A clinical study was performed on 236 patients admitted to the Department of Pediatrics of Yonsei University Hospital begween January, 1987 and June, 1991 with the diagnosis of Mycoplasma pneumoniae infection. This diagnosis was done when
anti-mycoplasmal antibody titers were higher than 1:40-or four fold increase during follow up (I. H. A. test).
We reviewed 21 cases among these patients who showed serum aminotransferase (ALT) level was higher than 40 IU/L and negative for hepatitis A, B and C virus markers.
1) Among the total 236 cases with Mycoplasma pneumoniae infections. the incidence of M. pneumoniae hepatitis was found in 8.9% (21 cases).
2) The peak incidence of age was 4 to 9 years of age (15 cases; 71.4%), and male-to-female ratio was 1.6:1.
3) The common symtpoms were cough (18 cases; 85.7%), sputum (47.6%), vomiting (47.6%), fever (38.1%) and skin rashes (28.6%) in that order. the common gastrointestinal symptoms were nausea and vomiting (10 cases; 47.6%), abdominal pain,
anorexia,
diarrhea and jaundice in that order.
4) The common physical findings were hepatomegaly (11 cases; 52.4%), rale (10 cases; 47.6%), pharyngeal injection, conjunctival injection, cervical lymphadenopathy, jaundice (9.5%),
5) WBC count was 5.000 to 14, 999/㎣ in 71.4% and neutrophilia (≥70%) was noted in 66.7% of cases. The corected ESR was higher than 14 mm/hr in 8 cases (53.3%) among 15 cases and CRP was positive in 8 cases (72.7%) among 11 cases.
6) Total bilirubin was 1.0~6.3mg/dl in 28.6% of the cases.
7) Cold agglutinin titers were higher than 1:64 in 14 cases (70.0%) among 20 cases. Antimvcoplasmal antibody titers were higher than 1:40 in all cases.
8) Serum AST level was 100~499IU/L in 57.1% of cases and higher than 1,000IU/L in 1 case. Serum ALT level was 100~499 IU/L in 66.7% of cases and higher than 1.000IU/L in 2 cases (9.5%).
9) On the chest X-ray examination, pulmonary infiltration was noted in 17 cases (81.0%) and right lower lobe involvement was the most common (11 cases; 64.7%). Pleural effusion was noted in 9 cases (42.9%).
10) Erythromycin was given in all cases. Serum ALT was normalized within 15.24±9.66 days and pulmonary consolidation resoved within 21.26±17.96 days after onset of administration.
11) The mean duration of hospitalization was 15.48±6.73 days.
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