Open Access Maced J Med Sci. 2023 May 26; 11(B):571-575. 571 Scientifc Foundation SPIROSKI, Skopje, Republic of Macedonia Open Access Macedonian Journal of Medical Sciences. 2023 May 26; 11(B):571-575. https://doi.org/10.3889/oamjms.2023.11618 eISSN: 1857-9655 Category: B - Clinical Sciences Section: Pediatrics The Average of Serum 25(OH)D in Children with Chronic Tonsillitis Melati Sudiro* , Arif Dermawan , Alfra Ulfa Department of Otorhinolaryngology-Head and Neck Surgery, Faculty of Medicine, Universitas Padjadjaran, Dr. Hasan Sadikin General Hospital, Bandung, Indonesia Abstract AIM: This study aims to determine serum 25(OH)D levels in children with chronic tonsillitis at Dr. Hasan Sadikin Bandung General Hospital. METHODS: This descriptive and cross-sectional study was conducted in patients with chronic tonsillitis aged 3–15 years from August 26, 2021, to April 26, 2022. The exclusion criteria include children who consumed Vitamin D for the past month, are in ongoing treatment for chronic tonsillitis, and have comorbidities that afect Vitamin D serum. Characteristics were taken from anamnesis, while Vitamin D serum was analyzed using the ELISA method, then data were presented in numbers and percentages. RESULTS: The average serum level of 25(OH)D was 16.43 ± 3.5 ng/mL. All 44 subjects sufered from a lack of Vitamin D, categorized as defciency, insufciency, and severe defciency, at 72.7%, 22.7%, and 4.6%, respectively. The majority of the cases were boys compared to girls, with 70.5% and 29.5%, respectively. CONCLUSION: All children with chronic tonsillitis were found to have 25(OH)D serum below the normal level, with an average of 16.43 ± 3.5 ng/mL, especially in boys aged 3–10 years. Edited by: Ksenija Bogoeva-Kostovska Citation: Sudiro M, Dermawan A, Ulfa A. The Average of Serum 25(OH)D in Children with Chronic Tonsillitis. Open Access Maced J Med Sci. 2023 May 26; 11(B):571-575. https://doi.org/10.3889/oamjms.2023.11618 Keywords: Chronic tonsillitis; Vitamin D level; Serum 25(OH)D *Correspondence: Melati Sudiro, Department of Otorhinolaryngology-Head and Neck Surgery, Faculty of Medicine Universitas Padjadjaran/Dr. Hasan Sadikin General Hospital, Bandung, Indonesia. Phone: +628112212745, E-mail: melati.sudiro@unpad.ac.id Received: 24-Mar-2023 Revised: 04-Apr-2023 Accepted: 16-May-2023 Copyright: © 2023 Melati Sudiro, Arif Dermawan, Alfra Ulfa Funding: This research did not receive any fnancial support. Competing Interests: The authors have declared that no competing interests exist. Open Access: This is an open-access article distributed under the terms of the Creative Commons Attribution- NonCommercial 4.0 International License (CC BY-NC 4.0) Introduction The Tonsils are a set of lymphoid organs, that play an important role in the immune system, which is known as Waldeyer’s ring and consists of the two Palatine tonsils, Adenoid tonsils, and the Lingual tonsils. Waldeyer’s ring protects the digestive and respiratory tract against pathogens. In children, the palatine tonsils are the most active when an antigen enters the body [1]. Chronic tonsillitis is an infammation of the lymphoid organs, mostly palatine tonsils, that persists due to acute or subclinical infection lasting for more than 3 months and characterized by crypts widening and hypertrophic or atrophic tonsils. Furthermore, its diagnosis is made when there is a history of chronic tonsillitis 3–4 times a year with no improvement after administering adequate antibiotics [1], [2]. Chronic tonsillitis is rarely seen in children <2 years old due to the less active immune system of the tonsils [1]. According to Bakar et al., the highest distribution of chronic tonsillitis occurs at the age of 1–10 years, accounting for 36% [2]. However, Haidara et al. reported that the peak incidence of chronic tonsillitis occurred at the age of 5–14 years at 50% [3]. Another study reported that more than half, accounting for 55.97%, of 2176 chronic tonsillitis patients were in the age range of 0–15 years [4]. The incidence of chronic tonsillitis in children varies among countries. According to Haidara et al., there are 40 million cases annually in the United States, 9 million in France, and 4 million in Spain [3]. Riskesdas 2018 reported that the prevalence of upper respiratory tract infections, including tonsillitis was 9.3% [5]. In addition, approximately 145 cases of children were reported at the Laryngo-pharyng division Otorhinolaryngology-Head and Neck Surgery (ORL- HNS) clinic in Dr. Hasan Sadikin Hospital (RSHS) from 2015 to 2020. The mechanism of chronic tonsillitis is unclear, but tonsils are known to prevent infections. The immune system, environmental factors, and pathogens are also known to play an important role in the occurrence of chronic tonsillitis. Another factor currently associated with chronic tonsillitis is Vitamin D defciency, which participates in immune system regulation, both innate and adaptive immune response [6], [7]. According to Yildiz et al., Vitamin D defciency was found in 4.7% of children with chronic tonsillopharyngitis [8]. Bergman et al. reported that oral Vitamin D supplementation can reduce the severity and prevent respiratory tract infections in Since 2002