Correlation of tuberculosis-related anemia severity with tuberculosis-induced inflammation in children: a six-year retrospective study.

BACKGROUND: Anemia is a common complication of tuberculosis (TB), and there is evidence that its prevalence is higher in patients with TB. Although TB is very important in epidemiology, careful investigation of TB-related anemia in children has not been carried out systematically. This study aimed to describe the details of anemia in children with TB and its association with clinical characteristics and the severity of inflammation. METHODS: In this retrospective study, we explored Hb levels in 103 children with pulmonary TB (PTB) and they were divided into anemic or non-anemic groups. Logistics regression analysis was used to study the associations between anemia and demographic characteristics. Spearman correlations analysis was performed to analyse the associations between the biochemical parameters and hemoglobin levels in blood. RESULTS: The prevalence of anemia in children with TB was 37.9% (48.7% showed microcytic hypochromic anemia, and 5.1% showed normal cell anemia). Compared with the anemia (n = 39) group, the non-anemic group (n = 64) had longer fever duration and increased respiratory rate (P < 0.05). In logistic regression analysis, anemia was associated with lower levels of Alb and higher levels of WBC, CRP, LDH, and ESR (P < 0.05). Spearman correlations analysis showed a significant negative correlation between hemoglobin (Hb) levels and inflammatory markers. After one month of antitubercular therapy (ATT), the Hb levels of 76.9% children returned to normal. CONCLUSIONS: Anemia is common among children with TB at diagnosis. The majority of children with TB-related anemia are mild to moderate microcytic hypochromic anemia. There is a strong correlation between the severity of anemia and the inflammation induced by TB. This suggests that anemia is a biomarker of the severity of TB in clinical practice among children.

Mycoplasma pneumoniae pneumonia-associated thromboembolism with plastic bronchitis: a series of five case reports and literature review.

BACKGROUND: Mycoplasma pneumoniae pneumonia is a common respiratory infection among children. However, the occurrence of thromboembolism with plastic bronchitis in association with Mycoplasma pneumoniae pneumonia is extremely rare. This case series presents five cases of children with Mycoplasma pneumoniae pneumonia who developed thromboembolism and plastic bronchitis. The clinical presentation, diagnostic approach, and management strategies are discussed. METHODS: A retrospective analysis was conducted on medical records from a pediatric hospital. Patient demographics, clinical features, laboratory findings, imaging results, treatment modalities, and outcomes were collected. RESULTS: The patients in our case series presented with varying degrees of respiratory distress, cough, and fever. Imaging studies revealed evidence of thromboembolism based on pulmonary artery occlusion. Bronchial casts were observed by bronchoscopy. Laboratory tests demonstrated elevated D-dimer levels and fibrinogen degradation products. All patients received a combination of low molecular weight heparin anticoagulation and supportive care. CONCLUSION: Thromboembolism with plastic bronchitis associated with Mycoplasma pneumoniae pneumonia is a rare but potentially serious complication in children. Prompt recognition and management are crucial for improving patient outcomes. This case series highlights the diverse clinical presentations, diagnostic challenges, and treatment strategies for this unique clinical entity. Further research is needed to better understand the pathogenesis and optimal management of this condition.

Successful treatment of pleural empyema and necrotizing pneumonia caused by methicillin-resistant Staphylococcus aureus infection following influenza A virus infection: A case report and literature review.

With the rapid increase in the number of infections, children with Staphylococcus aureus (S. aureus) infection secondary to Influenza A virus (IAV), appear to have a great possibility of causing severe complications and illness. Despite some cases and research findings regarding the death of children with IAV and S. aureus, coinfection included, there were few details about successful treatment of pleural empyema and necrotizing pneumonia caused by methicillin-resistant Staphylococcus aureus (MRSA) infection following IAV. In this case report, we describe the clinical symptoms and treatment of a teenager with pleural empyema and necrotizing pneumonia related to S. aureus secondary infection who was initially infected by IAV. This case highlights the importance of early recognition and application of thoracoscopy for this potentially fatal pleural empyema caused by MRSA and IAV coinfection. We conclude that this is a significant case that contributes to raising awareness regarding rarely occurring severe respiratory infections by MRSA in a child with normal immune function after IAV. In addition, further studies are needed to explore risk factors for IAV coinfection with S. aureus.

Analysis of the risk factors and clinical features of Mycoplasma pneumoniae pneumonia with embolism in children: a retrospective study.

BACKGROUND: Mycoplasma pneumoniae pneumonia (MPP) is a prevalent disease in community-acquired pneumonia among children. However, in addition to respiratory manifestations, it may also develop extra-pulmonary complications. Embolism is one of the uncommon extra-respiratory manifestations prone to severe sequelae and even death. This study aims to analyze the clinical features of MPP with embolism in children, and explore the associated risk factors of embolism in MPP patients. METHODS: A retrospective case-control analysis was performed on 48 children with MPP admitted to our hospital wards between January 2010 and December 2021. Embolism group comprised children with embolism by CTA or MRA results, whereas the non-embolism group comprised children with clinical suspicion of embolism but negative diagnostic imaging support. The clinical features, laboratory findings and imaging were analyzed to explore the risk factors for embolism in children with MPP. RESULTS: A total of 48 children with MPP were enrolled in the study (16 cases and 32 controls). In the embolism group, 10 patients (62.5%) had pulmonary embolism, 3 patients (18.75%) presented ventricle embolism, 2 patients (12.5%) presented cerebral and carotid artery embolism, one patient (6.25%) had a cerebral embolism, limb, and spleen, respectively. The univariate analysis revealed the maximum body temperature (Tmax), CRP, D-dimer (closest to CTA/MRA), the percentage of neutrophils (N%), pulmonary consolidation (⩾ 2/3 lobe), pleural effusion and atelectasis have significant differences between the embolism group and non-embolism group (P < 0.05). Multivariate logistic regression analysis showed that D-dimer (closest to CTA/MRA) > 3.55 mg/L [OR = 1.255 (95% CI: 1.025-1.537), P < 0.05], pulmonary consolidation (⩾ 2/3 lobe) [OR = 8.050 (95% CI: 1.341-48.327), P < 0.05], and pleural effusion [OR = 25.321 (95% CI: 2.738-234.205), P < 0.01] were independent risk factors for embolism in children with MPP. CONCLUSION: In conclusion, MPP with embolism patients have more D-dimer values and severe radiologic manifestations.

Novel Prognostic Signature for Acute Myeloid Leukemia: Bioinformatics Analysis of Combined CNV-Driven and Ferroptosis-Related Genes.

Background: Acute myeloid leukemia (AML), which has a difficult prognosis, is the most common hematologic malignancy. The role of copy number variations (CNVs) and ferroptosis in the tumor process is becoming increasingly prominent. We aimed to identify specific CNV-driven ferroptosis-related genes (FRGs) and establish a prognostic model for AML. Methods: The combined analysis of CNV differential data and differentially expressed genes (DEGs) data from The Cancer Genome Atlas (TCGA) database was performed to identify key CNV-driven FRGs for AML. A risk model was constructed based on univariate and multivariate Cox regression analysis. The Gene Expression Omnibus (GEO) dataset was used to validate the model. Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analyses were conducted to clarify the functional roles of DEGs and CNV-driven FRGs. Results: We identified a total of 6828 AML-related DEGs, which were shown to be significantly associated with cell cycle and immune response processes. After a comprehensive analysis of CNVs and corresponding DEGs and FRGs, six CNV-driven FRGs were identified, and functional enrichment analysis indicated that they were involved in oxidative stress, cell death, and inflammatory response processes. Finally, we screened 2 CNV-driven FRGs (DNAJB6 and HSPB1) to develop a prognostic risk model. The overall survival (OS) of patients in the high-risk group was significantly shorter in both the TCGA and GEO (all p < 0.05) datasets compared to the low-risk group. Conclusion: A novel signature based on CNV-driven FRGs was established to predict the survival of AML patients and displayed good performance. Our results may provide potential targets and new research ideas for the treatment and early detection of AML.

Case Report: Clinical Analysis of Fulminant Mycoplasma pneumoniae Pneumonia in Children.

Fulminant Mycoplasma pneumoniae pneumonia (FMPP) accounts for 0.5-2% of all MPP cases, which is considered as MPP combined with severe complications such as hypoxemia, acute respiratory distress syndrome, or acute respiratory failure. It primarily affects young adults with no underlying disease. Although some studies have proved the severity of FMPP, the details about clinical diagnosis and treatment of FMPP in children have been rarely reported. In this case study, we described three cases who suffered from FMPP. These children not only developed acute lung injury and multiple organ involvement within 7 days of treatment, but were also found plastic bronchitis by bronchoscopy. Finally, all the patients were treated successfully with azithromycin, glucocorticoid, and bronchoscopy lavage. We conclude that this case study would contribute to raise awareness with respect to FMPP, which may occur at a younger age with faster disease progression and common extrapulmonary manifestations. It also reinforces the importance of early identification and prompt intervention to save life of children and reduces sequelae. Further studies are needed about mechanism of FMPP.