title: Utility of serum ferritin and lactate dehydrogenase as surrogate markers for steroid therapy for Mycoplasma pneumoniae pneumonia.
abstract: BACKGROUND
  Patients with severe mycoplasma pneumonia having very high serum interleukin-18 levels may require systemic corticosteroid treatment. However, we know of no laboratory markers that have been identified to assess the precise severity of Mycoplasma pneumoniae pneumonia. Thus, we investigated the usefulness of four clinical laboratory tests as severity indicators and surrogate markers for initiation of steroid therapy in these patients.
  
  
  METHODS
  For 22 Japanese children (including 3 patients who needed systemic corticosteroid therapy) diagnosed with Mycoplasma pneumoniae pneumonia, white blood cell counts and serum concentrations of interleukin-18, C-reactive protein, lactate dehydrogenase, and ferritin were determined in the acute and recovery phases.
  
  
  RESULTS
  In total, 8 and 14 patients were classified as moderate and mild pneumonia, respectively, according to clinical manifestations. The serum interleukin-18 level in the acute phase of the pneumonia group was significantly higher than that of age-matched controls. Furthermore, serum interleukin-18, lactate dehydrogenase and ferritin levels in the acute phase increased in parallel with the severity of the pneumonia. The serum ferritin level was also higher in the acute phase than in the recovery phase. Positive correlations between the levels of serum interleukin-18, lactate dehydrogenase and ferritin were observed in the acute phase.
  
  
  CONCLUSIONS
  Serum lactate dehydrogenase and ferritin levels may be useful as indicators of the severity of pediatric Mycoplasma pneumoniae pneumonia for initiation of corticosteroid therapy.
authors: Department of Pediatrics, Hitachiomiya Saiseikai Hospital, Ibaraki, Japan; Department of Pediatrics, Jichi Medical University School of Medicine, Tochigi, Japan. Electronic address: kawamatar@jichi.ac.jp.
authors: Ryou
authors: R
authors: Kawamata
authors: Department of Pediatrics, Jichi Medical University School of Medicine, Tochigi, Japan.
authors: Koji
authors: K
authors: Yokoyama
authors: Department of Pediatrics, Hitachiomiya Saiseikai Hospital, Ibaraki, Japan.
authors: Miori
authors: M
authors: Sato
authors: Department of Pediatrics, Hitachiomiya Saiseikai Hospital, Ibaraki, Japan.
authors: Masahide
authors: M
authors: Goto
authors: Department of Pediatrics, Jichi Medical University School of Medicine, Tochigi, Japan; Department of Pediatrics, Shin-Oyama City Hospital, Tochigi, Japan.
authors: Yasuyuki
authors: Y
authors: Nozaki
authors: Department of Bacteriology, Ibaraki Prefectural Institute of Public Health, Ibaraki, Japan.
authors: Takeshi
authors: T
authors: Takagi
authors: Department of Pediatrics, Jichi Medical University School of Medicine, Tochigi, Japan.
authors: Hideki
authors: H
authors: Kumagai
authors: Department of Pediatrics, Jichi Medical University School of Medicine, Tochigi, Japan.
authors: Takanori
authors: T
authors: Yamagata
mesh_terms: D000305:Adrenal Cortex Hormones / Q000493:pharmacokinetics / Q000627:therapeutic use*; D000893:Anti-Inflammatory Agents / Q000493:pharmacokinetics / Q000627:therapeutic use*; D015415:Biomarkers / Q000097:blood*; D002648:Child; D015331:Cohort Studies; D016903:Drug Monitoring / Q000379:methods*; D005260:Female; D005293:Ferritins / Q000097:blood*; D006801:Humans; D020382:Interleukin-18 / Q000097:blood; D007770:L-Lactate Dehydrogenase / Q000097:blood*; D008297:Male; D009177:Mycoplasma pneumoniae; D011019:Pneumonia, Mycoplasma / Q000097:blood / Q000175:diagnosis* / Q000188:drug therapy / Q000453:epidemiology
chemical_list: D000305:Adrenal Cortex Hormones; D000893:Anti-Inflammatory Agents; D015415:Biomarkers; D020382:Interleukin-18; D005293:Ferritins; D007770:L-Lactate Dehydrogenase
keywords: Children; Ferritin; Interleukin-18; Lactate dehydrogenase; Mycoplasma pneumonia; Mycoplasma pneumoniae