scholarly journals Clinical characteristics of refractory Mycoplasma pneumoniae pneumonia in children treated with glucocorticoid pulse therapy

2021 ◽  
Author(s):  
Zhenli Zhu ◽  
Tongqiang Zhang ◽  
Wei Guo ◽  
Yaoyao Ling ◽  
Jiao Tian ◽  
...  
Keyword(s):  
Clinical Features ◽  
Mycoplasma Pneumoniae ◽  
Pulse Therapy ◽  
Roc Curve Analysis ◽  
Related Factors ◽  
Laboratory Findings ◽  
Usage Rate ◽  
Group I ◽  
Group Ii ◽  
Mycoplasma Pneumoniae Pneumonia

Abstract Background: To observe the effect of corticosteroids in the treatment of children with refractory Mycoplasma pneumoniae pneumonia(RMPP) under different doses, to summarize the clinical features of children treated with glucocorticoid pulse therapy.Methods: The clinical data of 125 children with RMPP hospitalized in Tianjin Children's Hospital from September 2018 to October 2019 were retrospectively analyzed. They were divided into two groups according to the dose of hormone. Compare the clinical features, laboratory findings, and imaging between the two groups of children, and use meaningful related indicators as ROC curves to find reference indicators for pulse therapy.Results: (1)The median age of the group II was older than that of the group I(P<0.05).(2)We found more severe presentations, higher incidence of extra-pulmonary complications and more serious radiological findings in group II, which needed oxygen more often, higher the hormone amount, higher usage rate of gamma globulin, higher usage rate of bronchoscopy, and higher incidence of plastic bronchitis(P<0.05).(3)WBC, CRP, LDH, FER, D-D dimer, APTT, TT, PCT, IL-6 and the percentage of neutrophils in peripheral blood in Group II were higher than those in Group I(P<0.05).(4)In ROC curve analysis, CRP, LDH, FER, and neutrophils of leukocyte classification were independent related factors that could be used as valuable predictors of methylprednisolone pulse therapy for RMPP in children. The cut-off values were CRP44.45mg/L, LDH590IU/L, FER411ng/L, and neutrophils in leukocyte classification were 73.75%, respectively.Conclusion: CRP≥44.45mg/L, LDH≥590IU/L, FER≥411ng/L, neutrophil≥73.75%, lung consolidation and pleural effusion are found in RMPP patients, which should be treated with pulse dose of methylprednisolone in time to reduce the incidence of severe RMPP and the occurrence of severe sequelae.

scholarly journals Clinical characteristics of refractory mycoplasma pneumoniae pneumonia in children treated with glucocorticoid pulse therapy

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Zhenli Zhu ◽  
Tongqiang Zhang ◽  
Wei Guo ◽  
Yaoyao Ling ◽  
Jiao Tian ◽  
...  
Keyword(s):  
Clinical Features ◽  
Mycoplasma Pneumoniae ◽  
Pulse Therapy ◽  
Roc Curve Analysis ◽  
Related Factors ◽  
Laboratory Findings ◽  
Usage Rate ◽  
Group I ◽  
Group Ii ◽  
Mycoplasma Pneumoniae Pneumonia

Abstract Background To observe the effect of corticosteroids in the treatment of children with refractory Mycoplasma pneumoniae pneumonia (RMPP) under different doses, to summarize the clinical features of children treated with glucocorticoid pulse therapy. Methods The clinical data of 125 children with RMPP hospitalized in Tianjin Children’s Hospital from September 2018 to October 2019 were retrospectively analyzed. They were divided into two groups according to the dose of hormone. Compare the clinical features, laboratory findings, and imaging between the two groups, and use meaningful related indicators as ROC curves to find reference indicators for pulse therapy. Results (1) The median age of the group II was older than that of the group I(P < 0.05). (2) We found more severe presentations, higher incidence of extra-pulmonary complications and more serious radiological findings in group II, which needed oxygen more often, higher the hormone, higher usage rate of gamma globulin, higher usage rate of bronchoscopy, and higher incidence of plastic bronchitis(P < 0.05). (3) WBC, CRP, LDH, FER, D-D dimer, APTT, TT, PCT, IL-6 and the percentage of neutrophils in peripheral blood in Group II were higher than those in Group I(P < 0.05). (4) In ROC curve analysis, CRP, LDH, FER, and neutrophils of leukocyte classification were independent related factors that could be used as valuable predictors of methylprednisolone pulse therapy for RMPP in children. The cut-off values were CRP44.45 mg/L, LDH590IU/L, FER411ng/L, and neutrophils in leukocyte classification were 73.75%, respectively. Conclusion CRP ≥ 44.45 mg/L, LDH ≥ 590 IU/L, FER ≥ 411 ng/L, neutrophil≥73.75%, lung consolidation, and pleural effusion may be predictors that guide the treatment of RMPP with pulse dose of GC.

scholarly journals Clinical characteristics of refractory Mycoplasma pneumoniae pneumonia in children treated with glucocorticoid pulse therapy

2021 ◽  
Author(s):  
Zhenli Zhu ◽  
Tongqiang Zhang ◽  
Wei Guo ◽  
Yaoyao Ling ◽  
Jiao Tian ◽  
...  
Keyword(s):  
Clinical Features ◽  
Mycoplasma Pneumoniae ◽  
Pulse Therapy ◽  
Roc Curve Analysis ◽  
Related Factors ◽  
Laboratory Findings ◽  
Usage Rate ◽  
Group I ◽  
Group Ii ◽  
Mycoplasma Pneumoniae Pneumonia

Abstract Background: To observe the effect of corticosteroids in the treatment of children with refractory Mycoplasma pneumoniae pneumonia (RMPP) under different doses, to summarize the clinical features of children treated with glucocorticoid pulse therapy.Methods: The clinical data of 125 children with RMPP hospitalized in Tianjin Children's Hospital from September 2018 to October 2019 were retrospectively analyzed. They were divided into two groups according to the dose of hormone. Compare the clinical features, laboratory findings, and imaging between the two groups, and use meaningful related indicators as ROC curves to find reference indicators for pulse therapy.Results: (1)The median age of the group II was older than that of the group I(P<0.05).(2)We found more severe presentations, higher incidence of extra-pulmonary complications and more serious radiological findings in group II, which needed oxygen more often, higher the hormone, higher usage rate of gamma globulin, higher usage rate of bronchoscopy, and higher incidence of plastic bronchitis(P<0.05).(3)WBC, CRP, LDH, FER, D-D dimer, APTT, TT, PCT, IL-6 and the percentage of neutrophils in peripheral blood in Group II were higher than those in Group I(P<0.05).(4)In ROC curve analysis, CRP, LDH, FER, and neutrophils of leukocyte classification were independent related factors that could be used as valuable predictors of methylprednisolone pulse therapy for RMPP in children. The cut-off values were CRP44.45mg/L, LDH590IU/L, FER411ng/L, and neutrophils in leukocyte classification were 73.75%, respectively.Conclusion: CRP≥44.45mg/L, LDH≥590IU/L, FER≥411ng/L, neutrophil≥73.75%, lung consolidation and pleural effusion are found in RMPP patients, which could be treated with pulse dose of methylprednisolone in time to reduce the incidence of severe RMPP and the occurrence of severe sequelae.

scholarly journals Clinical characteristics of refractory Mycoplasma pneumoniae pneumonia in children treated with glucocorticoid pulse therapy

2020 ◽  
Author(s):  
Zhenli Zhu ◽  
Tongqiang Zhang ◽  
Wei Guo ◽  
Yaoyao Ling ◽  
Jiao Tian ◽  
...  
Keyword(s):  
Mycoplasma Pneumoniae ◽  
Clinical Characteristics ◽  
Clinical Manifestations ◽  
Pulse Therapy ◽  
Methylprednisolone Pulse Therapy ◽  
Methylprednisolone Pulse ◽  
Conventional Dose ◽  
Group I ◽  
Group Ii ◽  
Mycoplasma Pneumoniae Pneumonia

Abstract Objective: To observe the effect of corticosteroids in the treatment of children with refractory Mycoplasma pneumoniae pneumonia（RMPP）under different doses, to summarize the clinical characteristics of children treated with glucocorticoid pulse therapy.Methods: The clinical data of 125 children with RMPP hospitalized in Tianjin Children's Hospital from September 2018 to October 2019 were retrospectively analyzed. They were divided into two groups according to the dose of hormone. Group I was given conventional dose methylprednisolone 2mg/kg/day (<200mg/day) (n=81), and group II was treated with methylprednisolone pulse therapy ≥200mg/day(n=44). Compare the clinical manifestations, laboratory findings, and imaging between the two groups of children, and use meaningful related indicators as ROC curves to find reference indicators for pulse therapy.Results: (1)The age and weight of the group II were greater than the group I（P<0.05）. (2) The symptoms of group II were more serious than group I, with higher incidence of hypoxemia, longer fever, longer hospital stays, higher incidence of extrapulmonary complications, and more severe radiological findings (P<0.05). (3)The more severe the disease was, the higher hormone amount，use rate of gamma globulin，use rate of bronchoscopy , and incidence of plastic bronchitis (P<0.05)were.(4) WBC, CRP, LDH, FER, D-D dimer, APTT, TT, PCT, IL-6 and the percentage of neutrophils in peripheral blood in Group II were higher than those in Group I(P<0.05). Moreover, the lymphocyte percentage level in group II was lower than that in group I(P<0.05). (5) In ROC curve analysis, CRP, LDH, FER, and neutrophils of leukocyte classification were independent related factors that could be used as valuable predictors of methylprednisolone pulse therapy for RMPP in children. The cut-off values were CRP 44.45 mg/L, LDH 590 IU/L, FER 411 ng/L, and neutrophils in leukocyte classification were 73.75%, respectively.Conclusions: Conventional dose methylprednisolone can improve the clinical symptoms and imaging findings of most children with RMPP rapidly. However, CRP 44.45 mg/L, LDH 590 IU/L, FER 411 ng/L, neutrophil 73.75%, lung consolidation and pleural effusion were found in RMPP patients, which should be treated with pulse dose of methylprednisolone in time to reduce the incidence of severe RMPP and the occurrence of severe sequelae.

scholarly journals Insights into the Therapeutic of Glucocorticoid for Refractory Mycoplasma Pneumoniae Pneumonia in Children

2020 ◽  
Author(s):  
Zhenli Zhu ◽  
Tongqiang Zhang ◽  
Wei Guo ◽  
Yaoyao Ling ◽  
Jiao Tian ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Regression Analysis ◽  
Mycoplasma Pneumoniae ◽  
Logistic Regression Analysis ◽  
Roc Curve ◽  
Severe Illness ◽  
Group Iii ◽  
Group I ◽  
Group Ii ◽  
Mycoplasma Pneumoniae Pneumonia

Abstract Objective To observe the efficacy and safety of different doses of glucocorticoid for refractory mycoplasma pneumoniae pneumonia in children, analyze the clinical characteristics in different groups of patients, and explore the factors related to affect illness severity for children with refractory mycoplasma pneumoniae pneumonia and guide the dosage of glucocorticoids.Methods Retrospective analysis was performed on 279 children with refractory mycoplasma pneumoniae pneumonia hospitalized in our hospital between September 2018 and October 2019. 23 children were excluded, the remaining 256 children were divided into three subgroups: Group I was not given methylprednisolone (n=75), group II (n=115) was given methylprednisolone ≤125mg/d, and group III was given methylprednisolone >125mg/d (n=66). The clinical features, laboratory data, radiological manifestations between three subgroups of children were compared, relevant indicators with meaningful were used for ROC curve and multiple logistic regression analysis, and the optimal values of related factors were analyzed.Results The median age and median weight of the group III were greater than the group II（P <0.05）, the median age and median weight of the group I were greater than the group II（P <0.05）, there was no statistical significance in median age and median weight between group III and group I（P>0.05）. The group II is more serious than that of group I, and group III is more serious than that of group II, higher incidence of hypoxemia, longer fever, longer hospital stays, higher incidence of extrapulmonary complications, and more severe of radiological findings (P <0.05). The more severe presentation of disease, hormones dosage was larger, the use rate of gamma globulin was higher, the use rate of bronchoscopy was higher, and higher incidence of plastic bronchitis (P <0.05). Meanwhile, WBC, CRP, LDH, FER, D-D dimer, APTT, PLT, PCT, IL-6, ALT and the percentage of neutrophils in the three groups showed a gradual upward trend (P <0.05). In ROC curve analysis, WBC, neutrophils percentage, CRP, LDH, Fer, PCT and IL-6 can be used to distinguish RMPP with different severity and to guide the dosage of glucocorticoids. Multivariate logistic regression analysis showed that LDH 424.5IU/L, PCT 0.145ng/ml, IL-6 26.69pg/ml and lung consolidation were significant predictors for the severity of RMPP and glucocorticoids dose.Conclusions LDH 424.5IU/L, PCT 0.145 ng/ml, IL-6 26.69pg/ml and pulmonary consolidation as markers of disease severity in patients with RMPP and the dosage of glucocorticoids, which can aid in early recognition of children with severe illness, use appropriate doses of hormones, and reduce sequelae.

scholarly journals Early prediction of necrotizing pneumonia from mycoplasma pneumoniae pneumonia with large pulmonary lesions in children

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Yunlian Zhou ◽  
Mengting Hu ◽  
Bei Ye ◽  
Zhimin Chen ◽  
Yuanyuan Zhang
Keyword(s):  
Mycoplasma Pneumoniae ◽  
Clinical Manifestations ◽  
Necrotizing Pneumonia ◽  
Radiological Findings ◽  
Roc Curve Analysis ◽  
Laboratory Findings ◽  
Pulmonary Lesions ◽  
Ct Value ◽  
Ifn Γ ◽  
Mycoplasma Pneumoniae Pneumonia

Abstract To compare the different features of necrotizing pneumonia (NP) and non-NP (NNP) caused by Mycoplasma pneumoniae pneumonia (MPP) with large pulmonary lesions, and explore the predictor for NP to differentiate from MPP. A retrospective study of MPP patients with large pulmonary lesions hospitalized from January 2008 to December 2019 was enrolled, and clinical manifestations, laboratory findings, radiological findings were analyzed. Of 135 MPP patients with large pulmonary lesions, 56 were in the NP group, 79 were in the NNP group. We found the median length of fever days were much longer in NP group than those in NNP group. Higher levels of WBC, CRP, LDH, IL-6 in NP group were observed. Furthermore, the incidence of pulmonary consolidation was much higher in NP patients than that in NNP patients, while the CT value of large pulmonary lesion was much lower in NP patients. In ROC curve analysis, the cut-off values for the CT value and IFN-γ were 36.43 and 7.25 pg/ml, respectively. NP caused by MPP might be easier to suffer from prolonged clinical course, severe laboratory and radiological findings. CT value of large pulmonary lesions and IFN-γ could be used as biomarkers to predict NP from MPP with large pulmonary lesions in children.

scholarly journals Malformations of Cortical Development, Cognitive Involvementand Epilepsy: A Single Institution Experience in 19 Young Patients

Children ◽  
2021 ◽  
Vol 8 (8) ◽  
pp. 637
Author(s):  
Valeria Venti ◽  
Maria Chiara Consentino ◽  
Pierluigi Smilari ◽  
Filippo Greco ◽  
Claudia Francesca Oliva ◽  
...  
Keyword(s):  
Clinical Features ◽  
Cortical Development ◽  
Young Patients ◽  
Cortical Dysplasia ◽  
Drug Resistant ◽  
Malformations Of Cortical Development ◽  
Group Iii ◽  
Group I ◽  
Cognitive Involvement ◽  
Group Ii

Background. Malformations of cortical development (MCD) include a wide range of congenital disorders mostly causing severe cognitive dysfunction and epilepsy. Objective: to report on clinical features including cognitive involvement, epileptic seizures with response to antiseizure medications, comorbidities in young patients affected by MCD and followed in a single tertiary hospital. Patients and methods: A retrospective review of the medical records and magnetic resonance images (MRI) of 19 young patients with an age ranging between eight days and fifteen years affected by MCD and admitted to Pediatrics Department University of Catania, Italy from October 2009 and October 2020 were selected. Patients were distinguished in three groups following the Barcovich et al. 2012 classification for MCD: 4 (21%) in Group I; 8 (42%) in Group II; and, and 7 (37%) in Group III. Clinical features and MRI of the patients including cognitive involvement, epilepsy type and response to drugs treatment were analyzed. Results: In Group I, two patients showed cortical dysplasia and two dysembryoplastic neuroepithelial tumors plus focal cortical dysplasia; developmental delay/intellectual disability (DD/ID) was severe in one, moderate in one and absent in two; the type of seizures was in all the cases focal to bilateral tonic-clonic (FBTCs), and drug resistant was found in one case. In Group II, three patients showed neuronal hetero-topias and five had pachygyria-lissencephaly: DD/ID was severe in four, moderate in two, and absent in two; the type of seizure was focal (FS) in five, focal to bilateral tonic-clonic (FBTCs) in two, infantile spasms (IS) in one, and drug resistant was found in three. In Group III, six showed polymicrogyria and one schizencephaly: DD/ID was found severe in five, moderate in two, and the type of seizure was focal (FS) in five, FBTCS in two, and drug resistance was found in three.

scholarly journals Correlation between chest radiographic findings and clinical features in hospitalized children with Mycoplasma pneumoniae pneumonia

PLoS ONE ◽  
2019 ◽  
Vol 14 (8) ◽  
pp. e0219463 ◽  
Author(s):  
Yeon Jin Cho ◽  
Mi Seon Han ◽  
Woo Sun Kim ◽  
Eun Hwa Choi ◽  
Young Hun Choi ◽  
...  
Keyword(s):  
Clinical Features ◽  
Mycoplasma Pneumoniae ◽  
Hospitalized Children ◽  
Radiographic Findings ◽  
Mycoplasma Pneumoniae Pneumonia
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