Abstract:
The study was aimed to evaluate the role of the specific serologic diagnosis of Mycoplasma infection and clinical peculiarities of
bronchopulmonary diseases with recurrent episodes of wheezing
in children.
Seventy-six children (ages 6 months to 7 years) with wheezing
disorders (bronchial asthma and obstructive bronchitis) were
included in our study. The diagnosis, classification of asthma,
and asthma severity levels were based on GINA guidelines. The
determination of M. pneumonia and M. hominis IgG, IgA, IgM
antibodies were performed by using an enzyme-linked immunosorbent assay (Human, Germania).
Analysis of the serologic examination results showed that 56
patients had the Mycoplasma infection and 20 exhibited no signs of
Mycoplasma infection. In I group (the Mycoplasma-positive group)
4 patients had bronchial asthma, and 6 patients with obstructive bronchitis had specific antibodies in diagnostic titers (IgM
0,35±0,01 (cut-off 0,25), IgG 0,33±0,13 (cut-off 0,30±0,03) and
IgA 1,47±0,01 (cut-off 0,801), IgG 1,18±0,46 (cut-off 0,33±0,02)
accordingly). In the remainder of the first group (47 children), 10
children had b\ronchial asthma and 36 children had obstructive
bronchitis associated with acute pneumonia. Levels of specific
antibodies consisted of: M. pneumonia (4 children) IgM 0,29±0,02
(cut-off 0,25), IgG 0,47±0,02 (cut-off 0,32) and M. hominis (4
children) IgA 0,25±0,15 (cut-off 0,24), IgG 1,03±0,25; cut-off
0,3±0,01 and in 2 children a mix infection (M. hominis and M.
pneumonia IgG 0,80±0,2 (cut-off 0,28) and IgG 0,50±0,07 (cut-off
0,33) accordingly) (in the group with pneumonia and bronchial
asthma) and M. pneumonia 0,45±0,06 (cut-off 0,34), IgG 0,44±0,02
(cut-off 0,35) and M. hominis IgM 0,34±0,09 (cut-off 0,30), IgG
0,97±0,17 (cut-off 0,29) (in the group with pneumonia and obstructive bronchitis).
In II group (the Mycoplasma-negative group) 4 patients had
obstructive bronchitis and 16 children had pneumonia, including
6 children with associated bronchial asthma and 10 patients had
pneumonia with obstructive bronchitis. The levels of specific
antibodies was below the cut-off: M. pneumonia IgM 0,18±0,09
(cut-off 0,52±0,15), IgG 0,17±0,02 (cut-off 0,33±0,03), M. pneumoniae IgM 0,1±0,02 (cut-off 0,25), IgG 0,14±0,02 (cut-off 0,27)
and in last group IgM 0,1±0,04 (cut-off 0,25) and IgG 0,17±0,04
(cut-off 0,29) accordingly.
The Evolution of pneumonia in children with Mycoplasma
infection was complicated in 11 cases: in 6 cases with pleural
effusion and in 5 cases with atelectasia (patients from the Mycoplasma-negative group had pleural effusion only in 2 cases).
Mycoplasma infection in children with obstructive bronchitis and bronchial asthma is a significant risk factor, thus the identification of this infectious agent is important for the development of
efficient programs of treatments in pediatric pneumology
Description:
Department of Pediatrics, Nicolae Testemitanu State Medical and Pharmaceutical University, Laboratory of Immunology, Scientific Research Institute for Maternal and Child Health Care, Congresul III al Medicilor de Familie din Republica Moldova, 17–18 mai, 2012, Chişinău, Republica Moldova, Conferinţa Naţională „Maladii bronhoobstructive la copii”, consacrată profesorului universitar, doctor habilitat Victor Gheţeul, 27 aprilie, Chişinău, Republica Moldova
