Analysis of clinical characteristics of children with allergic purpura complicated with Mycoplasma pneumoniae infection
Objective To explore the clinical manifestations and laboratory examination characteristics of children with Henoch-Schonlein purpura(HSP)complicated with Mycoplasma pneumoniae(MP)infection,and analyze the diagnosis and treatment strategies and prognosis of such children.Methods The clinical data of 112 children with HSP who were treated in our hospital were retrospectively analyzed.At the same time,70 healthy children who underwent physical examinations were selected as the control group.The MP infection status of children in each group was detected,and the positive rates of MP in children of different groups were compared and analyzed.Venous blood of children was collected to determine the percentage of Th17 cells and Treg cells in the samples,and the differences in immune function of children in different groups were compared.Results Among 112 children with HSP,35 cases were infected with MP,with an infection rate of 31.25％.In contrast,only 8 of the 70 children in the control group were infected with MP,with an infection rate of 11.43％.There was a significant difference in the MP infection rate between the two groups.Among children with HSP,73 cases had their first onset,and 39 cases had two or more onsets.The MP positive rate in the first-onset group was 16.44％,while in the recurrence group,the MP positive rate was as high as 58.97％.There was a significant difference in the MP positive rate between the two groups.Among 65 male children with HSP,20 cases were MP positive,accounting for 30.77％;among 47 female children,15 cases were MP positive,accounting for 31.91％.There was no significant difference in the MP positive rate between genders.The MP positive rate of children aged 1-5 years was 47.37％,that of 5-9 years old was 32.26％,and that of＞9 years old was 19.35％.There was no statistical difference in the MP positive rate among different ages.The MP positive rate in spring was 53.85％,in summer it was 13.33％,in autumn it was 18.75％,and in winter it was 33.33％.There was a significant difference in the MP positive rate among different seasons.Among MP-positive children,the cutaneous type accounted for 14.29％,the abdominal type accounted for 5.71％,the joint type accounted for 17.14％,the renal type accounted for 14.29％,and the mixed type accounted for 48.57％.Among MP-negative children,the cutaneous type accounted for 10.39％,the abdominal type accounted for 22.08％,the joint type accounted for 23.38％,the renal type accounted for 3.9％,and the mixed type accounted for 40.26％.There were significant differences in the abdominal and renal types between the two groups(P＜0.05),and there were no significant differences in other types(P＞0.05).In children with positive MP,the initial symptom was all rash,with abdominal pain accounting for 47.71％,vomiting accounting for 28.57％,gastrointestinal bleeding accounting for 14.29％,and joint swelling and pain accounting for 57.14％.In children with negative MP,the initial symptom was also all rash,with abdominal pain accounting for 37.66％,vomiting accounting for 22.08％,gastrointestinal bleeding accounting for 7.79％,and joint swelling and pain accounting for 32.47％.There was a significant difference in joint swelling and pain between the two groups(P＜0.05),while there was no significant difference in other symptoms(P＞0.05).31.43％of children with positive MP were complicated with Henoch-Schonlein purpura nephritis,and 15.58％of children with negative MP were complicated with Henoch-Schonlein purpura nephritis.The difference was not statistically significant(P＞0.05).The percentage of Th17 cells in children in the MP positive group was(3.64±0.56)％,and the percentage of Treg cells was(10.57±1.04)％.The percentage of Th17 cells in children in the MP negative group was(2.63±0.55)％,and the percentage of Treg cells was(12.45±1.77)％.The percentage of Th17 cells in healthy children was(1.79±0.31)％,and the percentage of Treg cells was(14.88±1.69)％.The percentage of Th17 cells in children in the MP positive group was significantly higher than that in children in the MP negative group and healthy children,and the percentage of Treg cells was significantly lower than that in children in the MP negative group and healthy children.The comparison differences were statistically significant(P＜0.05).Conclusion Children with HSP complicated with MP infection had abnormal immune function,manifested as an increased proportion of Th17 cells and a decreased proportion of Treg cells,which may be related to the development and severity of the disease.At the same time,the difference in the positive rate of MP infection in different seasons suggested that environmental factors may have a certain impact on the infection.Although there was no statistically significant difference in the complication rate of Henoch-Schonlein purpura nephritis,the incidence of abdominal and renal types in children with positive MP was relatively high,which needed clinical attention.
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