Increased Total Serum Immunoglobulin E Is Likely to Cause Complications of Mycoplasma pneumoniae Pneumonia in Children

ObjectiveTo investigate the correlation between serum immunoglobulin E (IgE) levels and the complications in children with Mycoplasma pneumoniae pneumonia (MPP).MethodsA retrospective study of MPP patients hospitalized from May 2019 to July 2021 was performed. We analyzed the clinical manifestations, complications, laboratory findings, and treatments.ResultsA total of 275 patients who met the inclusion criteria were enrolled in the study. We divided patients into two groups based on whether there were complications. Complications occurred in 147 patients, of which pulmonary complications were more common than extrapulmonary complications. The IgE level in the complication group was higher than that in the non-complication group with p = 0.041. Patients with complications of necrotizing pneumonitis, pneumothorax, skin rash, or bronchiolitis obliterans had higher IgE levels. There was no statistically significant difference in IgE levels between pulmonary complications and extrapulmonary complications. The older the age, the greater the probability of complications (p = 0.001). The group with complications was more likely to have chest pain (p = 0.000), while the group without complications was more likely to have wheezing (p = 0.017). The use of bronchoscopy and glucocorticoids was higher in the complication group than in the non-complication group (p = 0.000).ConclusionsMPP patients with higher IgE levels had more severe clinical symptoms and complications. We speculated that IgE might be a biomarker for complications after MP infection.

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

Scientific Reports ◽

10.1038/s41598-020-76083-5 ◽

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.

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Increased Total Serum Immunoglobulin E in Children Developing Mycoplasma pneumoniae-related Extra-pulmonary Diseases

Iranian Journal of Allergy Asthma and Immunology ◽

10.18502/ijaai.v17i5.307 ◽

2018 ◽

Cited By ~ 1

Author(s):

Dimitri Poddighe ◽

Elena Virginia Comi ◽

Ilaria Brambilla ◽

Amelia Licari ◽

Paola Bruni ◽

...

Keyword(s):

Mycoplasma Pneumoniae ◽

Immunoglobulin E ◽

Respiratory Infections ◽

Pulmonary Diseases ◽

Serum Immunoglobulin ◽

Total Serum ◽

Significant Elevation ◽

Serum Ige ◽

Group I ◽

Extra Pulmonary

Mycoplasma pneumoniae has been recognized to be involved in several extra-pulmonary diseases, but the underlying immunologic mechanisms are still largely unknown. Recently, we observed a significant elevation of serum Immunoglobulin E (IgE) in a small group of these children. Here, we assessed total serum IgE levels in children affected with Mycoplasma pneumoniae-related extra-pulmonary diseases. We prospectively collected the data of 162 children admitted to the hospital (because of respiratory infections or extra-pulmonary diseases) who were evaluated for Mycoplasma pneumoniae serology and total serum IgE levels, concomitantly. Based upon clinical and serology aspects, 3 groups of children were identified: I) with non-mycoplasma respiratory disease; II) with mycoplasma-related respiratory diseases; III) with extra-pulmonary diseases related to concomitant/recent Mycoplasma pneumoniae infection. Interestingly, children with Mycoplasma pneumoniae-related extra-pulmonary diseases showed a significant elevation of total serum IgE. In particular, patients developing Mycoplasma pneumoniae-related extra-pulmonary diseases (group III) showed significantly higher level of IgE than both previous groups (p<0.001 vs. group I; p<0.01 vs. group II). In conclusion, hospitalized children diagnosed with Mycoplasma pneumoniae-related extra-pulmonary diseases resulted to have significantly increased serum IgE compared to children developing respiratory illnesses only.

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

BMC Infectious Diseases ◽

10.1186/s12879-021-05830-4 ◽

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.

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Effect of Aerosol Inhalation of Budesonide Suspension on Clinical Efficacy, Remission Time of Asthma and Disappearance Time of Rales in Children with Mycoplasma Pneumoniae Pneumonia

Tobacco Regulatory Science ◽

10.18001/trs.7.5.1.75 ◽

2021 ◽

Vol 7 (5) ◽

pp. 3057-3062

Author(s):

TingTing Zheng ◽

XiNi Liu ◽

Xuechun Chen

Keyword(s):

Mycoplasma Pneumoniae ◽

Clinical Efficacy ◽

Oral Treatment ◽

Control Group ◽

Study Group ◽

Aerosol Inhalation ◽

Significant Difference ◽

Disappearance Time ◽

And Control ◽

Mycoplasma Pneumoniae Pneumonia

To investigate the effect of aerosol inhalation of budesonide suspension on clinical efficacy, remission time of asthma and disappearance time of rales in children with mycoplasma pneumoniae pneumonia. Methods: 100 cases of mycoplasma pneumoniae pneumonia in our hospital from February 2019 to February 2021 were randomly divided into study group (n = 50) and control group (n = 50). The control group was given azithromycin intravenous drip followed by oral treatment, and the study group was given aerosol inhalation of budesonide suspension on the basis of the control group. Results: Compared with the control group, disappearance time of rales in the study group, remission time of cough, remission time of asthma and time of hospitalization in the study group were relatively short (P<0.05), and the efficacy in the study group was relatively high (P<0.05). There was no significant difference in the incidence of nausea, vomiting, abdominal pain, diarrhea and hoarseness between the two groups (P>0.05). The improvement of FVCS FEV1 and PEF and other indexes was relatively high in the study group by comparing with the control group (P<0.05). Conclusion: Aerosol inhalation of budesonide suspension in children with mycoplasma pneumoniae pneumonia can effectively enhance the therapeutic effect, promote the improvement of lung function, and reduce the disappearance time of rales and remission time of asthma, so it can be popularized.

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Mutations in domain V of Mycoplasma pneumoniae 23S rRNA are not associated with clinical characteristics of M. pneumoniae pneumonia in children: a case control study

10.21203/rs.2.23539/v1 ◽

2020 ◽

Author(s):

Huan Deng ◽

Yifan Zhu ◽

Jiamin Zhang ◽

Qiangquan Rong ◽

Yao Quan ◽

...

Keyword(s):

Mycoplasma Pneumoniae ◽

Lymphocyte Count ◽

Clinical Characteristics ◽

Clinical Symptoms ◽

Laboratory Data ◽

Point Mutations ◽

Community Acquired Pneumonia ◽

Pulmonary Complications ◽

23S Rrna ◽

Domain V

Abstract Background Mycoplasma pneumoniae (MP) is a common agent of community-acquired pneumonia in children and young adults that can lead to refractory or persistent Mycoplasma pneumoniae pneumonia (MPP). Macrolide-resistant MP harbors point mutations in domain V of 23S ribosomal Ribonucleic Acid (rRNA) with substitutions detected at positions 2063, 2064, 2067 and 2617. This study’s purpose is to investigate the prevalence and clinical characteristics of mutations in domain V of MP 23S rRNA. Methods We sequenced the 23S rRNA domain V of MP strains collected from children with MPP. Clinical and laboratory data were also obtained, including gender, age, duration of fever, duration of fever after the start of macrolide therapy, MP-Deoxyribonucleic Acid (DNA) load at enrollment, leukocyte count, neutrophil count, and lymphocyte count, immunomodulators treatment and pulmonary complications.Results Of 276 strains, 255 (92.39 %) harbored A to G transition at the position 2063 (A2063G), and 21 (7.61 %) were not mutated. There were no significant differences in gender, age, duration of fever, duration of fever after the start of macrolide therapy, MP-DNA load at enrollment, hospitalization days, lymphocyte count and pulmonary complications when patients were stratified based on the presence or absence of domain V mutations. We also found that children with refractory MPP experienced higher MP-DNA load than the non-refractory MPP, but the prevalence of domain V mutations was comparable.Conclusions We found that clinical MP strains harbored very high mutation rate in 23S rRNA domain V, especially A2063G mutation. However, these mutations were not associated with clinical symptoms, laboratory results, pulmonary complications and development of refractory pneumonia. Instead, MP-DNA load was significantly different between refractory and non-refractory MPP.

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Correlation between Clinical Symptoms of Coeliac Disease, Serum IgA Anti TTG and Biopsy in Pediatric Population of Northern India

Asian Journal of Clinical Pediatrics and Neonatology ◽

10.47009/ajcpn.2020.8.1.16 ◽

2020 ◽

Vol 8 (1) ◽

pp. 65-68

Author(s):

Sumit Jeena ◽

Jaswinder Kaur ◽

Nishant Wadhwa

Keyword(s):

Coeliac Disease ◽

Clinical Symptoms ◽

Tissue Transglutaminase ◽

Pediatric Population ◽

Clinical Manifestations ◽

North India ◽

P Value ◽

Serum Iga ◽

Significant Difference ◽

The Mean

Background: Celiac disease is basically an immune-mediated enteropathic condition produced by permanent sensitivity to gluten in genetically susceptible subjects. There is paucity of data in north India regarding clinical symptoms of coeliac disease, Serum IgA Anti TTG and Biopsy in pediatric population. The present study was conducted with the aim to determine the correlation between clinical symptoms of coeliac disease, Serum IgA Anti TTG and Biopsy in pediatric population of northern India.Materials and Methods: The present study was conducted in prospective including 73 pediatric patients at Department of Pediatric Gastroenterology, Institute of Child Health, Sir Gangaram Hospital, New Delhi, India. Esophagogastroduodenoendoscopy and serum anti Ig A tissue transglutaminase were performed. The characteristic scalloping of the folds were looked for in endoscopy followed by four duodenal biopsies performed from second part of duodenum and histological grading was performed as per modified marsh system. Patients with Serum IgA anti tTG>20 U/ml were confirmed to be at risk. Complete histological work up was done including hemoglobin, RBC indices and peripheral blood smear examination. The association of clinical manifestations with disease grade was also established with correlation coefficient. All the data thus obtained was arranged in a tabulated form and analyzed using SPSS software. Probability value of less than 0.05 was regarded as significant.Results: There were 4 males and 16 females with marsh grade 1 and 2 and mean age of 7.3±1.9 years. There were 5 males and 8 females with marsh grade 3a and mean age of 6.8±2.3 years. The mean weight of 18.11±3.89, height of 103.17±8.73 and BMI of 16.26±3.78 was observed amongst subjects with Marsh grade 1 and 2. The mean weight of 15.12±3.17, height of 99.28±9.19 and BMI of 15.02±3.20was observed amongst subjects with Marsh grade 3a. Diarrhoea was maximum amongst subjects with grade 3c and 4(70%) and minimum amongst Grade 1 and 2 (40%). There was a significant difference between the frequency of anemia amongst different grades as the p value was less than 0.05.Conclusion: The most common presenting signs and symptoms were diarrhea and abdominal pain. The study also concluded that the incidence of anemia increases with higher marsh grades.

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The Value of Neutrophil/monocyte Ratio in Early Diagnosis of Children Mycoplasma Pneumoniae Pneumonia

10.21203/rs.3.rs-64768/v1 ◽

2020 ◽

Author(s):

Shasha Yao ◽

Yao Xie ◽

Fei Chen ◽

Xiao Chen ◽

Miao Zhang ◽

...

Keyword(s):

Platelet Count ◽

Early Diagnosis ◽

Blood Cell ◽

Mycoplasma Pneumoniae ◽

Viral Infections ◽

Clinical Symptoms ◽

Monocyte Count ◽

Neutrophil Lymphocyte Ratio ◽

Imaging Characteristics ◽

Mycoplasma Pneumoniae Pneumonia

Abstract Background:To investigate the value of blood cell analysis in early diagnosis of mycoplasma pneumoniae pneumonia (MP). Methods:The clinical parameters, including patient characteristics, clinical symptoms, imaging characteristics and laboratory examination data of the patients hospitalized in the Department of Pediatrics, Nanjing Jiangning Hospital from January 2018 to March 2020 due to community-acquired pneumonia were collected for retrospective analysis. The data were analyzed by SPSS 22.0 software for statistical analysis. P<0.05 was considered statistically significant.Results:The levels of white blood cell count (WBC), absolute neutrophil count (NEU), absolute monocyte count (MON), platelet count (PLT), neutrophil/lymphocyte ratio(NLR), mean platelet volume/platelet count (MPV/PLT) and neutrophil/monocyte ratio (NMR) in children with bacterial pneumonia (BP)were significantly higher than those of children withMP and children withviral pneumonia (VP), the NMR level in children withMP was higher than that of children with VP,the NMR levelsin the three groups of children were significantly different (P<0.05).Combined with the NMR level, the children’s age andpulmonary consolidation information,the AUC areas of MP, BP and VP had high accuracy fordifferential diagnosis of MP. Conclusion:As a comprehensive indicator of neutrophils and monocytes, NMR may differentiate pneumonia caused by mycoplasma pneumoniae, bacterial and viral infections, which provides new direction for early differential diagnosis of pneumonia.

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