Low serum vitamin D levels and recurrent inflammatory spinal cord disease

Background: Low 25-hydroxyvitaminDlevels have been associated with a higher risk of developing multiple sclerosis and increased relapse rates in patients with multiple sclerosis. As a sterol hormone involved in multiple immunologic pathways, vitamin D may play a role in preventing monophasic immune-mediated central nervous system attacks from developing into recurrent disease. Objective: To investigate the association between low serum vitamin D levels and recurrent spinal cord disease. Design, Setting, and Patients: We performed a retrospective analysis at Johns Hopkins Transverse Myelitis Center, Baltimore, Maryland, evaluating 25- hydroxyvitamin D levels in 77 patients with monophasic and recurrent inflammatory diseases of the spinal cord. Main Outcome Measure: Levels of 25-hydroxyvitamin D. Results: Vitamin D levels are significantly lower in patients who developed recurrent spinal cord disease, adjusting for season, age, sex, and race. Conclusions: This study provides a basis for a prospective trial of measuring 25-hydroxyvitaminDlevels in these patient populations and assessing the influence of vitamin D supplementation on the frequency of relapses in those with recurrent inflammatory spinal cord disease.