All issues > Volume 38(9); 1995

Original Article

J Korean Pediatr Soc. 1995;38(9):1210-1219. Published online September 15, 1995.

A Study of Relationship between Bronchial Hyperreactivity (BHR) and Atopic Findings in Mycoplasma pneumoniae Pneumonia

In Kyeong IK Seo¹, Weon Jeong WJ Bae¹, Jae Ook JO Lee¹, Im Ju IJ Kang¹

¹Department of Pediatrics, Fatima Hospital, Taegu, Korea

Abstract

Purpose
: The respiratory infection due to Mycoplasma pneumoniae among school aged children and adolescents was recognized as an important cause of wheezing or BHR. This study was performed to evaluate relationship between BHR to Mch inhalation challenge and atopic findings in M. pneumoniae pneumonia.
Methods
: 61 patients with M. pneumoniae pneumonia who were admitted to the department of Pediatrics, Fatima Hospital, Taegu during the period of 1 year from May 1993 to April 1994 were involved in this study. These patients were separated into reactive and non-reactive groups according to the result of Mch inhalation challenge test and atopic findings such as peripheral eosinophil counts, total serum IgE levels, past & family history of allergic disease, Water's view and pulmonary function tests were compared. Mch inhalation challenge test was performed as follows ; normal saline was inhaled 5 times by tidal breath through De Vilbiss 646 inhaler and FEV1 was measured as baseline. According to Chai's standardized method, Mch was diluted to 0.075-25.0mg/ml concentration, and accumulated Mch per 5 tidal breaths was graded 0.375-225.0 B.U.(1B.U.=1 inhalation of 1mg/ml). PD20 was determined to the concentration at which the FRV1 fell to 20% below baseline.
Results
: 1) Out of 61 patents with pneumoniae pneumonia, 42 cases(68.9%) showed positive response to Mch inhalation challenge. The incidence was more prevalent in male as the male to female ratio was 2:1 in reactive group. 2) Age had no effect on severity of BHR as correlation coefficient between age and PD20 was 0.08 in male and 0.21 in female. 3) Associated maxillary sinusitis had no significant difference in both groups. 4) There was no significant difference in peripheral eosinophil counts and total serum IgE levels of both groups. 5) Past history of allergic respiratory disease and family history of atopy were significantly higher in reactive group(p<0.05). 6) The results of pulmonary function tests after recovery of acute illness were within the predictive value. 7) 11 cases among 16 cases who showed severe bronchial reactivity during the first examination.
Conclusion
: BHR to Mch in M. pneumoniae pneumonia was significantly associated with male sex, past history of allergic respiratory disease and family history of atopy. On follow up study, we found that majority of reactive group were normalized except relatively higher reactive patients.

Keywords :Bronchial hyperreactivity, Methacholine inhalation challenge, Mycoplasma pneumoniae