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ORIGINAL ARTICLE
Korean J Pediatr 2015 June;58(6) :211-217.
Published online 2015 June 15.       
Hepatitis associated with Mycoplasma pneumoniae infection in Korean children: a prospective study
Kyu Won Kim1, Jae Jin Sung1, Hann Tchah1, Eell Ryoo1, Hye Kyung Cho1, Yong Han Sun1, Kang Ho Cho1, Dong Woo Son1, In Sang Jeon1, Yun Mi Kim2
11Department of Pediatrics, Gachon University Gil edical Center, Incheon, Korea
2Department of Nursing, Gachon University, Incheon, Korea
Corresponding Author: Hann Tchah ,Tel: +82-32-460-8429, Fax: +82-32-460-3224, Email: onecar@gilhospital.com
Copyright © 2015 by The Korean Pediatric Society
ABSTRACT
Purpose: Mycoplasma pneumoniae (MP) infection is a major cause of respiratory infection in schoolaged children. Extrapulmonary manifestations of MP infection are common, but liver involvement has been rarely reported. The aim of this study was to determine the clinical characteristics of MPassociated hepatitis.
Methods: This prospective study included 1,044 pediatric patients with MP infection diagnosed serologically with MP IgM at one medical center from January 2006 to December 2012. Eighty of these patients had elevated levels of serum aspartate aminotransferase (AST) and alanine aminotransferase (ALT), each greater than 50 IU/L, without any other specific liver disorder and were compared with the 964 children without liver disorders.
Results: In total, 7.7% of patients with MP infection had a diagnosis of hepatitis, especially in fall and winter. The ratio of male to female patients was 1.7:1, and the mean age of the patients was 5 years and 5 months. The most common symptoms were cough, fever, and sputum. Anorexia was the most common gastrointestinal symptom, followed by nausea/vomiting, diarrhea, and abdominal pain. Mean levels of AST and ALT were 100.65 IU/L and 118.73 IU/L, respectively. Serum AST/ALT level was normalized within 7.5 days on average without complications. The mean duration of hospitalization (11.3 days) was longer for children with hepatitis than for those without hepatitis (P =0.034).
Conclusion: MP-associated hepatitis is not uncommon and has a relatively good prognosis. Therefore, clinicians should be concerned about liver involvement in MP infection but avoid further unnecessary evaluation of hepatitis associated with MP.
Keywords: Mycoplasma pneumoniae | Hepatitis | Macrolides
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