Management of refractory Mycoplasma pneumoniae pneumonia: Utility of measuring serum lactate dehydrogenase level

Inamura, Norikazu; Miyashita, Naoyuki; Hasegawa, Shunji; Kato, Atsushi; Fukuda, Yoko; Saitoh, Aki; Kondo, Eisuke; Teranishi, Hideto; Wakabayashi, Tokio; Akaike, Hiroto; Tanaka, Takaaki; Ogita, Satoko; Nakano, Takashi; Terada, Kihei; Ouchi, Kazunobu

doi:10.1016/j.jiac.2014.01.001

Cited by 95 publications

(104 citation statements)

References 13 publications

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“…Another study showed that children with M. pneumoniae infection who were possible candidates for steroid therapy usually had significantly elevated levels of LDH (Ͼ 480 IU/L). 35 Inamura et al 13 performed ROC curve analysis and showed that the cutoff of LDH for refractory M. pneumoniae pneumonia was 410 IU/L. The cutoffs were greater than in our study.…”

Section: Discussioncontrasting

confidence: 50%

“…Based on a review of the literature, there are a few reports on the role of LDH, C-reactive protein, and ESR in refractory M. pneumoniae pneumonia, but they are limited to case series. 4,13,14 In this study, we explored whether LDH, Creactive protein, and ESR are potential laboratory markers that could be used to predict refractory M. pneumoniae pneumonia in a large sample.…”

Section: Introductionmentioning

confidence: 99%

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Lactate Dehydrogenase as a Biomarker for Prediction of RefractoryMycoplasma pneumoniaePneumonia in Children

et al. 2015

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BACKGROUND: Corticosteroids have been used for refractory Mycoplasma pneumoniae pneumonia and have beneficial effects. The aim of this study was to identify the biomarkers for predicting refractory M. pneumoniae pneumonia in a timely fashion to initiate steroid therapy. METHODS: This was a prospective cohort study of children with M. pneumoniae pneumonia admitted to the Children's Hospital of Fudan University from September 2012 to August 2013. Lactate dehydrogenase (LDH) and other laboratory tests, including complete blood counts, C-reactive protein, erythrocyte sedimentation rate (ESR), alanine aminotransferase, aspartate aminotransferase, ␣-hydroxybutyrate dehydrogenase (HBDH), creatine kinase, and creatine kinase MB, were performed on admission. Based on the definition of refractory M. pneumoniae pneumonia, subjects were divided into 2 groups: refractory M. pneumoniae pneumonia and usual M. pneumoniae pneumonia.The diagnostic values of laboratory findings were analyzed. RESULTS: In total, 653 subjects were enrolled, including 300 in the refractory pneumonia group and 353 in the usual pneumonia group. There was no significant difference in sex distribution between the 2 groups. The average age in the refractory M. pneumoniae pneumonia group was greater than that in the usual M. pneumoniae pneumonia group. Compared with the usual pneumonia group, the refractory pneumonia group showed significantly higher levels of C-reactive protein, serum LDH, serum HBDH, serum alanine aminotransferase, serum aspartate aminotransferase, and neutrophils and higher ESRs. Logistic regression showed that age, LDH, and ESR were the significant factors in predicting refractory M. pneumoniae pneumonia. In addition, LDH and HBDH were strongly correlated, and receiver operating characteristic curve analysis showed that the area under the curve of LDH was 0.718 with a cutoff of 379 IU/L, that of ESR was 0.683 with a cutoff of 32.5 IU/L, and that of HBDH was 0.691 with a cutoff of 259.5 IU/L. CONCLUSIONS: Serum LDH can be used as a biomarker to predict refractory M. pneumoniae pneumonia at the early stage of hospitalization.

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Section: Discussioncontrasting

confidence: 50%

Section: Introductionmentioning

confidence: 99%

Lactate Dehydrogenase as a Biomarker for Prediction of RefractoryMycoplasma pneumoniaePneumonia in Children

et al. 2015

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“…If severe M. pneumoniae pneumonia is an immune-mediated disease, immune-suppressive therapy is a rational approach. In several studies, a combination of corticosteroids and antibiotic therapy demonstrated satisfactory clinical effects and reduced serum IL-18 levels in patients with severe M. pneumoniae pneumonia [11][12][13]. IL-18 is a macrophage-derived cytokine.…”

Section: à3mentioning

confidence: 99%

“…Several studies have demonstrated that an excessive host cellular response, especially with respect to IL-18, plays a critical role in the development of serious pulmonary manifestations [8][9][10][11][12][13]. Thus, immunosuppressive therapy, such as with corticosteroids, down-regulates the cell-mediated immune responses and has been shown to have a profound beneficial effect [2][3][4][5][6][7][11][12][13][14]. On this point, little information is available concerning the histology of M. pneumoniae pneumonia in humans because pneumonia severity is usually mild, and the histological findings of severe M. pneumoniae pneumonia have mainly been investigated using autopsy specimens.…”

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confidence: 99%

Histological findings in severe Mycoplasma pneumoniae pneumonia

Miyashita

Narita

Tanaka

et al. 2017

Journal of Medical Microbiology

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“…Serum level of LDH is widely considered as an auxiliary marker in early stage of diseases to predict progression or severity of tissue damage in various diseases including necrotising enterocolitis, nasopharyngeal carcinoma and pneumonia [14][15][16][17]. For KD patients, LDH level > 590 IU/L is proposed as one predictor for assessing resistance to intravenous immunoglobulin (IVIG) therapy [18,19].…”

Section: Introductionmentioning

confidence: 99%

Lactate Dehydrogenase is involved in but not the Target Antigen in Children with Kawasaki Disease

Zhao¹,

Zhao²,

Du³

et al. 2016

J Cardiovasc Med Cardiol

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Management of refractory Mycoplasma pneumoniae pneumonia: Utility of measuring serum lactate dehydrogenase level

Cited by 95 publications

References 13 publications

Lactate Dehydrogenase as a Biomarker for Prediction of RefractoryMycoplasma pneumoniaePneumonia in Children

Lactate Dehydrogenase as a Biomarker for Prediction of RefractoryMycoplasma pneumoniaePneumonia in Children

Histological findings in severe Mycoplasma pneumoniae pneumonia

Lactate Dehydrogenase is involved in but not the Target Antigen in Children with Kawasaki Disease

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