Objective:
To investigate the clinical characteristics,
diagnosis and
treatment of
mycoplasma pneumoniae(MP)
pneumonia in
children with pseudo-macrocytic
erythrocytes.
Methods:
The clinical data of 50
children with
mycoplasma pneumoniae pneumonia with pseudo-macrocytic
erythrocytes in the Department of
Pediatrics at Shengjing
Hospital of
China Medical
University from January 2019 to August 2020 were analyzed retrospectively.
Results:
Among the 50 cases, there were 32
boys and 18
girls.The
blood routine examination showed that pseudo-macrocytic
erythrocytes,
red blood cells decreased significantly,
mean corpuscular volume,
mean corpuscular hemoglobin, and
mean corpuscular hemoglobin concentration increased significantly, as well as MP-
IgM was positive.Sixteen cases were complicated with
herpes simplex virus infection, one with
Epstein Barr virus infection, and six with both
herpes simplex virus and
Epstein Barr virus infection at the same
time.All 50 cases were MP
pneumonia, pulmonary imaging showed
lobar pneumonia, and 25 cases were complicated with
pleural effusion, including 32 cases of refractory MP
pneumonia.The clinical symptoms of three cases were extrapulmonary manifestations,
hemolytic anemia and diagnosed with
cold agglutinin syndrome.In 36
children with D-dimer more than 252 μg/L, one case had
femoral vein thrombosis and one case had
pulmonary embolism.
Conclusion:
Pseudo-macrocytic phenomenon may
play important
roles in clinical etiological
diagnosis, severity of
disease and refractory MP
pneumonia.The
children with
hemolytic anemia suggest
cold agglutinin syndrome, and the hypercoagulable
state of MP
infection may be related to the aggregation of
red blood cells caused by
cold agglutinin in MP
infection.