Comparative analysis of Mycoplasma Pneumoniae and Drug-induced Stevens-Johnson Syndrome/Toxic Epidermal Necrolysis in Children.

IF 1.2 4区医学 Q2 MEDICINE, GENERAL & INTERNAL

Pakistan Journal of Medical Sciences Pub Date : 2025-03-01 DOI:10.12669/pjms.41.3.10286

Xiaoyuan Wu, Lei Kang, Yanhong Jia, Li Jia, Fang Guo

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引用次数: 0

Abstract

Objective: To compare the differences between clinical characteristics, therapeutic management, and prognosis of mycoplasma pneumonia (MP) and drug-induced Stevens-Johnson syndrome (SJS)/toxic epidermal necrolysis (TEN) in children.

Methods: This was a retrospective study. The clinical data of SJS and TEN patients admitted to Hebei Children's Hospital from 2014-2024 were retrospectively analyzed and divided into the MP group and the drug group based on laboratory findings and the ALDEN algorithm for comparative study.

Results: A total of 42 cases were included in the study. Among them, 20 cases were in the MP group and 22 cases were in the drug group. The median age of MP group was 108.0 (54.0, 129.0) months, which was greater than drug group with 42.0 (22.5, 75.0) months, and the difference was statistically significant (P < 0.05). Ten cases (50.0%) in the MP group had chest CT suggestive of consolidation of lung/pleural effusion, which was higher than the two cases (9.1%) in the drug group, with a statistically significant difference (P<0.05). Both groups were given systemic corticosteroids (Cs) treatment, and the proportion of children receiving Cs shock therapy combined with intravenous immunoglobulin (IVIG) in the MP group was significantly lower than that in the drug group, with a statistically significant difference (P<0.05). When SCORTEN score ≧3, the proportion of the MP group receiving Cs shock therapy and IVIG application increased. The median SCORTEN score in both groups was two, corresponding to a predicted mortality rate of 12.2%, whereas all children in the MP group survived and three died in the drug group, with an actual mortality rate of 13.6%.

Conclusion: MP infection and drugs constitute the predominant triggers of SJS/TEN in children, with non-steroidal anti-inflammatory drugs (NSAIDs) and Chinese patent medicines (CPMs) as the main sensitizing drugs. For those with SCORTEN≦2 points, macrolides combined with conventional dose Cs may be the first-line treatment option for them.

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儿童肺炎支原体与药物性Stevens-Johnson综合征/中毒性表皮坏死松解的比较分析。

目的：比较儿童肺炎支原体（MP）与药物性Stevens-Johnson综合征(SJS)/中毒性表皮坏死松解症（TEN）的临床特点、治疗管理及预后的差异。方法：回顾性研究。回顾性分析河北省儿童医院2014-2024年收治的SJS和TEN患儿的临床资料，根据实验室结果和ALDEN算法分为MP组和药物组进行对比研究。结果：共纳入42例。其中，MP组20例，药物组22例。MP组患者年龄中位数为108.0（54.0,129.0）个月，高于药物组的42.0（22.5,75.0）个月，差异有统计学意义（P < 0.05）。MP组胸部CT提示肺/胸腔积液实变10例（50.0%），高于药物组2例（9.1%），差异有统计学意义(p)结论：MP感染和药物是儿童SJS/ Ten的主要诱发因素，非甾体抗炎药（NSAIDs）和中成药（CPMs）是主要致敏药物。对于SCORTEN≤2分的患者，大环内酯类药物联合常规剂量c可能是他们的一线治疗选择。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Pakistan Journal of Medical Sciences 医学-医学：内科

CiteScore

4.10

自引率

9.10%

发文量

363

审稿时长

3-6 weeks

期刊介绍： It is a peer reviewed medical journal published regularly since 1984. It was previously known as quarterly "SPECIALIST" till December 31st 1999. It publishes original research articles, review articles, current practices, short communications & case reports. It attracts manuscripts not only from within Pakistan but also from over fifty countries from abroad. Copies of PJMS are sent to all the import medical libraries all over Pakistan and overseas particularly in South East Asia and Asia Pacific besides WHO EMRO Region countries. Eminent members of the medical profession at home and abroad regularly contribute their write-ups, manuscripts in our publications. We pursue an independent editorial policy, which allows an opportunity to the healthcare professionals to express their views without any fear or favour. That is why many opinion makers among the medical and pharmaceutical profession use this publication to communicate their viewpoint.