Value of serum IgE, LDH, and IL-18 in the early identification of refractory mycoplasma pneumoniae pneumonia in children

Corresponding author: GUAN Zheng, 404033462@qq.com

DOI: 10.12201/bmr.202606.00009

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  Abstract: Objective To investigate the role of serum immunoglobulin E (IgE), lactate dehydrogenase (LDH), and interleukin-18 (IL-18) in the early identification of refractory mycoplasma pneumoniae pneumonia (RMPP) in children. Methods This study retrospectively analyzed 166 children with mycoplasma pneumoniae pneumonia (MPP) hospitalized in our hospital between August 2022 and June 2024, including 48 cases of refractory MPP (RMPP) and 118 cases of general MPP (GMPP). Serum levels of IgE, LDH, and IL-18 were compared between the two groups. Binary logistic regression analysis was performed to identify independent risk factors for progression from MPP to RMPP, and receiver operating characteristic (ROC) curves were used to evaluate the clinical value of IgE, LDH, and IL-18 alone and in combination, in the early identification of RMPP. Internal validation was performed using the Bootstrap method (1000 resamples), and a nomogram was constructed to visually assess the early identification of RMPP. Results Serum levels of IgE, LDH, and IL-18 in the RMPP group were significantly higher than those in the GMPP group (all P<0.01). For individual markers, the optimal cut-off values for IgE, LDH, and IL-18 were 112.40 U/mL (AUC=0.830, sensitivity 79.2%, specificity 79.7%), 296.15 U/L (AUC=0.859, sensitivity 83.3%, specificity 72.9%), and 397.70 pg/mL (AUC=0.840, sensitivity 77.1%, specificity 76.3%), respectively. The combined model yielded an AUC of 0.924 with a sensitivity of 91.7% and specificity of 75.4%. After Bootstrap internal validation (1000 iterations), the corrected AUC of the combined model was 0.910 (95%CI: 0.863–0.957). Conclusion Serum levels of IgE, LDH, and IL-18 have certain auxiliary diagnostic value in the early identification of RMPP and may provide reference for clinical decision-making.

  Key words: refractory mycoplasma pneumoniae pneumonia; immunoglobulin E; lactate dehydrogenase; interleukin-18; early identification

  Submit time: 3 June 2026

  Copyright: The copyright holder for this preprint is the author/funder, who has granted biomedRxiv a license to display the preprint in perpetuity.
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