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EC2-mutant Mycoplasma pneumoniae in pediatric ITP: severe hemorrhage with accelerated platelet recovery
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EC2-mutant Mycoplasma pneumoniae in pediatric ITP: severe hemorrhage with accelerated platelet recovery
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Journal Article
EC2-mutant Mycoplasma pneumoniae in pediatric ITP: severe hemorrhage with accelerated platelet recovery
2025
Overview
Background evidence indicates that the macrolide-resistant EC2 mutant of Mycoplasma pneumoniae (MP) emerged as the predominant strain during the 2023–2024 epidemic, being associated with immune-mediated complications (e.g., severe immune thrombocytopenia [ITP]), whose clinical characteristics and prognosis remain undefined. This study aimed to compare the severity of bleeding, treatment response and long-term prognosis in children with newly diagnosed severe ITP and non-MP-associated ITP with MP-related mutations during the epidemic of EC2 mutant strains. A cohort of children with MP-ITP or non-MP ITP admitted to Beijing Children’s Hospital from October 2023 to February 2024 was enrolled. Twelve-month outcomes included baseline platelet counts, bleeding severity, short-term responses (at 1 week/1 month/3 months), and sustained remission rates at 6/12 months. The MP group (
n
= 20, median age 6.4 years) showed lower baseline platelet counts (12.0 × 10⁹/L) and higher proportions of severe bleeding (grade 3/4: 30%) compared with non-MP controls (
n
= 46, median age 5.5 years; platelets 21.0 × 10⁹/L; grade 3/4: 13%). Following monotherapy/combination therapy, A one-way analysis of covariance(ANCOVA) revealed significantly higher platelet counts in MP-ITP at 3–12 months (
p
≤ 0.008), with consistently higher complete response rates in MP-ITP (100% at 1 month, 90% at 12 months) than in non-MP controls (87% at 1 month, 78% at 12 months). In conclusion, MP-related ITP was characterized by severe bleeding but demonstrated favorable treatment responses and long-term outcomes, warranting further investigation of its immunopathogenic mechanisms.
Publisher
Springer Berlin Heidelberg,Springer Nature B.V
Subject
/ Anti-Bacterial Agents - therapeutic use
/ Child
/ COVID-19
/ Drug Resistance, Bacterial - genetics
/ Female
/ Humans
/ Infant
/ Male
/ Medicine
/ Mutation
/ Mycoplasma pneumoniae - drug effects
/ Mycoplasma pneumoniae - genetics
/ Oncology
/ Pneumonia, Mycoplasma - blood
/ Pneumonia, Mycoplasma - complications
/ Pneumonia, Mycoplasma - drug therapy
/ Pneumonia, Mycoplasma - microbiology
/ Proteins
/ Purpura, Thrombocytopenic, Idiopathic - blood
/ Purpura, Thrombocytopenic, Idiopathic - complications
/ Purpura, Thrombocytopenic, Idiopathic - drug therapy
/ Purpura, Thrombocytopenic, Idiopathic - microbiology
/ Toxins
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