Multifocal thrombosis with peripheral gangrene in a young boy: Mycoplasma infection triggered cold agglutinin disease

Sudhakar, Murugan; Mohandoss, Vichithra; Chaudhary, Himanshi; Ahluwalia, Jasmina; Bhattarai, Dharmagat; Jindal, Ankur Kumar

doi:10.1016/j.imbio.2021.152075

Cited by 1 publication

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“…There is increasing interest in the impact of M. pneumonia infection on autoimmune diseases ( 2 , 6 ), and many case reports have examined this relationship ( 7 , 8 ). However, there is no definitive evidence of a causal relationship because these studies had cross-sectional designs ( 9 , 10 ), observational studies lacking appropriate controls ( 11 ), and examined small numbers of patients who were mostly from specialist clinics ( 12 ).…”

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confidence: 99%

Investigating the occurrence of autoimmune diseases among children and adolescents hospitalized for Mycoplasma pneumoniae infections

Ha,

Kim,

Cha

et al. 2023

Front. Immunol.

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BackgroundMycoplasma pneumoniae infection is common in the general population and may be followed by immune dysfunction, but links with subsequent autoimmune disease remain inconclusive.ObjectiveTo estimate the association of M. pneumoniae infection with the risk of subsequent autoimmune disease.MethodsThis retrospective cohort study examined the medical records of South Korean children from 01/01/2002 to 31/12/2017. The exposed cohort was identified as patients hospitalized for M. pneumoniae infection. Each exposed patient was matched with unexposed controls based on birth year and sex at a 1:10 ratio using incidence density sampling calculations. The outcome was subsequent diagnosis of autoimmune disease, and hazard ratios (HRs) were estimated with control for confounders. Further estimation was performed using hospital-based databases which were converted to a common data model (CDM) to allow comparisons of the different databases.ResultsThe exposed cohort consisted of 49,937 children and the matched unexposed of 499,370 children. The median age at diagnosis of M. pneumoniae infection was 4 years (interquartile range, 2.5–6.5 years). During a mean follow-up time of 9.0 ± 3.8 years, the incidence rate of autoimmune diseases was 66.5 per 10,000 person-years (95% CI: 64.3–68.8) in the exposed cohort and 52.3 per 10,000 person-years (95% CI: 51.7–52.9) in the unexposed cohort, corresponding to an absolute rate of difference of 14.3 per 10,000 person-years (95% CI: 11.9–16.6). Children in the exposed cohort had an increased risk of autoimmune disease (HR: 1.26; 95% CI: 1.21–1.31), and this association was similar in the separate analysis of hospital databases (HR: 1.25; 95% CI 1.06–1.49).ConclusionM. pneumoniae infection requiring hospitalization may be associated with an increase in subsequent diagnoses of autoimmune diseases.

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