Mycoplasma infection aggravates cardiac involvements in Kawasaki diseases: a retrospective study

Guoyan Lu; Xing Li; Jie Tang; Yuxi Jin; Yang Wang; Kaiyu Zhou; Yifei Li

doi:10.3389/fimmu.2023.1310134

Mycoplasma infection aggravates cardiac involvements in Kawasaki diseases: a retrospective study

Front Immunol. 2024 Jan 17:14:1310134. doi: 10.3389/fimmu.2023.1310134. eCollection 2023.

Authors

Guoyan Lu^#¹, Xing Li^#¹, Jie Tang¹, Yuxi Jin¹, Yang Wang¹, Kaiyu Zhou¹, Yifei Li¹

Affiliation

¹ Department of Pediatrics, Ministry of Education Key Laboratory of Women and Children's Diseases and Birth Defects, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China.

^# Contributed equally.

Abstract

Background: Mycoplasma pneumoniae (MP) infection serves as a substantial cofactor in Kawasaki disease (KD) among patients. Although the dominant issue triggering KD has recently focused on MP infection, the complete demonstration of the relationship between MP infection and KD remains elusive. This study endeavors to scrutinize and compare the clinical manifestations and cardiac involvement between MP-triggered KD and non-infection-associated KD.

Method: This retrospective study (2023-039, approved by the Institutional Review Board of West China Second University Hospital of Sichuan University) encompassed 247 consecutive patients diagnosed with KD between June 2017 and December 2022. Patients were categorized into two groups: the MP group (n = 38) and the non-MP group (n = 209). Univariable analysis was utilized to discern differences in clinical features, severity of inflammation, and initial or persistent cardiac complications between the two groups.

Results: The MP group exhibited a more intricate clinical profile compared with the non-MP group, characterized by prolonged hospital stays, a higher incidence of incomplete KD, and elevated comorbidities. In addition, MP infection correlated with severe hematological disorders, coagulation dysfunction, and myocardial injuries. Our findings revealed that MP infection led to prolonged inflammation after initial treatment with intravenous immunoglobulin. Although initial cardiac assessments failed to discern disparities between the two groups, MP infection notably exacerbated coronary artery aneurysms (CAAs), resulting in sustained dilation.

Conclusions: Recognizing MP infection as a significant infectious factor associated with KD is imperative. In patients with KD, MP infection significantly prolongs inflammation and causes hematological disturbances during the initial treatment phase. Moreover, the presence of MP infection exacerbates the progression of CAAs and myocardial injuries during the subacute phase of KD, consequently contributing to the persistence of CAAs.

Keywords: Kawasaki disease; coronary artery injuries; inflammation; mycoplasma pneumoniae; prognosis.

Publication types

Research Support, Non-U.S. Gov't
Comment

MeSH terms

Coronary Aneurysm* / etiology
Heart Diseases*
Humans
Inflammation / complications
Mucocutaneous Lymph Node Syndrome* / drug therapy
Pneumonia, Mycoplasma* / complications
Pneumonia, Mycoplasma* / epidemiology
Retrospective Studies

Grants and funding

The author(s) declare financial support was received for the research, authorship, and/or publication of this article. This work was supported by grants from Technology Project of Sichuan Province of China (2021YFQ0061) and the National Natural Science Foundation of China (82270249). The funding did not participate in the design of the study and collection, analysis, and interpretation of data and in writing the manuscript.