Clinical differences according to radiological patterns in childhood Mycoplasma pneumoniae pneumonia

PURPOSE: This study was conducted to evaluate the difference of clinical characteristics of pneumonia in children caused by Mycoplasma pneumoniae, according to their chest radiographic patterns. METHODS: We analyzed medical records of 921 children who were admitted to Soonchunhyang University Buchon Hospital due to M. pneumoniae pneumonia from January 2008 to December 2011. Enrolled children were divided into 2 groups by radiological patterns: lobar/lobular pneumonia group (group 1) and broncho/interstitial pneumonia group (group 2). RESULTS: The number of patients in group 1 was 295 (32%) and in group 2, 626 (68%). Lobar/lobular pneumonia occurred in older children compared to broncho/interstitial pneumonia (mean age, 6.4 years vs. 4.2 years; P=0.00). Group 1 had significantly longer durations of fever and hospitalization than group 2. The frequency of pleural effusion was significantly higher in group 1. Erythrocyte sedimentation rate and C-reactive protein values were higher in group 1. Coinfections with respiratory viruses were more frequent in group 2. The history of allergic diseases were more common in group 2 (P=0.006). In 2011, lobar/lobular pneumonia was more frequent and the duration of fever was longer compared with 2008-2010. CONCLUSION: In M. pneumoniae pneumonia, patients with lobar/lobular pneumonia were more older and had more severe clinical features and laboratory findings. Because there was an outbreak with severe clinical course in 2011, we wonder that the outbreak was related to the macrolide resistant M. pneumoniae. Careful attention about clinical course and consequences of patients with lobar/lobular pneumonia is required.

Clinical Follow-up of Children and Adolescents with Hashimoto's Thyroiditis and Hashitoxicosis

OBJECTIVE: The purpose is to study the natural course and clinical feature according to thyroid function at diagnosis of Hashimoto's thyroiditis in children and adolescent. We studied to know the difference of clinical finding and change of thyroid autoantibody titers between Hashitoxicosis and typical Hashimoto's thyroiditis. METHODS: We analyzed retrospectively clinical data in 55 patients diagnosed as Hashimoto's thyroiditis. 47 were followed for more than 2 years and they were classified into euthyroid, compensated hypothyroidism, overt hypothyroidism, and hyperthyroidism according to thyroid hormone status at diagnosis. We investigated age, family history, initial thyroid function, initial thyroid autoantibody titers, changes of thyroid function, and changes of thyroid autoantibody titers. RESULTS: At diagnosis, 10 of 47 patients were in euthyroid, 17 in compensated hypothyroidism, 17 in overt hypothyroidism and 3 in hyperthyroidism. There was no statistically significant difference in the clinical data among the 4 groups of patients. Among the 47 patients, 4 patients had presented Hashitoxicosis. These patients' characteristics were similar to the patients with typical Hashimoto's thyroiditis. They had variable duration of hyperthyroidism range from 3 months to 5 years. It was possible to observe the rise of autoantibody titers from the patients with Hashitoxicosis when thyroid function was shifted to hypothyroidism. However it was not statistically significant. CONCLUSION: The clinical progress of Hashimoto's thyroiditis and hashitoxicosis varied widely. It is necessary to conduct more researches on the occurrence of Hashitoxicosis and the association with the change of autoantibodies on the patients with Hashimoto's thyroiditis.