Abdullah AKKUŞ, Sevgi PEKCAN, Fatih ERCAN, Suat SAVAŞ, Gökhan GÖZÜN, Uğur SARAÇ, Hasan ÇETİN, Nefise Betül ERCAN, Mustafa GENÇELİ, Özge Metin AKCAN, Mehmet ÖZDEMİR
Anatolian Current Medical Journal - 2026;8(1):167-173
Aims: This study aimed to to describe clinical and radiological characteristics of cold agglutinin-positive pediatric patients and to evaluate factors associated markers of disease severity, including CT utilization, respiratory support and length of hospitalization, in patients with suspected Mycoplasma pneumonia infection and cold agglutination positivity. Methods: A retrospective analysis was conducted on patients aged 0-18 years who presented to the pediatric clinics of Necmettin Erbakan University between January 2015 and January 2025 and had cold agglutinin positivity. Demographics, presenting symptoms, pulmonary and extrapulmonary findings, imaging results, treatment settings, respiratory support needs, and laboratory parameters were extracted from medical records. Comparative analyses between patients with and without chest CT imaging were performed using appropriate statistical tests. Results: A total of 242 patients (52.9% female; mean age 8.31+/-4.41 years) were included. The most frequent symptoms were cough (83.5%), nonspecific complaints (42.6%), and fever (38.4%). Abnormal respiratory findings were present in 45.0%, most commonly bilateral crackles. Extrapulmonary manifestations occurred in 20.2% of patients. Chest X-rays showed bilateral involvement in 47.9%. Patients who underwent CT imaging had significantly higher rates of abnormal respiratory findings, increased need for supplemental oxygen or noninvasive support, and longer hospital stays (p<0.001). Conclusion: Cold agglutination-positive pediatric patients demonstrated a wide clinical spectrum. The association between CT utilization and markers of more severe disease underscores the need for careful monitoring and early recognition of high-risk cases.
