Mycoplasma pneumoniae Seroprevalence and Total IgE Levels in Patients with Juvenile Idiopathic Arthritis

Abstract

Background. Mycoplasma pneumoniae (M. pneumoniae) is implicated in several immune-mediated extrapulmonary manifestations, including reactive arthritis. Recently, increased total serum IgE were reported in children developing M. pneumoniae-related extrapulmonary diseases (MpEPDs). Here, we aimed at analyzing these aspects in children affected with rheumatic disorders and, in detail, Juvenile Idiopathic Arthritis (JIA). Methods. M. pneumoniae serology (IgG and IgM) and total serum IgE were concomitantly analyzed in 139 pediatric patients diagnosed with: JIA (Group 1, n = 85 ), or any rheumatic disease other than JIA (Group 2, n = 27 ), or non-inflammatory endocrinological disorders (Group 3, n = 27 ). Results. Overall, 19.4% M. pneumoniae seroprevalence was observed in this hospitalized pediatric population, without signicant differences among the three groups. No significant differences in total serum IgE levels were noted among these groups; however, a second analysis excluding children with very high (and clearly abnormal) IgE levels suggested that JIA patients and, in detail, those with oligopolyarticular forms may have higher serum IgE concentrations. This relative difference among groups in serum IgE level seems to be more pronounced in M. pneumoniae seropositive children. Conclusions. M. pneumoniae infection should be actively sought in children developing immune-mediated diseases, including patients affected with JIA and, especially, in oligopolyarticular forms. There is some evidence that total serum IgE levels may tend to be increased in patients with oligopolyarticular JIA subtype and especially in those resulting as M. pneumoniae seropositive. However, further and focused research is needed to confirm these preliminary results and to clarify the relation between M. pneumoniae infection, atopic status, and immune-mediated arthritis.

Increased Total Serum Immunoglobulin E Is Likely to Cause Complications of Mycoplasma pneumoniae Pneumonia in Children

“…This was in contrast to previous reports ( Shokrollahi et al., 2017 ; Mărginean et al., 2021 ). Another study showed that increased total serum IgE was associated with reactive arthritis in patients with MP infection ( Poddighe et al., 2021 ). Encephalitis, which affected children, was the most frequent neurological complication of MP ( Arighi et al., 2018 ).…”

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

“…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 ). There are also conflicting results from case–control studies regarding the relationship of M. pneumoniae infection with common childhood autoimmune diseases, such as Kawasaki disease and Guillain–Barre’s syndrome ( 13 ).…”