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

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.

Model based on the automated AI-Driven CT quantification is effective for the diagnosis of refractory Mycoplasma pneumoniae pneumonia

“…Some biomarkers linked to in ammatory reactions had been used to predict RMPP by previous studies 21,26 . The peak temperature in the RMPP group was signi cantly higher than that in the CMPP group on the rst day of admission 27 . These markers were higher in the RMPP group than in the CMPP group, implying that children with refractory M. pneumoniae pneumonia have more pronounced in ammatory responses.…”

“…After an MP infection, hepatic impairment is common extrapulmonary damage 21 . The study showed that the AST in the RMPP group was higher 27 .…”