizziness Complaints. Firat University Health Science Medicine Journal 2018;32(3):123-127.
• Fried MP. The evaluation of dizziness in children. Laryngoscope 1980;90(9):1548-1560.
• Li CM, Hoffman HJ, Ward BK, et al. Epidemiology of Dizziness and Balance Problems in Children in the United States: A Population-Based Study. J Pediatr. 2016;171:240-7.e1-3. https://doi: 10.1016/j.jpeds.2015.12.002
• Devaraja K. Vertigo in children; a narrative review of the various causes and their management. Int. J. Pediatr. Otorhinolaryngol. 2018;111:32-38 https://doi.org/10.1016/j.ijporl.2018.05.028
• Erbek SH, Erbek SS, Yilmaz I, Topal O, Ozgirgin N, Ozluoglu LN, et al. Vertigo in childhood: A clinical experience. Int. J. Pediatr. Otorhinolaryngol. 2006;70(9):1547-1554 https://doi.org/10.1016/j.ijporl.2006.04.001
• Batu ED, Anlar B, Topçu M, Turanli G, Aysun S. Vertigo in childhood: A retrospective series of 100 children. Eur. J. Paediatr. Neurol. 2015;19(2):226-232 https://doi.org/10.1016/j.ejpn.2014.12.009
• Humphriss RL, Hall AJ. Dizziness in 10 year old children: An epidemiological study. Int. J. Pediatr. Otorhinolaryngol. 2011;75(3):395-400. https://doi.org/10.1016/j.ijporl.2010.12.015
• Bhandari A, Goswami A. Differential Diagnosis of Vertigo in Children. Ann. Otol. Neurotol. 2019;02(01):21-26.
• Ralli G, Atturo F, de Filippis C. Idiopathic benign paroxysmal vertigo in children, a migraine precursor. Int. J. Pediatr. Otorhinolaryngol. 2009;73 Suppl 1:S16-S18. https://doi.org/10.1016/S0165-5876(09)70004-7
• Balatsouras DG, Kaberos A, Assimakopoulos D, Katotomichelakis M, Economou NC, Korres SG. Etiology of vertigo in children. Int. J. Pediatr. Otorhinolaryngol 2007;71(3):487-494 https://doi.org/10.1016/j.ijporl.2006.11.024
• Furman JM, Marcus DA, Balaban CD. Migrainous vertigo: Development of a pathogenetic model and structured diagnostic interview. Curr. Opin. Neurol. 2003;16(1):5-13 https://doi.org/10.1097/01.wco.0000053582.70044.e2
• Gioacchini FM, Alicandri-Ciufelli M, Kaleci S, Magliulo G, Re M. Prevalence and diagnosis of vestibular disorders in children: A review. Int. J. Pediatr. Otorhinolaryngol. 2014;78(5):718-724 https://doi.org/10.1016/j.ijporl.2014.02.009
• Abu-Arafeh I, Russell G. Paroxysmal vertigo as a migraine equivalent in children: A population-based study. Cephalalgia 1995;15(1):22-25 https://doi.org/10.1046/j.1468-2982.1995.1501022.x
• Davitt M, Delvecchio MT, Aronoff SC. The Differential Diagnosis of Vertigo in Children A Systematic Review of 2726 Cases. Pediatr. Emerg. Care 2017;36(8):368-371 https://doi.org/10.1097/PEC.0000000000001281
• Karatoprak E, Sözen G, Yılmaz K. How often do neurological disorders lead to dizziness in childhood? Turk Arch Pediatr 2021;56(3): 249-53.