Allergy Asthma Respir Dis.
2022 Oct;10(4):207-214. 10.4168/aard.2022.10.4.207.
The incidence and risk factors of extrapulmonary manifestations in Mycoplasma pneumoniae pneumonia
- Park YK1
- Park YN2
- Moon JE3
- Kim HB
1 - Shin M2
- Lee E4
- Kim CH5
- Lee JS5
- Lee YJ6
- Kim BS7
- Kim HY8
- Jung S8
- Kim Y9
- Kim S9
- Park C9
- Seo JH10
- Shim JY11
- Sol IS11
- Sung M12
- Song DJ13
- Ahn YM14
- Oh HL15
- Yu J16
- Lee KS17
- Jang GC18
- Jang YY19
- Chung HL19
- Chung EH20
- Choi SM21
- Choi YJ22
- Han MY23
- Kim JT24
- Kim CK1
- Yang HJ25
- Affiliations
-
- 1Department of Pediatrics, Inje University Sanggye Paik Hospital, Seoul, Korea
- 2Department of Pediatrics, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine, Bucheon, Korea
- 3Department of Biostatistics, Clinical Trial Center, Soonchunhyang University Bucheon Hospital, Bucheon, Korea
- 4Department of Pediatrics, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, Korea
- 5Department of Pediatrics, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Korea
- 6Department of Pediatrics, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin, Korea
- 7Department of Pediatrics, Gangneung Asan Hospital, University of Ulsan College of Medicine, Gangneung, Korea
- 8Department of Pediatrics, Pusan National University Children’s Hospital, Yangsan, Korea
- 9SCH Biomedical Informatics Research Unit, Soonchunhyang University Seoul Hospital, Seoul, Korea
- 10Departmentof Pediatrics, Dankook University Hospital, Dankook University Medical School, Cheonan, Korea
- 11Department of Pediatrics, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
- 12Department of Pediatrics, Soonchunhyang University Gumi Hospital, Soonchunhyang University College of Medicine, Gumi, Korea
- 13Department of Pediatrics, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea
- 14Department of Pediatrics, Eulji General Hospital, Eulji University, Seoul, Korea
- 15Department of Pediatrics, Korea Cancer Center Hospital, Ilsan, Korea
- 16Department of Pediatrics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
- 17Department of Pediatrics, Hanyang University Guri Hospital, Hanyang University College of Medicine, Guri, Korea
- 18Department of Pediatrics, National Health Insurance Service Ilsan Hospital, Ilsan, Korea
- 19Department of Pediatrics, Catholic University of Daegu School of Medicine, Daegu, Korea
- 20Department of Pediatrics, Chungnam National University School of Medicine, Daejeon, Korea
- 21Department of Pediatrics, Dongguk University Gyeongju Hospital, Gyeongju, Korea
- 22Departmentof Pediatrics, Seoul National University Children Hospital, Seoul, Korea
- 23Department of Pediatrics, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Korea
- 24Department of Pediatrics, The Catholic University of Korea Uijeongbu St. Mary's Hospital, Uijeongbu, Korea
- 25Department of Pediatrics, Soonchunhyang University Seoul Hospital, Soonchunhyang University College of Medicine, Seoul, Korea
- KMID: 2534608
- DOI: http://doi.org/10.4168/aard.2022.10.4.207
Abstract
- Purpose
Mycoplasma pneumoniae pneumonia (MP) is a major cause of community-acquired pneumonia (CAP) in children and is associated with extrapulmonary manifestations (EPM). The incidence and risk factors for EPM in children are unknown.
Methods
This was a retrospective study involving 65,243 pediatric patients with CAP between 2010 and 2015 at 23 nationwide hospitals in South Korea. Medical records were reviewed to collect information regarding the clinical characteristics, radiological results, and laboratory findings. Logistic regression with multivariate analysis was performed to evaluate the risk factors associated with EPM in MP.
Results
The incidence of EPM was 23.9%, including elevation of liver enzymes (18.1%), mucocutaneous manifestations (4.4%), proteinuria (4.1%), cardiovascular and neurological manifestations (0.4%), hematologic manifestations (0.2%), and arthritis (0.2%). Statistical analysis showed that mucocutaneous manifestations significantly increased with elevated alanine aminotransferase (adjusted odds ratio [aOR], 3.623; 95% confidence interval [CI], 1.933-6.790) and atopic sensitization (aOR, 2.973; 95% CI, 1.615–5.475) and decreased with respiratory virus coinfection (aOR, 0.273; 95% CI, 0.084–0.887). Elevated liver enzymes were significantly associated with elevated lactate dehydrogenase (aOR, 3.055; 95% CI, 2.257–4.137), presence of pleural effusion (aOR, 2.635; 95% CI, 1.767–3.930), and proteinuria with respiratory virus coinfection (aOR, 2.245; 95% CI, 1.113–4.527).
Conclusion
Approximately 24% of pediatric patients with MP had various EPM. As the risk factors associated with each EPM were different, it is necessary to evaluate the various clinical aspects and findings of MP to predict and prepare for the occurrence of EPM.
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