Clinical and Experimental Pediatrics

Original Article

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

Crossref 1

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.

DOI: https://doi.org/10.3345/cep.2026.00290

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.

DOI: https://doi.org/10.3345/cep.2026.00199

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.

DOI: https://doi.org/10.3345/cep.2025.02978

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.

DOI: https://doi.org/10.3345/cep.2026.00038

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.

DOI: https://doi.org/10.3345/cep.2025.02817

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.

DOI: https://doi.org/10.3345/cep.2025.02439

Endocrinology

Intramuscular and subcutaneous gonadotropin-releasing hormone agonist tests for central precocious puberty in girls: a randomized controlled trial

Worapimon Lerdrassameethad, Suttipong Wacharasindhu, Vichit Supornsilchai, Khomsak Srilanchakon

Clin Exp Pediatr. 2026;69(6):518-523. Published online April 15, 2026

Question: Did the intramuscular (IM) and subcutaneous (SC) administration of gonadotropin-releasing hormone (GnRH) agonists have comparable timing and diagnostic utility for evaluating central precocious puberty in girls?
Finding: Both the IM and SC GnRH stimulation tests demonstrated comparable times to peak luteinizing hormone levels.
Meaning: Clinicians may consider the IM route as a time-efficient alternative, as it offers similar diagnostic utility for central precocious puberty without compromising the detection of hypothalamic-pituitary-gonadal axis activation.

DOI: https://doi.org/10.3345/cep.2026.00052

Anthropometric trajectories of Korean children and adolescents with severe obesity

Jeongho Han, Hakyung Lee, Dong Jun Ha, Jieun Lee, Yong Hee Hong, Hwa Young Kim, Jaehyun Kim

Clin Exp Pediatr. 2026;69(6):508-517. Published online April 10, 2026

Question: How do body mass index (BMI) and metabolic markers change over time in severely obese Korean children and adolescents receiving only lifestyle modifications?
Finding: Among 124 participants, BMI z scores decreased modestly over 2.6 years, primarily in younger prepubertal boys. However, most remained severely obese, with minimal improvement in body composition or metabolic markers.
Meaning: Lifestyle interventions alone have limited efficacy for severe pediatric obesity. Early and more intensive treatments are required.

DOI: https://doi.org/10.3345/cep.2025.02999

Pulmonology

High-Risk CCL14 lineage drives severe Mycoplasma pneumoniae pneumonia in children: a study in central China

Chunbo Hao, Zijie Li, Yanjuan Yu, Song Wang, Genhao Wang, Gaijing Jia, Tiantian Sun, Shouhang Chen, Yang Wu, Yu Tang, Fang Wang, Guangcai Duan, Yuefei Jin

Clin Exp Pediatr. 2026;69(6):497-507. Published online April 10, 2026

Web of Science 1 Crossref 1

Question: Are the predominant circulating strains of Mycoplasma pneumoniae associated with disease severity and clinical indicators?
Finding: The common cluster label 14 (CCL14) lineage was a high-risk clone circulating in central China that demonstrated a strong association between severe pediatric pneumonia and a distinct hyperinflammatory profile.
Meaning: Targeted molecular surveillance of the CCL14 lineage may facilitate early risk stratification and guide clinical management to reduce the burden of severe disease.

DOI: https://doi.org/10.3345/cep.2025.02796

Endocrinology

Thyroid peroxidase gene variants and susceptibility to congenital hypothyroidism and autoimmune thyroid disease among Egyptian pediatric cohort

Hala M. Sakhr, Mohammed H. Hassan, Esraa Abbass Abdallah, Amira Mahmoud Ewis, Mohamed Hesham Mohamed, Shymaa Gaber Rizk

Clin Exp Pediatr. 2026;69(6):486-496. Published online March 26, 2026

Question: Which factors influence pediatric thyroid disorder susceptibility and severity?
Finding: Anemia, selenium deficiency, excess copper, and the thyroid peroxidase (TPO) Arg³⁸⁶His polymorphism, especially with the histidine/histidine genotype, are strongly associated with pediatric thyroid disease and high thyroid-stimulating hormone levels.
Meaning: Pediatric thyroid disorders are multifactorial. The TPO Arg³⁸⁶His variant may help identify children at higher risk of severe thyroid dysfunction, enabling earlier diagnosis, improved risk stratification, and more personalized clinical management.

DOI: https://doi.org/10.3345/cep.2025.02957

Neurology

Classification of neurocognitive impairment in pediatric drug-resistant focal epilepsy by quantifying seizure-affected brain network abnormalities in clinical diffusion-weighted imaging connectome

Jeong-Won Jeong, Min-Hee Lee, Yoon Ho Hwang, Michael Behen, Aimee Luat, Csaba Juhász, Eishi Asano

Clin Exp Pediatr. 2026;69(5):443-454. Published online March 13, 2026

Question: Does epilepsy affect neurocognitive functions in pediatric drug-resistant focal epilepsy?
Finding: Diffusion magnetic resonance imaging (MRI) connectome could identify new imaging markers for seizure-associated structural abnormalities. New markers reflect deviations of local efficiency in neurocognitive networks and provide outstanding discretionary capacity for neurocognitive impairments, achieving an accuracy range of 90%–98% in the independent test patients.
Meaning: Supplementary MRI-driven decisions could be performed for personalized interventions to mitigate long-term neurocognitive effects.

DOI: https://doi.org/10.3345/cep.2025.02936

Neonatology (Perinatology)

Association between impaired renal function based on decline in serum creatinine level and brain injury in neonates with hypoxic-ischemic encephalopathy

Mélaine Boget, William Rozalen, Jeanne Fayard, Mohamed Boucekine, Diane Gillot, Isabelle Grandvuillemin, Farid Boubred

Clin Exp Pediatr. 2026;69(5):437-442. Published online April 27, 2026

Question: The clinical relevance of impaired renal function (IRF), based on the rate of serum creatinine level decline during the week after birth, in neonates treated with therapeutic hypothermia for hypoxic-ischemic encephalopathy need further investigation.
Finding: In this study, neonates with IRF had 2-fold higher risk of early death or severe brain injury.
Meaning: IRF can be used as a marker of adverse neonatal outcomes.

DOI: https://doi.org/10.3345/cep.2025.02670

Nutrition

Human milk macronutrient composition and intake in relation to preterm infant growth: a cohort study

Eakkarin Mekangkul, Chonnikant Visuthranukul, Anongnart Sirisabya, Thaninee Chitsinchayakul, Santi Punnahitananda, Sirinuch Chomtho

Clin Exp Pediatr. 2026;69(5):428-436. Published online April 22, 2026

Question: Is macronutrient intake, particularly that from human milk, distinctly associated with the growth of preterm infants?
Finding: Total protein and fat intake derived from human milk and fortifiers showed distinct positive associations with weight gain velocity.
Meaning: Particular attention to protein and fat composition during individualized human milk fortification can optimize weight gain in preterm infants.

DOI: https://doi.org/10.3345/cep.2025.02509

Neurology

Clinical application of whole exome and genome sequencing in pediatric neurodevelopmental disorders

Keun Soo Lee, Seung Hwan Oh, Ja Young Lee, Go Hun Seo, Da Eun Roh, Ji Kyoung Park, Bo Lyun Lee

Clin Exp Pediatr. 2026;69(5):417-427. Published online April 22, 2026

Question: What is the diagnostic utility of whole exome sequencing (WES) and whole genome sequencing (WGS) in unexplained neurodevelopmental disorders (NDDs)?
Finding: WES and WGS achieved a combined diagnostic yield of 39.1% in children with NDDs. Novel variants accounted for over half the pathogenic findings, and trio-based or phenotype-driven testing improved the diagnostic rate.
Meaning: Comprehensive genomic sequencing integrated with clinical phenotyping enhances diagnostic yield among children with NDDs.

DOI: https://doi.org/10.3345/cep.2025.02775

Hematology

Effects of induction-phase acute kidney injury and age at diagnosis on chronic kidney disease in pediatric acute lymphoblastic leukemia: a time-to-event cohort study

Pongpak Phongphiew, Nuanpan Penboon, Kanhatai Chiengthong, Pornpimol Rianthavorn

Clin Exp Pediatr. 2026;69(5):407-416. Published online March 5, 2026

Question: In pediatric acute lymphoblastic leukemia (ALL), what are the incidence and causes of induction-phase acute kidney injury (AKI), and which factors predict chronic kidney disease (CKD)?
Finding: Induction AKI occurred in 43% of patients, while CKD developed in 1 of 8 patients. The 5-year CKD-free survival rate was 94%. Older age at diagnosis was a continuous independent determinant of CKD risk.
Meaning: Induction AKI is common and clinically relevant. Older children warrant closer kidney monitoring during and after therapy.

DOI: https://doi.org/10.3345/cep.2025.02327

Neonatology (Perinatology)

Context-dependent features of transcriptomic landscapes in pregnant mother-neonate dyads of preeclampsia

Yu-Chun Cheng, Yun-Ju Lai, Wei-Shiung Lian, Ching-Chang Tsai, Hsin-Hsin Cheng, Hong-Ren Yu, Mao-Meng Tiao, Jiunn-Ming Sheen, Ying-Lun Hsu, Feng-Sheng Wang, I-Chun Lin

Clin Exp Pediatr. 2026;69(5):394-406. Published online February 19, 2026

Question: What genes are commonly altered in mother-neonate dyads immediately after shared exposure to preeclampsia?
Finding: Perinatal/peripartum gene expression in preeclampsia is context-dependent, involves diverse signaling pathways, and is associated with some perinatal features.
Meaning: Our results may help build the fundamentals for managing future cardiometabolic risks in these populations. Further investigation of the long-term influence of these candidate genes on cardiometabolic phenotypes is required.

DOI: https://doi.org/10.3345/cep.2025.02565

Neurology

Long-term outcome in children with infantile epileptic spasms syndrome: a multicenter retrospective study in Korea

Sun Ah Choi, Minhye Kim, Hye Jin Kim, Woo Joong Kim, Byung Chan Lim, Ji Yeon Han, Hunmin Kim, Min-Jee Kim, Mi-Sun Yum, Jiwon Lee, Jeehun Lee, Hyewon Woo, Jon Soo Kim

Clin Exp Pediatr. 2026;69(5):386-393. Published online February 19, 2026

Web of Science 1 Crossref 1

Question: How have epilepsy and cognitive outcomes of children with infantile epileptic spasms syndrome (IESS) evolved over the past 20 years?
Finding: Approximately 78% of children developed chronic epilepsy, and one-third progressed to drug-resistant epilepsy, while 90% of them exhibited intellectual disabilities.
Meaning: Given the poor outcomes associated with IESS, consensus guidelines tailored to Korean clinical practice are required to ensure timely treatment and improve outcomes.

DOI: https://doi.org/10.3345/cep.2025.02089

Cardiology

Value of demographic factors in early identification of pediatric malignant vasovagal syncope in head-up tilt test

Shuo Wang, Yuwen Wang, Hong Cai, Ping Liu, Fang Li, Chuan Wen, Liqun Liu, Runmei Zou, Cheng Wang

Clin Exp Pediatr. 2026;69(4):353-361. Published online March 5, 2026

Question: Can demographic factors identify pediatric malignant vasovagal syncope pre-head-up tilt test (HUTT)?
Finding: Age/body mass index are independent protectors; <12.9 years age cuts risk 20%/yr.
Meaning: Enables early risk stratification to optimize HUTT safety for children.

DOI: https://doi.org/10.3345/cep.2025.02397

Hematology

Outcomes of hematopoietic stem cell transplantation for pediatric patients with transfusion-dependent thalassemia in Thailand

Kleebsabai Sanpakit, Kamala Laohverapanich, Bunchoo Pongtanakul, Nattee Narkbunnam, Chayamon Takpradit, Usanarat Anurathapan, Samart Pakakasama, Supanun Lauhasurayotin, Kanhatai Chiengthong, Thirachit Chotsampancharoen, Pornpun Sripornsawan, Piya Rujkijyanont, Duantida Songdej, Nongnuch Sirachainan, Suradej Hongeng

Clin Exp Pediatr. 2026;69(4):340-352. Published online March 13, 2026

Question: Can hematopoietic stem cell transplantation (HSCT) cure pediatric transfusion-dependent thalassemia in Thailand? What influences its outcomes?
Finding: Among 266 HSCT procedures, 5-year overall survival and event-free survival rates were 91.3% and 81.0%, respectively. Outcomes were comparable between related and unrelated donors. Pre-HSCT ferritin >2,500 ng/mL, low CD34+ cell dose, and oral busulfan conditioning were associated with unfavorable survival. Longterm complications affected 22.7% of survivors.
Meaning: Optimizing pre-HSCT care, ensuring adequate grafting, and long-term surveillance are crucial.

DOI: https://doi.org/10.3345/cep.2025.02173

Neonatology (Perinatology)

Hemodynamics and cerebral oxygenation in the neonatal transition: a prospective pilot study

Daniel Pfurtscheller, Christoph Schlatzer, Nina Höller, Bernhard Schwaberger, Lukas P. Mileder, Nariae Baik-Schneditz, Magdalena Holter, Gerhard Pichler

Clin Exp Pediatr. 2026;69(4):330-339. Published online January 13, 2026

Question: How is arterial blood pressure related to cerebral oxygenation during the immediate postnatal transition in neonates?
Finding: Among preterm infants requiring respiratory support, cerebral oxygenation was associated with diastolic and mean arterial pressures, indicating passive pressure perfusion.
Meaning: Compromised preterm infants are vulnerable to impaired autoregulation with cerebral oxygenation fluctuations, highlighting the need for hemodynamic and cerebral monitoring plus routine monitoring of arterial oxygen saturation and heart rate.

DOI: https://doi.org/10.3345/cep.2025.02572

Cardiology

Influence of atrial septal defect on mitral valve growth after repair of coarctation of the aorta or an interrupted aortic arch in infants

Yi-Chia Wang, Heng-Wen Chou, Chi-Hsiang Huang, Hsing-Hao Huang, Yih-Sharng Chen, En-Ting Wu, Shyh-Jye Chen, Ming-Tai Lin, Shuenn-Nan Chiu, Shu-Chien Huang

Clin Exp Pediatr. 2026;69(4):322-329. Published online January 13, 2026

Web of Science 1 Crossref 1

Question: Does atrial septal defect (ASD) physiology affect postrepair mitral valve growth in patients with coarctation of the aorta or an interrupted aortic arch?
Finding: Mitral valve growth occurred after biventricular repair but not single-ventricle palliation, particularly in patients with small valves and low ASD pressure gradients.
Meaning: The ASD pressure gradient determines mitral valve growth and should guide surgical strategies in patients with borderline hypoplastic left heart syndrome.

DOI: https://doi.org/10.3345/cep.2025.02110

Neonatology (Perinatology)

Perinatal risk factors for hemodynamically significant patent ductus arteriosus in very low birth weight infants

Jie Hee Jue, So Young Shin, Jae Hyun Park, Chun Soo Kim, Hee Joung Choi

Clin Exp Pediatr. 2026;69(4):313-321. Published online December 22, 2025

Question: What perinatal factors influence patent ductus arteriosus (PDA) in and improve outcomes of preterm infants?
Finding: Lower birth weight, frequent surfactant treatment, and maternal hypertension increased hemodynamically significant PDA risk in very low birth weight infants, whereas chorioamnionitis and premature rupture of membranes protected against it. A lower birth weight and incomplete antenatal steroid use increased the risk of surgical ligation, whereas small for gestational age reduced it.
Meaning: Recognizing these factors may enable early, targeted intervention and reduce the need for surgical management.

DOI: https://doi.org/10.3345/cep.2025.01893

Prolonged cerebral oxygenation surveillance with algorithm-based management: a neurocritical care bundle for extremely preterm infants

Kai-Hsiang Hsu, Wei-Hung Wu, Shu-Yu Lin, Chih-Chen Chang, Mei-Yin Lai, I-Hsyuan Wu, Shih-Ming Chu, Ming-Chou Chiang, Reyin Lien

Clin Exp Pediatr. 2026;69(4):304-312. Published online December 22, 2025

Web of Science 1

Question: Is prolonged monitoring of regional cerebral oxygen saturation (rcSO₂) and hemodynamic parameters a feasible approach? Can these measures predict the neurological outcomes in extremely preterm infants?
Finding: We used a neurocritical care bundle from birth to discharge or term-equivalent age. Infants with poor outcomes had significantly lower rcSO₂ values.
Meaning: Understanding rcSO₂ and hemodynamic parameters may help manage cerebral hypoxia and reduce neurological complications in extremely preterm infants.

DOI: https://doi.org/10.3345/cep.2025.02117

Validation of a new Japanese classification for predicting severe bronchopulmonary dysplasia in preterm infants

Masato Ito, Shinya Hirano, Fumihiko Namba

Clin Exp Pediatr. 2026;69(3):274-281. Published online January 20, 2026

Web of Science 1 Crossref 1

Question: Can the revised Japanese classification predict severe bronchopulmonary dysplasia (BPD) early in preterm infants?
Finding: Small for gestational age and bubbly/cystic chest radiographic patterns were independently associated with severe BPD, and subtypes I and III showed particularly strong associations.
Meaning: This classification may facilitate early risk stratification and guide timely supportive strategies to prevent progression to severe BPD.

DOI: https://doi.org/10.3345/cep.2025.02642

Thrombocytopenia in preterm infants born to mothers with systemic lupus erythematosus: a retrospective cohort study

Ru Xue, Guoqing Zhang, Xiafang Chen, Jun Bu, Lanlan Mi, Fei Bei

Clin Exp Pediatr. 2026;69(3):266-273. Published online December 22, 2025

Question: What are the characteristics and clinical implications of thrombocytopenia in preterm neonates born to mothers with systemic lupus erythematosus?
Finding: Nearly one-third of preterm infants developed thrombocytopenia. Key modulators of this risk included gestational age, maternal hypertensive disorders of pregnancy, and hydroxychloroquine use. Thrombocytopenia may be associated with neonatal morbidity.
Meaning: Platelet count should be monitored during the first week of life, and infants should be assessed for potential complications.

DOI: https://doi.org/10.3345/cep.2025.01942

Allergy

Can a basophil activation test of cord blood predict a cow's milk allergy?

Dilara Fatma Kocacik Uygun, Durmuş Burgucu, Vedat Uygun, Gül Alkan Bulbul, Fulden Duyar, Cem Yasar Sahnal, Aysen Bingöl

Clin Exp Pediatr. 2026;69(3):257-265. Published online January 20, 2026

Question: Can a basophil activation test (BAT) of cord blood predict a cow's milk allergy?
Finding: Infants with a high casein-BAT value were more likely to develop food allergy symptoms in the first year, whereas cow’s milk BAT showed no predictive association.
Meaning: Cord blood casein BAT may help identify newborns at increased risk for early-life food allergies, enabling closer monitoring and preventive strategies, although larger studies are needed for validation.

DOI: https://doi.org/10.3345/cep.2025.01697

Other

Improvements in obesity-related measures among Asian patients with severe obesity following a structured lifestyle intervention

Pei-Shan Chen, Shu-Mei Tsai, Chih-Hsuan Chang, Hui-Ru Yang, Yen-Ju Huang, Hsiang-Yin Liu, Kai-Chi Chang, Huey-Ling Chen

Clin Exp Pediatr. 2026;69(3):247-256. Published online December 22, 2025

Question: How does obesity severity affect baseline fitness and improvements in key obesity-related measures following participation in a structured lifestyle modification program?
Finding: Severely obese youth showed poorer baseline physical fitness but greater improvements in key obesity-related measures following lifestyle interventions.
Meaning: Early targeted intervention may help prevent progression to more severe obesity and declines in physical fitness in patients with obesity.

DOI: https://doi.org/10.3345/cep.2025.01774

Hematology

Granulocyte transfusion improves survival in pediatric febrile neutropenia: a 15-year cohort study

Witsanu Phetsai, Kleebsabai Sanpakit, Jassada Buaboonnam, Kamon Phuakpet, Nassawee Vathana, Nattee Narkbunnam, Fon Kladed, Chayamon Takpradit

Clin Exp Pediatr. 2026;69(3):236-246. Published online January 12, 2026

Question: Does granulocyte transfusion improve survival and clinical recovery in pediatric febrile neutropenia?
Finding: In this 15-year real-world cohort, granulocyte transfusion significantly increased 30-day survival (92.3 % vs. 65.4%; adjusted odds ratio, 0.105; P=0.020) and accelerated fever and neutrophil recovery without serious adverse events.
Meaning: Granulocyte transfusion may be an effective adjunctive therapy for severe neutropenic infections in children, particularly in low- and middle-income settings.

DOI: https://doi.org/10.3345/cep.2025.01186

Nephrology (Genitourinary)

Discordance between antibiotic therapy and recurrent urinary tract infections in young children with third-generation cephalosporin-resistant infections

Yusin Kim, Hyun A Lee, Gil Lee, Kyungseok Park, Ye Kyung Kim, Peong Gang Park

Clin Exp Pediatr. 2026;69(3):228-235. Published online November 26, 2025

Question: Does completing a third-generation cephalosporin course, despite in vitro resistance, increase the early urinary tract infection recurrence rate in children?
Finding: Among 989 Korean children, discordant therapy increased the 2-month recurrence risk by 40% compared with concordant or susceptible therapy.
Meaning: Checking isolate susceptibility and switching to an active oral drug may curb recurrence and limit the use of broad-spectrum antibiotics.

DOI: https://doi.org/10.3345/cep.2025.01417

Gastroenterology

Longitudinal analysis of gut microbiota dysbiosis and bacterial signatures predictive of postoperative enterocolitis in children with Hirschsprung disease

Sireekarn Chantakhow, Chanon Kunasol, Jiraporn Khorana, Kanokkan Tepmalai, Nipon Chattipakorn, Siriporn C. Chattipakorn

Clin Exp Pediatr. 2026;69(3):214-227. Published online December 10, 2025

Question: Do gut microbiota differ between patients with Hirschsprung disease (HSCR) and healthy children, and can specific bacterial taxa predict postoperative HSCRassociated enterocolitis (HAEC)?
Finding: Patients with HSCR showed gut dysbiosis with reduced diversity. Postoperative microbial changes included increased alpha diversity. Certain taxa, such as Eubacterium and Collinsella, were associated with recovery or HAEC.
Meaning: Distinct microbial signatures may help identify HAEC risk and guide microbiota-based strategies to improve outcomes.

DOI: https://doi.org/10.3345/cep.2025.01886

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Original article