ArticleAnnals of hematology2025
EC2-mutant Mycoplasma pneumoniae in pediatric ITP: severe hemorrhage with accelerated platelet recovery.
Article in Annals of hematology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background evidence indicates that the macrolide-resistant EC2 mutant of Mycoplasma pneumoniae (MP) emerged as the predominant strain during the 2023-2024 epidemic, being associated with immune-mediated complications (e.g., severe immune thrombocytopenia [ITP]), whose clinical characteristics and prognosis remain undefined. This study aimed to compare the severity of bleeding, treatment response and long-term prognosis in children with newly diagnosed severe ITP and non-MP-associated ITP with MP-related mutations during the epidemic of EC2 mutant strains. A cohort of children with MP-ITP or non-MP ITP admitted to Beijing Children's Hospital from October 2023 to February 2024 was enrolled. Twelve-month outcomes included baseline platelet counts, bleeding severity, short-term responses (at 1 week/1 month/3 months), and sustained remission rates at 6/12 months. The MP group (n = 20, median age 6.4 years) showed lower baseline platelet counts (12.0 × 10⁹/L) and higher proportions of severe bleeding (grade 3/4: 30%) compared with non-MP controls (n = 46, median age 5.5 years; platelets 21.0 × 10⁹/L; grade 3/4: 13%). Following monotherapy/combination therapy, A one-way analysis of covariance(ANCOVA) revealed significantly higher platelet counts in MP-ITP at 3-12 months (p ≤ 0.008), with consistently higher complete response rates in MP-ITP (100% at 1 month, 90% at 12 months) than in non-MP controls (87% at 1 month, 78% at 12 months). In conclusion, MP-related ITP was characterized by severe bleeding but demonstrated favorable treatment responses and long-term outcomes, warranting further investigation of its immunopathogenic mechanisms.
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