Korean J Pediatr.  2015 Jun;58(6):211-217. 10.3345/kjp.2015.58.6.211.

Hepatitis associated with Mycoplasma pneumoniae infection in Korean children: a prospective study

• Kim KW
• Sung JJ
• Tchah H
• Ryoo E
• Cho HK
• Sun YH
• Cho KH
• Son DW
• Jeon IS
• Kim YM

• KMID: 1795117
• DOI: http://doi.org/10.3345/kjp.2015.58.6.211

Abstract

PURPOSE
Mycoplasma pneumoniae (MP) infection is a major cause of respiratory infection in school-aged children. Extrapulmonary manifestations of MP infection are common, but liver involvement has been rarely reported. The aim of this study was to determine the clinical characteristics of MP-associated hepatitis.
METHODS
This prospective study included 1,044 pediatric patients with MP infection diagnosed serologically with MP IgM at one medical center from January 2006 to December 2012. Eighty of these patients had elevated levels of serum aspartate aminotransferase (AST) and alanine aminotransferase (ALT), each greater than 50 IU/L, without any other specific liver disorder and were compared with the 964 children without liver disorders.
RESULTS
In total, 7.7% of patients with MP infection had a diagnosis of hepatitis, especially in fall and winter. The ratio of male to female patients was 1.7:1, and the mean age of the patients was 5 years and 5 months. The most common symptoms were cough, fever, and sputum. Anorexia was the most common gastrointestinal symptom, followed by nausea/vomiting, diarrhea, and abdominal pain. Mean levels of AST and ALT were 100.65 IU/L and 118.73 IU/L, respectively. Serum AST/ALT level was normalized within 7.5 days on average without complications. The mean duration of hospitalization (11.3 days) was longer for children with hepatitis than for those without hepatitis (P=0.034).
CONCLUSION
MP-associated hepatitis is not uncommon and has a relatively good prognosis. Therefore, clinicians should be concerned about liver involvement in MP infection but avoid further unnecessary evaluation of hepatitis associated with MP.

Keyword

Mycoplasma pneumoniae; Hepatitis; Macrolides

MeSH Terms

Abdominal Pain
Alanine Transaminase
Anorexia
Aspartate Aminotransferases
Child*
Cough
Diagnosis
Diarrhea
Female
Fever
Hepatitis*
Hospitalization
Humans
Immunoglobulin M
Liver
Macrolides
Male
Mycoplasma pneumoniae*
Pneumonia, Mycoplasma*
Prognosis
Prospective Studies*
Sputum
Alanine Transaminase
Aspartate Aminotransferases
Immunoglobulin M
Macrolides