Article 69(7); Jul 2026
Review Article
Endocrinology
Testosterone therapy in boys with constitutional delay of growth and puberty: a PubMed-based systematic review and exploratory meta-analysis
Ashraf T. Soliman, Fawzia Alyafei, Nada Alaaraj, Noor Hamed, Shayma Ahmed, Khaled A. Siddiq, Mohammed Qusad, Mohamed AlKhalaf
Clin Exp Pediatr. 2026;69(7):531-541.   Published online June 18, 2026
In boys with constitutional delay of growth and puberty, a short course of low-dose testosterone consistently accelerates linear growth and advances pubertal maturation. Long-term follow-up studies do not show a clinically meaningful effect of conservative regimens on near-adult height. As the pooled quantitative evidence represents only 46 boys in 2 controlled studies, treatment should remain individualized, while larger randomized trials using standardized patient-reported outcomes are needed.
Editorial
Pulmonology
Telomere biology disorders in childhood interstitial lung disease: new insights from the chILD-EU cohort
Andrew Courtwright
Clin Exp Pediatr. 2026;69(7):542-544.   Published online June 30, 2026
Greiner-Mai et al. expand recognition of telomere biology disorder (TBD)-associated interstitial lung disease (ILD) in children, demonstrating heterogenous radiographic and ILD subtypes in combination with variable extrapulmonary phenotypes, even in the absence of ultrashort peripheral blood telomere length (TL). While their findings highlight some of the limitations of current TL testing methods, they introduce critical questions regarding family screening and the role of antifibrotic and telomere-directed therapies in children with TBD-related ILD.
Original Article
Nephrology (Genitourinary)
Serum metabolomic profile in children with sepsis-associated acute kidney injury
Nisha Chaudhary, Praveen Singh, Abhijeet Saha, Shantanu Sengupta
Clin Exp Pediatr. 2026;69(7):545-554.   Published online April 15, 2026
Question: Can the potential metabolites/pathways involved in the pathogenesis of sepsis-associated acute kidney injury (SA-AKI) be identified using metabolomics?
Finding: We identified 18 novel metabolites involved in the pathogenesis of SA-AKI as well as 31 metabolites that were altered in severe AKI. Linoleic acid, linolenic acid, and phospholipid pathways were altered in SA-AKI.
Meaning: Once validated, these markers may be used to diagnose SA-AKI at an early stage before sufficient kidney injury occurs.
Neonatology (Perinatology)
Association between base excess levels and clinical outcomes among very low birth weight infants: a multicenter birth cohort study in South Korea
Ji Yoo Kim, Hyeon Jin Kim, Heeyoon Choi, Minji Kim, Jinseok Lee, Yong Sung Choi, Dong Keon Yon
Clin Exp Pediatr. 2026;69(7):555-562.   Published online May 21, 2026
Question: Is metabolic acidosis at birth in very low birth weight infants (VLBWIs) associated with long-term clinical outcomes?
Finding: Metabolic acidosis at birth was associated with increased mortality, adverse respiratory outcomes, neurological morbidities, and infection-related and gastrointestinal outcomes.
Meaning: VLBWIs with metabolic acidosis are at high risk of systemic complications. This finding emphasizes the need for close monitoring and comprehensive care.
Gastroenterology
Distinct age-dependent phenotypes of abnormal liver function tests derived from national Emergency Department data
Dong-Uk Kim, Shinjie Choi, Yeji Kim, Lia Kim, Jung Ok Shim, Jin Soo Moon, Jong Woo Hahn, Hye Ran Yang, Ju Young Chang, Jae Sung Ko
Clin Exp Pediatr. 2026;69(7):563-571.   Published online May 14, 2026
Question: What are the clinical phenotypes and pathogen associations of pediatric and adult Emergency Department visits for abnormal liver function tests?
Finding: Pediatric visits showed fever-predominant profiles with temporal correlations with respiratory viruses, whereas adult visits revealed population-level temporal associations between enteric pathogens and infectious gastroenteritis, upper gastrointestinal disorders, and metabolic comorbidity clustering.
Meaning: These findings provide novel population-level evidence of age-specific pathogen associations and support distinct age-stratified clinical diagnostics.
Hematology
Peripheral blood cell counts of prematurely born, small for gestational age neonates
Mara O. Zuiderwijk, Sophie Groene, Enrico Lopriore, Vincent Bekker, Michiel H.D. Schoenaker
Clin Exp Pediatr. 2026;69(7):572-581.   Published online May 12, 2026
Question: As small for gestational age (SGA) neonates are more susceptible to infections, we hypothesized that their complete blood count and leukocyte differentiation might be affected.
Finding: The counts of multiple blood cells of extreme SGA neonates were affected as illustrated by multivariate analyses, which showed significant decreases in neutrophil, monocyte, lymphocyte, and thrombocyte counts.
Meaning: The mechanisms underlying this phenomenon and its clinical effects require further elucidation.
Other
Did government subsidy program improve quality of care for children with complex chronic conditions in children’s hospitals? A quasi-experimental study in South Korea
Riyoung Na, Myoung-Hee Kim, Seok-Jun Yoon
Clin Exp Pediatr. 2026;69(7):582-592.   Published online May 28, 2026
Question: Do government-funded Specialized Public Medical Centers for Children (SPMCCs) improve the quality of care for pediatric patients requiring complex and intensive medical care?
Finding: The SPMCC hospital designation reduced 30-day readmission rates among pediatric patients with severe conditions.
Meaning: Government investments are associated with improved quality of care for children with complex chronic conditions. Therefore, sustained government funding is essential to enhancing pediatric care quality.
Pulmonology
Telomere biology disorders associated with childhood interstitial lung disease
Maria Greiner-Mai, Christina Katharina Rapp, Katrin Knoflach, Daniel Gräfe, Franz Wolfgang Hirsch, Julia Ley-Zaporozhan, Simone Reu-Hofer, Julia Hentschel, Stefan Zielen, Monika Helena Tedy, Heymut Omran, Ernst Rietschel, Tuğba Sismanlar Eyuboglu, Ayse Tana-Aslan, Nagehan Emiralioglu, Nicola Ullmann, Samuele Naviglio, Massimo Maschio, Fabian Beier, Tuğba Ramaslı Gürsoy, Matthias Griese, Freerk Prenzel
Clin Exp Pediatr. 2026;69(7):593-603.   Published online June 18, 2026
Question: What are the pulmonary manifestations and clinical characteristics of telomere biology disorders in children with interstitial lung disease?
Finding: Telomere biology disorders are an important but often underrecognized cause of childhood interstitial lung disease and are associated with variable pulmonary, radiologic, and histopathologic findings, frequent multisystem involvement, and often severe disease progression.
Meaning: Early genetic testing and multidisciplinary evaluation are essential for timely diagnosis, optimized management, and improved outcomes in affected children.
Clinical Note
Neurology
Fulminant early-onset subacute sclerosing panencephalitis masquerading as leukodystrophy: a diagnostic challenge
Kaushik Ragunathan, Deb Kumar Boruah, Vishnupriya Veeraraghavan, Jaya Shankar Kaushik
Clin Exp Pediatr. 2026;69(7):604-608.   Published online June 18, 2026

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