Predictive value of C-reactive protein in response to macrolides in children with macrolide-resistantMycoplasma pneumoniaepneumonia

Seo, Young Ho; Kim, Jang Su; Seo, Sung Chul; Seo, Won Hee; Yoo, Young; Song, Dae Jin; Choung, Ji Tae

doi:10.3345/kjp.2014.57.4.186

Cited by 32 publications

(26 citation statements)

References 28 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…CRP is correlated with the degree of MPP and plays a role in estimating the severity of the disease. Seo et al19 reported that serum CRP could be a useful marker for predicting the efficacy of macrolides in MRMP. In this study, the levels of CRP were correlated with the severity of chest radiographic manifestations; however, the diagnostic value was poor.…”

Section: Discussionmentioning

confidence: 99%

Relationships between Th1/Th2 cytokine profiles and chest radiographic manifestations in childhood Mycoplasma pneumoniae pneumonia

Jiu-ling

Wang

2016

TCRM

View full text Add to dashboard Cite

BackgroundMycoplasma pneumoniae pneumonia (MPP) is one of the most common childhood community-acquired pneumonias, and the chest radiograph usually shows bronchial pneumonia, segmental/lobar pneumonia, or segmental/lobar pneumonia with pleural effusion. The imbalance of Th1/Th2 function after Mycoplasma pneumoniae infection is an important immunological mechanism of MPP. In this study, we aimed to evaluate the correlations between Th1/Th2 cytokine profiles and chest radiographic manifestations in MPP children.Patients and methodsA total of 87 children with MPP were retrospectively reviewed in this study. According to the chest radiographic manifestations, they were divided into the following three groups: bronchial MPP group, segmental/lobar MPP group, and segmental/lobar MPP with pleural effusion group. Clinical features and changes in Th1/Th2 cytokines were further analyzed.ResultsThe incidence of tachypnea and cyanosis was higher in children with segmental/lobar MPP with pleural effusion than in those with segmental/lobar or bronchial MPP. The peak body temperature of segmental/lobar MPP was higher than that of bronchial MPP, and the duration of fever and hospitalization was positively correlated with the severity of MPP. MPP children’s chest radiograph showed a relationship with the changes in Th1/Th2 cytokines. Serum interleukin-4, interleukin-10 (IL-10), interferon-γ, and tumor necrosis factor-α (TNF-α) of segmental/lobar MPP were significantly higher than those of bronchial MPP, and serum IL-10 (cutoff value: 27.25 pg/mL) can be used as a diagnostic predictor for segmental/lobar MPP. Serum TNF-α and interleukin-6 of segmental/lobar MPP with pleural effusion were significantly higher than those of segmental/lobar MPP without pleural effusion. Serum TNF-α (cutoff value: 60.25 pg/mL) can be used as a diagnostic predictor for segmental/lobar MPP with pleural effusion.ConclusionThere were significant correlations between Th1/Th2 cytokine profiles and chest radiographic manifestations in MPP children. Serum IL-10 and TNF-α can be used as an optimal predictor for segmental/lobar MPP and segmental/lobar MPP with pleural effusion, respectively.

show abstract

Section: Discussionmentioning

confidence: 99%

Relationships between Th1/Th2 cytokine profiles and chest radiographic manifestations in childhood Mycoplasma pneumoniae pneumonia

Jiu-ling

Wang

2016

TCRM

View full text Add to dashboard Cite

show abstract

“…The following variables were extracted: patient characteristics (e.g., age, sex), acute neurological and non-neurological symptoms, duration of prodromal non-neurological symptoms prior to the onset of neurological symptoms, presence or absence of macrolide (clarithromycin) resistance defined by the absence of defervescence within 72 h after initiation of clarithromycin [11], laboratory data, including white blood cell (WBC) count in the peripheral blood, serum levels of C-reactive protein (CRP) and sodium, presence or absence of pleocytosis in CSF, findings on electroencepharography (EEG), initial and follow-up neuroimaging, duration till recovery of clinical symptoms and of abnormal findings on neuroimaging, and outcome including neurological sequelae.…”

Section: Methodsmentioning

confidence: 99%

Mycoplasma pneumoniae-associated mild encephalitis/encephalopathy with a reversible splenial lesion: report of two pediatric cases and a comprehensive literature review

2016

View full text Add to dashboard Cite

BackgroundNo literature review exists on Mycoplasma pneumoniae-associated mild encephalitis/encepharopathy with a reversible splenial lesion (MERS).Methods M.pneumoniae-associated MERS cases were searched till August 2016 using PubMed/Google for English/other-language publications and Ichushi (http://www.jamas.or.jp/) for Japanese-language publications. Inclusion criteria were children fulfilling definition for encephalitis, M.pneumoniae infection, and neuroimaging showing hyperintensity in the splenium of the corpus callosum (SCC) alone (type I) or SCC/other brain areas (type II).ResultsWe described two children with type I and II M.pneumoniae-associated MERS. Thirteen cases found by the search and our 2 cases were reviewed. Mean age, male/female ratio, duration of prodromal illness was 8.3 years, 1.5 and 3.5 days. The most common neurological symptom was drowsiness, followed by abnormal speech/behavior, ataxia, seizure, delirium, confusion, tremor, hallucination, irritability, muscle weakness, and facial nerve paralysis. Fever was the most common non-neurological symptom, followed by cough, headache, gastrointestinal symptoms, headache, lethargy and dizziness. Seizure and respiratory symptoms were less common. All were diagnosed for M.pneumoniae by serology. Cerebrospinal fluid (CSF) M.pneumoniae was undetectable by PCR in the 3 patients. Three patients were clarithromycin-resistant. Leukocytosis, positive C-reactive protein, hyponatremia, CSF pleocytosis and slow wave on electroencephalography frequently occurred. All except 2 were type I MERS. Neuroimaging abnormalities disappeared within 18 days in the majority of patients. All type I patients completely recovered within 19 days. Two type II patients developed neurological sequelae, which recovered 2 and 6 months after onset.ConclusionsPrognosis of M.pneumoniae-associated MERS is excellent. Type II MERS may increase a risk of neurological sequelae.

show abstract

“…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%

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

et al. 2015

View full text Add to dashboard Cite

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.

show abstract

Predictive value of C-reactive protein in response to macrolides in children with macrolide-resistantMycoplasma pneumoniaepneumonia

Cited by 32 publications

References 28 publications

Relationships between Th1/Th2 cytokine profiles and chest radiographic manifestations in childhood<em> Mycoplasma pneumoniae</em> pneumonia

Relationships between Th1/Th2 cytokine profiles and chest radiographic manifestations in childhood<em> Mycoplasma pneumoniae</em> pneumonia

Mycoplasma pneumoniae-associated mild encephalitis/encephalopathy with a reversible splenial lesion: report of two pediatric cases and a comprehensive literature review

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

Contact Info

Product

Resources

About