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Predictive value of lactate dehydrogenase for Mycoplasma pneumoniae necrotizing pneumonia in children based on
Ren Yanhong1,2, Zhao Shuai1,2, Chen Dan1,2
1Respiratory Department, Children's Hospital Affiliated to Zhengzhou University, Henan Children's Hospital Zhengzhou Children's Hospital, Zhengzhou, 450018, Henan, China.
Insights
Lactate dehydrogenase (LDH) shows promise for early prediction of severe Mycoplasma pneumoniae necrotizing pneumonia (MPNP) in children. Elevated LDH levels indicate a higher risk, aiding timely intervention for better patient outcomes.
Area of Science:
- Pediatric Pulmonology
- Infectious Diseases
- Biomarker Discovery
Background:
- Mycoplasma pneumoniae necrotizing pneumonia (MPNP) presents a severe clinical course, necessitating early diagnostic indicators for improved prognosis.
- Current diagnostic methods may not sufficiently predict disease severity, highlighting the need for reliable biomarkers.
Purpose of the Study:
- To investigate the predictive value of lactate dehydrogenase (LDH) for identifying MPNP in pediatric patients.
- To explore the association between LDH levels and disease severity in children with Mycoplasma pneumoniae pneumonia.
Main Methods:
- Retrospective analysis of 128 children with MPNP and 118 with Mycoplasma pneumoniae pneumonia with pulmonary consolidation.
- Propensity score matching, multiple logistic regression, dose-response, and decision curve analyses were employed.
- Comparison of clinical and laboratory parameters between necrosis and consolidation groups.
Main Results:
- Necrosis group exhibited significantly higher WBC, PLT, neutrophils, CRP, PCT, ESR, D-dimer, fibrinogen, ALT, LDH, IgG, and IgM levels.
- Higher incidence of chest pain and dyspnea observed in the necrosis group.
- LDH levels, high fever, D-dimer, and fibrinogen identified as independent predictors of MPNP; non-linear dose-response relationship between LDH and MPNP incidence.
Conclusions:
- Lactate dehydrogenase (LDH) demonstrates significant clinical value as a potential serologic indicator for the early diagnosis and prediction of MPNP in children.
- Elevated LDH levels are associated with increased severity and risk of MPNP.
- Findings support LDH's utility in guiding early clinical intervention for MPNP patients.
Abstract:
Mycoplasma pneumoniae necrotizing pneumonia (MPNP) has a long and severe disease course, which seriously threatens to jeopardize patients' lives and health. Early prediction is essential for good recovery and prognosis. In the present study, we retrospect 128 children with MPNP and 118 children with Mycoplasma pneumoniae pneumonia combined with pulmonary consolidation to explore the predictive value of lactate dehydrogenase (LDH) in children with MPNP by propensity score matching method, multiple logistic regression analysis, dose-response analysis and decision curve analysis. The WBC count, PLT count and percentage of neutrophils were significantly higher in necrosis group than consolidation group. The serum CRP, PCT, ESR, D-D, FIB, ALT, LDH, IgG and IgM were significantly higher in necrosis group. Compared to consolidation group, necrosis group is more severe in chest pain and dyspnea. Multivariate logistic regression analysis showed that duration of LDH levels, high fever, D-dimer, and fibrinogen were independent predictive factors for the incidence of MPNP. Restricted cubic spline analysis showed that a non-linear dose-response relationship between the continuous changes of LDH level and the incidence of MPNP. Decision curve analysis revealed that LDH had an important clinical value in predicting MPNP. This study provides a potential serologic indicator for early diagnosis of MPNP.
