Ciliary ultrastructural abnormalities in Mycoplasma pneumoniae pneumonia in 22 pediatric patients

Liang, Hui; Jiang, Wujun; Han, Qing; Liu, Feng; Zhao, Deyu

doi:10.1007/s00431-011-1609-0

Cited by 14 publications

(10 citation statements)

References 20 publications

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“…In our study, we found that the presence of mucus plugs was associated with longer time to radiographic clearance in patients with RMPP. Liang and her colleagues8 found that M. pneumoniae pneumonia with severe cilia abnormalities was associated with longer time to radiographic clearance, but they did not focus on analysis of the mucus plugs in the bronchoscopic findings. Mucus plug formation was actually a manifestation of severe cilia abnormalities.…”

Section: Discussionmentioning

confidence: 99%

Independent predictors for longer radiographic resolution in patients with refractoryMycoplasma pneumoniaepneumonia: a prospective cohort study

Huang

Jiang

et al. 2018

BMJ Open

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ObjectivesTo examine prospectively the radiographic clearance of refractory Mycoplasma pneumoniae pneumonia (RMPP) in immunocompetent children, and to identify independent predictors of time to complete radiographic resolution in patients with RMPP.DesignA prospective cohort study.SettingChildren’s Hospital of Soochow University, China.ParticipantsA total of 187 patients with RMPP treated with bronchoscopy were prospectively enrolled in the study between January 2012 and December 2015.MethodsSerial chest radiographs were obtained after discharge every 4 weeks up to a maximum of 24 weeks after diagnosis or until large infiltration on chest radiographs had resolved. Multivariate logistic regression was performed to identify independent predictors of time to complete radiographic resolution.ResultsOf the 187 patients with RMPP, bronchial mucus plug formation was detected in 73 (39.0%). C reactive protein (CRP) ≥50 mg/L, lactate dehydrogenase (LDH) ≥480 U/L, total fever duration ≥10 days and presence of mucus plugs were associated with longer time to radiographic clearance (all p<0.01). Compared with children without mucus plugs, those with mucus plugs were significantly more likely to have longer time to radiographic clearance (adjusted OR: 11.5; 95% CI 2.5 to 45.7; p<0.01).ConclusionClinicians might use duration of fever, CRP, LDH and presence of mucus plugs as parameters to identify children at a longer time to radiographic clearance in patients with RMPP.

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Section: Discussionmentioning

confidence: 99%

Independent predictors for longer radiographic resolution in patients with refractoryMycoplasma pneumoniaepneumonia: a prospective cohort study

Huang

Jiang

et al. 2018

BMJ Open

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“…The excessive inflammation reaction may lead to the immune disorder, which might be related to the severity of RMPP in children. Previous studies revealed that strong cellular immunological responses cause severe cilia abnormalities in RMPP1213. Severe cilia abnormalities reduce the immune function of the airways and disrupt mucociliary clearance, thereby causing the mucous plugs that are responsible for the development of large infiltrations or atelectasis on chest radiographs.…”

Section: Discussionmentioning

confidence: 99%

The clinical characteristics of corticosteroid-resistant refractory Mycoplasma Pneumoniae pneumonia in children

Wei

Jiang

Hao

2016

Sci Rep

Self Cite

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To analyze the clinical characteristics of corticosteroid-resistant refractory Mycoplasma pneumoniae pneumonia (RMPP) and explore the related factors that predict corticosteroid-resistant RMPP. Retrospective analysis of 183 children with RMPP in our hospital admitted between January 1, 2012, and December 31, 2014 was performed. Of the 183 RMPP cases, 36 (19.7%) were corticosteroid-resistant RMPP cases. Corticosteroid-resistant RMPP cases had a longer duration of fever and hospitalization compared with corticosteroid-sensitive RMPP cases (P < 0.05). The radiographic findings of 123 (83.7%) cases of corticosteroid-sensitive RMPP apparently resolved after one week of corticosteroid treatment compared with 4 (11.1%) corticosteroid-resistant RMPP cases that had apparently resolution (P < 0.01). Twenty-four (75%) corticosteroid-resistant RMPP patients who received bronchoscopy had mucus plug formation while none of the corticosteroid-sensitive RMPP patients had mucus plug formation (P < 0.05). Multiple logistic regression analysis showed that duration of fever ≥11 days, percentage of lymphocytes ≤32%, CRP ≥48.73 mg/L and LDH ≥ 545.7 U/L were significant predictors of corticosteroid-resistant RMPP. Patients with corticosteroid-resistant RMPP had more severe presentations and more serious radiological findings. Clinicians might use the parameters of duration of fever, CRP, LDH and proportion of lymphocytes to identify children at higher risk of corticosteroid-resistant RMPP.

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“…The procedure of BALF collection has been described elsewhere. [ 27 ] The bronchoscopy imaging and the MP detection in BALF were done 2 to 7 days postadmission; all other variables were routinely collected within 24 hours of admission.…”

Section: Methodsmentioning

confidence: 99%

The early examination of combined serum and imaging data under flexible fiberoptic bronchoscopy as a novel predictor for refractory Mycoplasma pneumoniae pneumonia diagnosis

Wang¹,

Lu²,

Feng³

et al. 2017

Medicine

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The treatment role of flexible bronchoscopy (FOB) for pediatric refractory Mycoplasma pneumoniae pneumonia (RMPP) has been well documented. Besides, the application indication of FOB is also studied in patients with general MPP (GMPP), especially in those with large pulmonary lesions. This study was designed to examine the diagnostic value of bronchoscopic features for RMPP.The FOB and bronchoalveolar lavage (BAL) were adopted for pediatric patients who showed clinical and radiograph indications. On the basis of the final diagnosis on discharge, patients were divided into general and refractory MPP groups. The clinical, laboratory, and bronchoscopic imaging features were retrospectively investigated between these 2 groups.From June 2012 to May 2014, a total of 62 RMPP and 101 GMPP patients were treated with therapeutic bronchoscopy. The comparison analysis showed that the CRP, HBDH, LDH were significantly different between RMPP and GMPP groups (all P < .001). In the bronchoscopic imaging, the mucus plug was significantly more commonly seen in the RMPP group (P < .001). Receiver operating characteristic (ROC) analysis revealed that the combined serum, clinical, and FOB imaging data possessed greater specificity and sensitivity than serum and clinical data alone.Our data suggest that the combined serum, clinical, and bronchoscopic imaging data might serve as a promising predictor for early RMPP diagnosis for pediatric patients with large pulmonary lesions.

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Ciliary ultrastructural abnormalities in Mycoplasma pneumoniae pneumonia in 22 pediatric patients

Cited by 14 publications

References 20 publications

Independent predictors for longer radiographic resolution in patients with refractoryMycoplasma pneumoniaepneumonia: a prospective cohort study

Independent predictors for longer radiographic resolution in patients with refractoryMycoplasma pneumoniaepneumonia: a prospective cohort study

The clinical characteristics of corticosteroid-resistant refractory Mycoplasma Pneumoniae pneumonia in children

The early examination of combined serum and imaging data under flexible fiberoptic bronchoscopy as a novel predictor for refractory Mycoplasma pneumoniae pneumonia diagnosis

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