{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,10]],"date-time":"2026-04-10T07:00:55Z","timestamp":1775804455292,"version":"3.50.1"},"reference-count":21,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,4,10]],"date-time":"2026-04-10T00:00:00Z","timestamp":1775779200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pediatr."],"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To compare the clinical characteristics and immune-inflammatory markers between Mycoplasma pneumoniae pneumonia children with and without atopic constitution, and to identify independent risk factors for severe MPP within the atopic group.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We retrospectively analyzed the medical records of 377 children diagnosed with MPP at Wuhan Children's Hospital between January 1, 2019, and December 31, 2024, who underwent allergen-specific immunoglobulin E (sIgE) testing for both inhalant and food allergens. The children were divided into two groups based on their atopic constitution: the atopic constitution group (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009282) and the non-atopic constitution group (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200995). General data, clinical symptoms, and laboratory test results were compared between the two groups. Logistic regression was used to identify independent risk factors for severe MPP in children with an atopic constitution, and ROC curves were used to determine the cutoff values for predictive markers.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among the 377 children with MPP, 282 (74.8%) were identified as having an atopic constitution. Within the atopic constitution group (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009282), 20 children (7.1%) progressed to severe Mycoplasma pneumoniae pneumonia (SMPP). No significant differences were observed between the atopic and non-atopic groups regarding age, fever duration, or length of hospital stay (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&amp;gt;\u20090.05). However, the atopic group showed a significantly higher incidence of wheezing (48.6% vs. 25.3%), stridor (34.4% vs. 20.0%), and dyspnea (15.2% vs. 4.2%) (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&amp;lt;\u20090.05). Multivariable logistic regression analysis revealed that oxygen therapy (OR\u2009=\u200957.49, 95% CI: 1.69\u20131,952.29,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.024), a history of corticosteroid use (OR\u2009=\u20099.28, 95% CI: 1.19\u201372.15,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.033), serum ferritin\u2009&amp;gt;\u2009107.61\u2005ng\/mL (OR\u2009=\u20091.01, 95% CI: 1.01\u20131.02,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&amp;lt;\u20090.05), and IgE\u2009&amp;gt;\u20091,060 IU\/mL (OR\u2009=\u20093.16, 95% CI: 1.10\u20139.07,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.032) were independent risk factors for severe MPP in children with atopic constitution. The ROC curve indicated that serum ferritin had the highest predictive performance (AUC\u2009=\u20090.75, 95% CI: 0.60\u20130.89).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Children with an atopic constitution exhibited a significantly higher prevalence of airway hyperreactivity symptoms during Mycoplasma pneumoniae infection compared to those without an atopic background. Clinically, high serum ferritin and IgE levels should be considered important independent risk factors for predicting severe MPP in children with an atopic constitution, which could facilitate early intervention and improve prognosis.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fped.2026.1760932","type":"journal-article","created":{"date-parts":[[2026,4,10]],"date-time":"2026-04-10T06:05:39Z","timestamp":1775801139000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Clinical characteristics of Mycoplasma pneumoniae pneumonia in children with atopic constitution and risk factors for disease severity: a retrospective comparative study"],"prefix":"10.3389","volume":"14","author":[{"given":"Yuehu","family":"Liu","sequence":"first","affiliation":[{"name":"Department of Respiratory Medicine, Wuhan Children's Hospital, Tongji Medical College, Huazhong University of Science and Technology","place":["Wuhan, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuan","family":"Fang","sequence":"additional","affiliation":[{"name":"Department of General Internal Medicine II, Wuhan Children's Hospital, Tongji Medical College, Huazhong University of Science and Technology","place":["Wuhan, China"]},{"name":"School of Nursing, Wuhan University, Wuhan, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peng","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine, Wuhan Children's Hospital, Tongji Medical College, Huazhong University of Science and Technology","place":["Wuhan, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wenqing","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine, Wuhan Children's Hospital, Tongji Medical College, Huazhong University of Science and Technology","place":["Wuhan, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiaoxia","family":"Lu","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine, Wuhan Children's Hospital, Tongji Medical College, Huazhong University of Science and Technology","place":["Wuhan, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2026,4,10]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"1907","DOI":"10.3389\/fimmu.2020.01907","article-title":"Research progress in atopic march","volume":"11","author":"Yang","year":"2020","journal-title":"Front Immunol"},{"key":"B2","doi-asserted-by":"publisher","first-page":"2925","DOI":"10.3390\/nu17182925","article-title":"The microecological-immune axis in pediatric allergic diseases: imbalance mechanisms and regulatory interventions","volume":"17","author":"Jiang","year":"2025","journal-title":"Nutrients"},{"key":"B3","doi-asserted-by":"publisher","first-page":"696","DOI":"10.3760\/cma.j.cn112140-20240407-00247","article-title":"Advancement in epidemiology of Mycoplasma pneumoniae pneumonia in children in China","volume":"62","author":"Liu","year":"2024","journal-title":"Zhonghua Er Ke Za Zhi"},{"key":"B4","doi-asserted-by":"publisher","first-page":"204","DOI":"10.2500\/aap.2014.35.3742","article-title":"The role of Mycoplasma pneumoniae infection in the initial onset and exacerbations of asthma","volume":"35","author":"Watanabe","year":"2014","journal-title":"Allergy Asthma Proc"},{"key":"B5","doi-asserted-by":"publisher","first-page":"1281479","DOI":"10.3389\/fped.2023.1281479","article-title":"Association of atopy with disease severity in children with Mycoplasma pneumoniae pneumonia","volume":"11","author":"Bian","year":"2023","journal-title":"Front Pediatr"},{"key":"B6","doi-asserted-by":"publisher","first-page":"6","DOI":"10.3760\/cma.j.issn.1674-2397.2019.01.002","article-title":"Guidelines for the diagnosis and treatment of community acquired pneumonia in children (2019 edition)","volume":"12","year":"2019","journal-title":"Chin J Clin Infect Dis"},{"key":"B7","first-page":"79","volume-title":"Guidelines for the Diagnosis and Treatment of Mycoplasma Pneumoniae Pneumonia in Children (2023 Edition). 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