Allergy, Asthma & Respiratory Disease

  • 제6권5호
  • /
  • Pages.248-254
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  • 2018
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  • 2288-0402(pISSN)
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  • 2288-0410(eISSN)
대한천식알레르기학회 (The Korean Academy of Asthma, Allergy and Clinical Immunology)
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Polymerase chain reaction 양성 소아 마이코플라스마 폐렴에서 혈청 IgM enzyme-linked immunosorbent assays의 진단적 가치

Diagnostic value of serum IgM enzyme-linked immunosorbent assays in polymerase chain reaction-positive Mycoplasma pneumonia in children

  • 이혜진 (가톨릭대학교 의과대학 소아과학교실) ;
  • 이윤태 (가톨릭대학교 의과대학 소아과학교실) ;
  • 김경훈 (가톨릭대학교 의과대학 소아과학교실) ;
  • 양은애 (가톨릭대학교 의과대학 소아과학교실) ;
  • 김환수 (가톨릭대학교 의과대학 소아과학교실) ;
  • 전윤홍 (가톨릭대학교 의과대학 소아과학교실) ;
  • 윤종서 (가톨릭대학교 의과대학 소아과학교실) ;
  • 김현희 (가톨릭대학교 의과대학 소아과학교실) ;
  • 김진택 (가톨릭대학교 의과대학 소아과학교실)
  • Lee, Hye Jin (Department of Pediatrics, College of Medicine, The Catholic University of Korea) ;
  • Lee, Yoon Tae (Department of Pediatrics, College of Medicine, The Catholic University of Korea) ;
  • Kim, Kyung Hoon (Department of Pediatrics, College of Medicine, The Catholic University of Korea) ;
  • Yang, Eun Ae (Department of Pediatrics, College of Medicine, The Catholic University of Korea) ;
  • Kim, Hwan Soo (Department of Pediatrics, College of Medicine, The Catholic University of Korea) ;
  • Chun, Yoon Hong (Department of Pediatrics, College of Medicine, The Catholic University of Korea) ;
  • Yoon, Jong-Seo (Department of Pediatrics, College of Medicine, The Catholic University of Korea) ;
  • Kim, Hyun Hee (Department of Pediatrics, College of Medicine, The Catholic University of Korea) ;
  • Kim, Jin Tack (Department of Pediatrics, College of Medicine, The Catholic University of Korea)
  • 투고 : 2018.03.14
  • 심사 : 2018.09.12
  • 발행 : 2018.09.30
⟨ 이전 논문 다음 논문 ⟩

초록

Purpose: Mycoplasma pneumoniae (MP) is a common cause of community-acquired pneumonia (CAP) in children. MP serum IgM and polymerase chain reaction (PCR) are the methods that enable early diagnosis in patients with MP pneumonia. The objective of this study was to investigate the clinical value of serum MP-specific IgM antibodies in PCR-positive MP pneumonia for the early diagnosis of MP pneumonia in children with CAP. Methods: Out of 129 patients with lower respiratory tract infection aged over 3 years, 90 CAP children were enrolled in the study. Throat swab MP real-time PCR and serum enzyme-linked immunosorbent assays (ELISA) IgM antibodies were performed. A positive rate of MP PCR and serum IgM, the level of IgM index, clinical features, and laboratory findings were analyzed. Results: MP PCR was positive in 57 cases. Longer fever duration before admission (P< 0.001), higher rates of lobar or segmental pneumonia (P= 0.048), unilateral infiltration (P= 0.038), and extrapulmonary symptoms (P= 0.049) were associated with MP PCR-positive pneumonia. Serum IgM index was significantly higher in MP PCR-positive pneumonia them in MP PCR-negative pneumonia ($3.9{\pm}3.0$ vs. $0.8{\pm}1.3$, P< 0.001). Using MP PCR as a gold standard, the sensitivity, specificity, positive predictive value and negative predictive value of serum IgM were 85.5%, 82.1%, 91.4%, and 71.9%, respectively. The area under the curves for serum IgM index was 0.892, and the ROC analysis indicated that an optimal cutoff value of 1.05 for serum IgM provided the highest sensitivity and specificity interestingly (83.9% vs. 85.7%, P< 0.001). Conclusion: Serum IgM ELISA has useful diagnostic value in PCR-positive MP pneumonia. Applying an IgM index cutoff of 1.05 improves diagnostic accuracy.

키워드

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