Pulmonary embolism in children with mycoplasma pneumonia: can it be predicted?

Purpose: To investigate the clinical characteristics of Mycoplasma pneumoniae (MP) pneumonia (MPP) combined with pulmonary embolism (PE) in children.

Methods: 291 hospitalized pediatric cases with MPP were enrolled from January 2018 to May 2024 and divided into the PE group (141 cases) and non-PE control group (150 cases). Clinical data of both groups were analyzed and compared.

Results: C-reactive protein (CRP), D-dimer, lactate dehydrogenase (LDH), and interleukin 6 (IL-6) were significantly higher in the PE group than in the non-PE control group. There were 85 males and 56 females in the PE group. The PE group has male-to-female ratio of 3: 2,and hemoptysis was observed in 11 children (7.08%), chest pain in 29 children (20.60%), and pulmonary necrosis in 89 children (63.12%). In the receiver operator curve(ROC), the areas under the curve(AUC) for D-dimer, CRP, IL-6, and LDH were 0.964, 0.690, 0.632, and 0.765, respectively. In the ROC curve, the cutoff values for D-dimer, CRP, IL-6, and LDH were 0.8 µg/ml, 24.2 mg/L, 37.8 pg/ml, and 461 U/L, respectively.

Conclusion: A proportion of children with MP infection combined with PE show atypical clinical symptoms. Children with MPP and elevated D-dimer levels, IL-6, CRP, erythrocyte sedimentation rate (ESR), and LDH may be prone to develop PE.