33 4 2012 8 JOURNAL OF TONGJI UNIVERSITY MEDICAL SCIENCE Vol. 33 No. 4 Aug. 2012 doi 10. 3969 /j. issn1008-0392. 2012. 04. 027 200072 MP R 725. 6 A 1008-0392 2012 04-0120-05 Extrapulmonary manifestations of Mycoplasma pneumoniae infection LI Cheng-mei YIN Shao-jun Dept. of Gereology Tenth People's Hospital Tongji University Shanghai 200072 China Abstract The pathogenesis of Mycoplasma pneumoniae MP is inclined to the two mechanisms of epithelial cell adhesion and immunological which immune dysregulation may play an important role in the pathogenicity of extra-pulmonary damage of M P. The manifestations of its extra-pulmonary usually involves multiple systems. including nervous system cardiovascular system urinary system. skin tissue immune system damage muscle and joint damage. Extra-pulmonary damage of MP should be paid attention in clinical w ork. mycoplasma pneumoniae MP 1 MP MP MP Ⅰ T 45% ~ 48. 8% 1-2 10. 7% 35. 7% 21. 4% 12. 5% 1. 8% 37. 5% MP 120 2011-08-31 2010082 1980. E-mail galaxyli0418@ hotmail. com. E-mail yinshaojun2010@ yahoo. com. cn
4 MP 1. 1 MP MP MP B IgM IgG Th 1 /Th 2 MP Th 1 Th 2 IgM MP 1 MP 3 ~ 4 2 ~ MP 4 3 8 7 MP 2 1. 2 MP MP 2. 1 MP MP 4-7 MP 1. 2. 1 MP - 8 MP MP 7% 8. 3% 9 70% MP MP MP 1 1. 2. 2 MP IgM IgG siga IgA MP IgM IgA 15% ~ 20% MP IgG MP MP IgM IgA MP cerebrospinal fluid MP CSF MD CSF-MP-IgM MP MP CSF 10 T B NK T MP CSF MP MP Lionadi 11 2 MP GC 121
33 2. 2 MP 17 MP MP MP Ⅱ ST-T ALT 6 creatine kinase MB isoenzyme CK-MB lactic dehydrogenase LDH 2. 6 MP MP MP MP MP 19 MP MP 2. 7% Stevens-Jonson S-JS 3 ~ 6 2 2 13 2. 3 MP MD IgG albumin ALB β 2 β 2 -microglobulin β 2 -M MP 2. 7 MP MP IgG CD4 + CD4 /CD8 IgM CD8 + 20 MP CD4 + MP MP B MP MP 2. 4 MP MP MP MP Coomb's MP Coomb's 72. 22% MP 2. 99% MP 2. 8 MP 14 MP MP disseminated intravascular coagulation MP 18 MP DIC 15 16 MP 21 2. 5 MP ALT MP 122
4 3 MP MP MP MP X MP MP 22 ctn-i MP 1 57-60. 2 Zhang B Chen ZM. Changes in clinical manifestation of mycoplasma pneumonia pneumonia in children older 4 MP than 3 years during 2000 2006 in Hangzhou J. Zhonghua Er Ke Za Zhi 2010 48 7 531-534. MP MP 3 Kashyap S Sarkar M. Mycoplasma pneumonia MP Clinical features and management J. Lung India 2010 27 2 75-85. 4 Yang J Hooper WC Phillips DJ et al. Cytokines in DIC MP Mycoplasma pneumoniae infections J. Cytokine MP-IgM Growth Factor Reviews 2004 15 15 2-3 MP-IgG 157-168. 5 Waites KB Talkingt on DF. Mycoplasma pneumoniae and its role as a human pathogen J. Clin Mictcbiol MP Rev 2004 17 4 697-728. 6 Yang J Hooer WC Phillips DJ et al. Cytokines in community acquiredpneumonia CAP CAP 30 31 ~ 50 MP 32. 8% 27. 8% 50 5 MP 1 Smith LG. Mycoplasma pneumonia and its complications J. Infect Dis Clin North Am 2010 24 Myceplasma pneumoniae infections J. Cytokine Growth Factor Rev 2004 15 2-3 157-168. 7 Martire B Foci C Cassano N et al. Persisten B-cell lymphopenia multiorgan disease and erythema multiforme caused by mycoplasma pneumoniae infection J. PedialrDerrmatol 2005 22 6 558-560. 8 Beskind DI Kein SM. Chorcoathctotic movement disorder in a boy with mycoplasma pneumonia encephalitic J. Anm Emerg Med 1994 23 1375-1378. 9. MP 17 J. 2004 19 7 426-427. MP 10 Lee KY. Pediatric respiratory in fections by Mycoplasma pneumoniae J. Expert Rev Anti Infect Ther 2008 6 4 509-521. 11 Leonaidi S Pavone P Rotolo N et al. Stroke in two 123
33 children with Mycoplasma pneumoniae infection A causal or casual relationship J. Pediatr Infect Dis J 2005 24 9 843-845. 12 Mitsugi N Takashi H Harumitsu. Cardiac thrombus associated with mycoplasma pneumonia infection J. Interactive cardiovascular and thoracic Surgery 2010 11 6 849-851. 13 Bogomolov BP Mol'kova TN Deviatkin Av. Cardiovascular system condition in respiratory mycoplasmosis J. Klin Med Mosk 2002 80 12 34-38. 14. MP of P1 and 16S rrna genes by nested PCR for detection J. 2003 21 6 374-371. 15 Chrussanthopoulos C Eboriadou M Montik K et al. Fatal disseminated intravascular coagulation caused by Mycoplasma pneumoniae J. Pediatr Infect Dis J 2001 20 6 634-635. 16 Joo CU Kim JS Han YM. Mycoplasma pneumoniae induced popliteal artery thrombosis treated with urokinase J. Postgrad Med J 2001 77 913 723-724. 17. 24. 56 J. 2003 21 J. 6 344-346. 18 Joo HC Young SK Bok KK. A case of acute hepatitis with Mycoplasma pneumonia infection and transient depression of multiple coagulation factors J. Yonsei Medical Journal 2008 49 6 1055-1059. 19 Orlandini Dega H Dubertretl. Cutaneous vaculitis revealing a mycoplasma pneumoniae infection J. Press Med 2004 66 33 19 Pt 2 1365-1366. 20. J. 2001 39 5 543-544. 21 Nour M Trabelsi A Maatouk N et al. Amplification of Mycoplasma pneumoniae in paediatric patients J. Pathol Biol Paris 2005 53 1 9-14. 22. I J. 2003 18 11 879-880. 23. J. 2011 29 5 575-577. 2010 33 9 643-645. 124