TY - JOUR T1 - Are we effectively monitoring and treating vitamin D deficient patients with tuberculosis? JF - European Respiratory Journal JO - Eur Respir J VL - 42 IS - Suppl 57 SP - 4620 AU - James Murray AU - Lara Wood AU - Ajitha Jayaratnam Y1 - 2013/09/01 UR - http://erj.ersjournals.com/content/42/Suppl_57/4620.abstract N2 - INTRODUCTIONHypovitaminosis D is associated with active tuberculosis (TB). It is controversial whether the condition predisposes to TB infection or is a result of it.AIMSFollowing release of local guidelines on vitamin D replacement, the aim was to examine if vitamin D replacement was effective in TB patients prior to this.METHODSTB cases from March 2011 - March 2012 treated at King George Hospital were identified via London TB Register. The hospital pathology database identified patients that had vitamin D levels measured and if this had been rechecked following supplementation. Levels were classified as replete; insufficient; deficient. Chronic kidney disease patients were excluded.RESULTS124 patients had vitamin D levels measured and commenced on supplementation. Of these, 97 were deficient, 25 had insufficient levels and 2 were replete. 30 patients had vitamin D levels re-checked (mean interval of 184 days). Initial tests in this group showed that 7 patients had insufficient levels and 23 were deficient. Following supplementation, 6 patients had insufficient levels, 21 were deficient and 3 were replete. 12 patients had lower vitamin D levels than at diagnosis. 3 were unchanged.CONCLUSIONSResults suggest vitamin D supplementation was ineffective in TB patients. Causative mechanism(s) remain unclear but could be due to disease process, indicate lack of patient compliance or a need for local guidelines (primary and secondary care). Re-audit in line with local guidelines and anticipated NICE guidelines may add clarity as to the causative mechanism(s). ER -