Serum lactate dehydrogenase isoenzymes 4 plus 5 is a better biomarker than total lactate dehydrogenase for refractory Mycoplasma pneumoniae pneumonia in children
Although usually self-limiting, Mycoplasma pneumoniae pneumonia (MPP) may lead to clinical or radiological deterioration despite macrolide antibiotic therapy, resulting in the development of refractory MPP (RMPP). Corticosteroids have been used to treat RMPP with beneficial effects. Serum lactate de...
| Main Authors: | , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2018-10-01
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| Series: | Pediatrics and Neonatology |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S1875957217304722 |
| _version_ | 1819002624952762368 |
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| author | Ta-Yu Liu Wei-Ju Lee Chih-Min Tsai Kuang-Che Kuo Chen-Hsiang Lee Kai-Sheng Hsieh Chin-Hao Chang Yu-Tsun Su Chen-Kuang Niu Hong-Ren Yu |
| author_facet | Ta-Yu Liu Wei-Ju Lee Chih-Min Tsai Kuang-Che Kuo Chen-Hsiang Lee Kai-Sheng Hsieh Chin-Hao Chang Yu-Tsun Su Chen-Kuang Niu Hong-Ren Yu |
| author_sort | Ta-Yu Liu |
| collection | DOAJ |
| description | Although usually self-limiting, Mycoplasma pneumoniae pneumonia (MPP) may lead to clinical or radiological deterioration despite macrolide antibiotic therapy, resulting in the development of refractory MPP (RMPP). Corticosteroids have been used to treat RMPP with beneficial effects. Serum lactate dehydrogenase (LDH) is a suggested biomarker for the use of steroid therapy. Since serum LDH is a non-specific marker and elevated in many inflammatory processes, this study investigates the predicting level of LDH isoenzymes for RMPP. Fifty-four children with non-refractory M. pneumoniae pneumonia (NRMPP) and 16 children with RMPP were enrolled in this study. In comparison to the NRMPP group, the RMPP group showed significantly higher levels of serum LDH. Concerning LDH isoenzymes, the RMPP group showed significantly lower proportions of LDH1 and LDH2, while higher LDH4 and LDH5 percentage. Receiver operating characteristic curve analysis showed that the area under the curve for the total LDH data was 0.812 with a cut-off of 408 IU/L (sensitivity of 75.0%, specificity of 72.2%). The areas under the curve for LDH4, LDH5, and [LDH4 + LDH5] were estimated to be 0.813, 0.818, and 0.829, respectively. The threshold for [LDH4 + LDH5] was estimated to be 109.4 IU/L (sensitivity, 75.0%; specificity, 87.0%). These results indicate that for the initiation of corticosteroid therapy, serum [LDH4 + LDH5] level is a more sensitive biomarker than total LDH. Key Words: children, LDH isoenzyme, refractory Mycoplasma pneumoniae pneumonia |
| first_indexed | 2024-12-20T23:08:04Z |
| format | Article |
| id | doaj.art-96843718a1324983b47208fc43a4928b |
| institution | Directory Open Access Journal |
| issn | 1875-9572 |
| language | English |
| last_indexed | 2024-12-20T23:08:04Z |
| publishDate | 2018-10-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Pediatrics and Neonatology |
| spelling | doaj.art-96843718a1324983b47208fc43a4928b2022-12-21T19:23:49ZengElsevierPediatrics and Neonatology1875-95722018-10-01595501506Serum lactate dehydrogenase isoenzymes 4 plus 5 is a better biomarker than total lactate dehydrogenase for refractory Mycoplasma pneumoniae pneumonia in childrenTa-Yu Liu0Wei-Ju Lee1Chih-Min Tsai2Kuang-Che Kuo3Chen-Hsiang Lee4Kai-Sheng Hsieh5Chin-Hao Chang6Yu-Tsun Su7Chen-Kuang Niu8Hong-Ren Yu9Department of Pediatrics, Chang Gung Memorial Hospital – Kaohsiung Medical Center and Graduate Institute of Clinical Medical Sciences, Chang Gung University College of Medicine, TaiwanDepartment of Pediatrics, Chiayi Chang Gung Memorial Hospital, TaiwanDepartment of Pediatrics, Chang Gung Memorial Hospital – Kaohsiung Medical Center and Graduate Institute of Clinical Medical Sciences, Chang Gung University College of Medicine, TaiwanDepartment of Pediatrics, Chang Gung Memorial Hospital – Kaohsiung Medical Center and Graduate Institute of Clinical Medical Sciences, Chang Gung University College of Medicine, TaiwanDepartment of Internal Medicine, Chang Gung Memorial Hospital – Kaohsiung Medical Center, TaiwanDepartment of Pediatrics, Chang Gung Memorial Hospital – Kaohsiung Medical Center and Graduate Institute of Clinical Medical Sciences, Chang Gung University College of Medicine, TaiwanDepartment of Respiratory Therapy, Chang Gung Memorial Hospital – Kaohsiung Medical Center, TaiwanDepartment of Pediatrics, E-Da Hospital/I-Shou University, Kaohsiung, TaiwanDepartment of Pediatrics, Chang Gung Memorial Hospital – Kaohsiung Medical Center and Graduate Institute of Clinical Medical Sciences, Chang Gung University College of Medicine, TaiwanDepartment of Pediatrics, Chang Gung Memorial Hospital – Kaohsiung Medical Center and Graduate Institute of Clinical Medical Sciences, Chang Gung University College of Medicine, Taiwan; Corresponding author. Department of Pediatrics, Kaohsiung Chang Gung Memorial Hospital, #123 Ta-Pei Road, Niao-Sung district, Kaohsiung 833, Taiwan. Fax: +886 7 733 8009.Although usually self-limiting, Mycoplasma pneumoniae pneumonia (MPP) may lead to clinical or radiological deterioration despite macrolide antibiotic therapy, resulting in the development of refractory MPP (RMPP). Corticosteroids have been used to treat RMPP with beneficial effects. Serum lactate dehydrogenase (LDH) is a suggested biomarker for the use of steroid therapy. Since serum LDH is a non-specific marker and elevated in many inflammatory processes, this study investigates the predicting level of LDH isoenzymes for RMPP. Fifty-four children with non-refractory M. pneumoniae pneumonia (NRMPP) and 16 children with RMPP were enrolled in this study. In comparison to the NRMPP group, the RMPP group showed significantly higher levels of serum LDH. Concerning LDH isoenzymes, the RMPP group showed significantly lower proportions of LDH1 and LDH2, while higher LDH4 and LDH5 percentage. Receiver operating characteristic curve analysis showed that the area under the curve for the total LDH data was 0.812 with a cut-off of 408 IU/L (sensitivity of 75.0%, specificity of 72.2%). The areas under the curve for LDH4, LDH5, and [LDH4 + LDH5] were estimated to be 0.813, 0.818, and 0.829, respectively. The threshold for [LDH4 + LDH5] was estimated to be 109.4 IU/L (sensitivity, 75.0%; specificity, 87.0%). These results indicate that for the initiation of corticosteroid therapy, serum [LDH4 + LDH5] level is a more sensitive biomarker than total LDH. Key Words: children, LDH isoenzyme, refractory Mycoplasma pneumoniae pneumoniahttp://www.sciencedirect.com/science/article/pii/S1875957217304722 |
| spellingShingle | Ta-Yu Liu Wei-Ju Lee Chih-Min Tsai Kuang-Che Kuo Chen-Hsiang Lee Kai-Sheng Hsieh Chin-Hao Chang Yu-Tsun Su Chen-Kuang Niu Hong-Ren Yu Serum lactate dehydrogenase isoenzymes 4 plus 5 is a better biomarker than total lactate dehydrogenase for refractory Mycoplasma pneumoniae pneumonia in children Pediatrics and Neonatology |
| title | Serum lactate dehydrogenase isoenzymes 4 plus 5 is a better biomarker than total lactate dehydrogenase for refractory Mycoplasma pneumoniae pneumonia in children |
| title_full | Serum lactate dehydrogenase isoenzymes 4 plus 5 is a better biomarker than total lactate dehydrogenase for refractory Mycoplasma pneumoniae pneumonia in children |
| title_fullStr | Serum lactate dehydrogenase isoenzymes 4 plus 5 is a better biomarker than total lactate dehydrogenase for refractory Mycoplasma pneumoniae pneumonia in children |
| title_full_unstemmed | Serum lactate dehydrogenase isoenzymes 4 plus 5 is a better biomarker than total lactate dehydrogenase for refractory Mycoplasma pneumoniae pneumonia in children |
| title_short | Serum lactate dehydrogenase isoenzymes 4 plus 5 is a better biomarker than total lactate dehydrogenase for refractory Mycoplasma pneumoniae pneumonia in children |
| title_sort | serum lactate dehydrogenase isoenzymes 4 plus 5 is a better biomarker than total lactate dehydrogenase for refractory mycoplasma pneumoniae pneumonia in children |
| url | http://www.sciencedirect.com/science/article/pii/S1875957217304722 |
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