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KMID : 1035620220100040207
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Allergy Asthma & Respiratory Disease
2022 Volume.10 No. 4 p.207 ~ p.214
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The incidence and risk factors of extrapulmonary manifestations in Mycoplasma pneumoniae pneumonia
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Park Yoo-Kyung
Park You-Na
Moon Ji-Eun
Kim Chang-Keun
Kim Hyo-Bin
Shin Mee-Yong
Lee Eun
Kim Cheol-Hong
Lee Ju-Suk
Lee Yong-Ju
Kim Bong-Seong
Kim Hyung-Young
Jung Sung-Su
Kim Yun-Sun
Kim Sang-Young
Park Cho-Rong
Seo Ju-Hee
Shim Jung-Yeon
Sol In-Suk
Sung Myong-Soon
Song Dae-Jin
Ahn Young-Min
Oh Hea-Lin
Yu Jin-Ho
Lee Kyung-Suk
Jang Gwang-Cheon
Jang Yoon-Young
Chung Hai-Lee
Chung Eun-Hee
Choi Sung-Min
Han Man-Yong
Kim Jin-Tack
Choi Yun-Jung
Yang Hyeon-Jong
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Abstract
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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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KEYWORD
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Mycoplasma pneumonia, Risk factors, Incidence, Extrapulmonary manifestation
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