To investigate clinical features and peripheral lymphocyte profiles in children with refractory Mycoplasma pneumoniae pneumonia (RMPP) versus those with common Mycoplasma pneumoniae pneumonia (CMPP) to identify immune disturbances that may serve as early predictive indicators.
Key Findings:
Children with RMPP exhibited more severe clinical manifestations than those with CMPP, including prolonged high fever, higher rates of severe disease and glucocorticoid use, and extensive lung involvement.
RMPP was characterized by significant reductions in absolute lymphocyte counts, particularly T cells and plasmablasts, alongside an accentuated systemic inflammatory response.
A four-indicator combined model demonstrated good discrimination for predicting RMPP with 96% sensitivity and 52% specificity.
Interpretation:
RMPP involves profound adaptive immunosuppression, marked by reductions in total lymphocytes and specific functional subsets, particularly plasmablasts, as indicated by the study findings.
Limitations:
The study was retrospective and conducted at a single center, which may limit generalizability.
Exclusion criteria may have omitted relevant cases that could provide additional insights.
Conclusion:
A model integrating plasmablast count, age, fever duration, and pleural effusion holds promise for early RMPP identification.
