Vitamin D deficiency in patients with tuberculous meningitis and its relationship with treatment outcome

G V Dangeti1, S Mailankody1, C Neeradi1

  • 1Department of Medicine.

Abstract

Insights

Vitamin D deficiency is common in tuberculous meningitis (TBM) patients, but serum levels do not impact treatment outcomes or interleukin-1β levels. This study highlights the prevalence of vitamin D insufficiency in TBM.

Area of Science:

  • Neurology
  • Infectious Diseases
  • Endocrinology

Background:

  • Tuberculous meningitis (TBM) is a severe infection with limited data on vitamin D deficiency and treatment outcomes.
  • Vitamin D's potential immunomodulatory effects, possibly mediated by interleukin-1β (IL-1β), suggest a role in TBM pathogenesis.

Purpose of the Study:

  • To determine the frequency of vitamin D deficiency in TBM patients.
  • To investigate the association between vitamin D levels and TBM treatment outcomes.
  • To explore the correlation between vitamin D and IL-1β levels in cerebrospinal fluid (CSF).

Main Methods:

  • Prospective study of 40 human immunodeficiency virus-negative TBM patients in southern India.
  • Measurement of serum 25-hydroxy vitamin D (25[OH]D) and CSF IL-1β levels on pretreatment samples.
  • Definition of good outcome as survival without severe neurological disability.

Main Results:

  • Vitamin D deficiency (<20 ng/ml) was observed in 25% of patients, and insufficiency (20-30 ng/ml) in 30%.
  • Pretreatment serum 25(OH)D levels did not significantly differ between patients with good and poor outcomes (P = 0.141).
  • CSF IL-1β levels showed no significant correlation with serum 25(OH)D levels (Spearman's ρ = 0.083, P = 0.609).

Conclusions:

  • Vitamin D deficiency and insufficiency are prevalent in TBM patients.
  • Serum 25(OH)D levels are not associated with TBM treatment outcomes.
  • No correlation was found between serum vitamin D and CSF IL-1β levels in TBM patients.

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