{
  "abstract": "Background: Thromboembolism is a critical complication of severe Mycoplasma pneumoniae pneumonia (SMPP) in children, yet its clinical spectrum and immunothrombotic mechanisms remain poorly defined. The “dual-hit” hypothesis—synergy between infection-induced inflammation and transient antiphospholipid antibodies (aPLs)—lacks integrated clinical validation.\n\nMethods: We report a case of extensive multi-system thrombosis in a 6-year-old boy with SMPP. A systematic review of literature (January 2020–December 2025) identified 19 studies comprising 199 pediatric cases.\n\nResults: In the index case, thrombosis coincided with hyperinflammation and transient aPLs, which seroconverted to negative upon recovery. Pooled analysis showed multi-system involvement in 27.1% of cases (54/199). Among tested patients (n = 65; 32.7% of the cohort), aPL positivity was 69.2% (45/65). Most patients achieved favorable outcomes with anticoagulation and immunomodulation.\n\nConclusion: This study is consistent with the “dual-hit” model in SMPP, where systemic inflammation may prime the endothelium and transient aPL positivity coincides with an extensive thrombotic burden. The high prevalence of multi-system involvement supports low-threshold vascular imaging and aPLs screening, along with biomarker-guided management. Transient aPLs should be interpreted as a potential risk-amplifying biomarker rather than a proven causal driver of thrombosis.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Pediatric Critical Care Medicine, Sichuan Provincial Maternity and Child Health Care Hospital , , ,",
    "Department of Radiology, Sichuan Provincial Maternity and Child Health Care Hospital , , ,"
  ],
  "article_type": null,
  "arxiv": null,
  "author_total": 8,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Yuhang Hu"
    },
    {
      "affs": [
        0
      ],
      "name": "Jian Chen"
    },
    {
      "affs": [
        0
      ],
      "name": "Lijuan Wu"
    },
    {
      "affs": [
        0
      ],
      "name": "Jing Xu"
    },
    {
      "affs": [
        0
      ],
      "name": "Xuemei Xu"
    },
    {
      "affs": [
        0
      ],
      "name": "Juan Du"
    },
    {
      "affs": [
        1
      ],
      "name": "Min Kang"
    },
    {
      "affs": [
        0
      ],
      "name": "Xianmin Wang"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/etbv1hw4gnqpc.bib",
  "cited_by": 0,
  "doi": "10.3389/fimmu.2026.1845246",
  "fulltext_url": "https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13661489/?tool=EBI",
  "id": "etbv1hw4gnqpc",
  "issns": [
    "1664-3224"
  ],
  "landing_url": "https://europepmc.org/article/PMC/PMC13661489",
  "language": "eng",
  "licence": "CC-BY",
  "licence_label": "CC BY",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "openalex",
      "2745|Systemic Lupus Erythematosus Research"
    ]
  ],
  "openalex": "W7214947098",
  "pdf_url": "https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13661489/pdf/?tool=EBI",
  "pmcid": "PMC13661489",
  "pmid": null,
  "published": "2026-09-30",
  "publisher": "Frontiers Media SA",
  "ris": "https://research.draconitic.com/paper/etbv1hw4gnqpc.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:17:20Z",
      "native_id": "PMC:PMC13661489",
      "source": "europepmc",
      "url": "https://europepmc.org/article/PMC/PMC13661489"
    },
    {
      "first_seen": "2026-10-30T12:19:15Z",
      "native_id": "10.3389/fimmu.2026.1845246",
      "source": "crossref",
      "url": "https://www.frontiersin.org/articles/10.3389/fimmu.2026.1845246/full"
    }
  ],
  "subjects": [
    {
      "field": "biology",
      "origin": "issn:1664-3224",
      "subfield": "immunology"
    }
  ],
  "title": "Pentasystem embolism associated with transient antiphospholipid antibodies in severe M. pneumoniae pneumonia: a “Dual-Hit” case report and systematic review",
  "title_text": "Pentasystem embolism associated with transient antiphospholipid antibodies in severe M. pneumoniae pneumonia: a “Dual-Hit” case report and systematic review",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:19:15Z",
  "url": "https://research.draconitic.com/paper/etbv1hw4gnqpc",
  "venue": "Frontiers in immunology",
  "versions": []
}