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"Most viewed" Articles are from the articles published in 2024 during the last six month.

Review Article
Gastroenterology
Anxiety disorders presenting as gastrointestinal symptoms in children – a scoping review   (13,923 times)
Anjali Kumar, Pramodh Vallabhaneni
Clin Exp Pediatr. 2025;68(5):344-351.   Published online January 13, 2025
A positive bidirectional relationship between gastrointestinal disorders and anxiety, but with no clear aetiology, was identified. Factors such as somatisation and pain catastrophising resulted in poorer pain-related outcomes in children. Further studies are required to understand this relationship in order to have targeted treatments and ensure better long term outcomes.
Hematology
Iron deficiency in children with a focus on inflammatory conditions   (13,767 times)
Na Hee Lee
Clin Exp Pediatr. 2024;67(6):283-293.   Published online May 21, 2024
· Iron deficiency has important effects on neurodevelopment and the immune system in children.
· Hepcidine plays an important role in iron homeostasis.
· Diagnosis and treatment of iron deficiency in chronic inflammatory disease are important for patients' quality of life and disease course.
Original Article
Hematology
Assessment of natural killer cell subpopulations in pediatric patients with transfusion-dependent β-thalassemia major   (13,731 times)
Fathia Ibrahim Elbassal, Mohamed Abdel Rehim Soliman, Nourhan Hossam Eldin Mohamed, Mai El-Sayad Abd El-Hamid, Hanan Hassan El-Sheity
Clin Exp Pediatr. 2025;68(12):981-990.   Published online September 12, 2025
Question: How does iron overload affect immunity in pediatric patients with transfusion-dependent β-thalassemia major?
Finding: Iron overload in these patients is associated with disrupted natural killer (NK) cell subpopulations, reflecting impaired innate immunity.
Meaning: This highlights the need to monitor immune profile alongside iron status during thalassemia management.
Guideline
Infection
Recommendation for use of 15- and 20-valent pneumococcal conjugate vaccines in Korean infants and children   (13,280 times)
Ki Wook Yun, Dong Hyun Kim, Jong Gyun Ahn, Byung-Wook Eun, Jin Lee, Jina Lee, Taek-Jin Lee, Hyunju Lee, Dae Sun Jo, Eun Young Cho, Hye-Kyung Cho, Soo-Han Choi, Young June Choe, Ui Yoon Choi, Yun-Kyung Kim; The Committee on Infectious Diseases of the Korean Pediatric Society
Clin Exp Pediatr. 2026;69(1):76-83.   Published online December 30, 2025
Compared to PCV13, PCV15 includes 2 (22F and 33F), and PCV20 includes 7 (8, 10A, 11A, 12F, 15B, 22F, and 33F) additional serotypes. The vaccination schedule remains the same: primary doses at 2, 4, and 6 months, and a booster at 12–15 months. If PCV13 was administered in the primary series, PCV15 and PCV20 may be used to complete it or as a booster.
Original Article
Pulmonology
Efficacies of different treatment strategies for infants hospitalized with acute bronchiolitis   (12,823 times)
Hyeri Jeong, Dawon Park, Eun Kyo Ha, Ju Hee Kim, Jeewon Shin, Hey-Sung Baek, Hyunsoo Hwang, Youn Ho Shin, Hye Mi Jee, Man Yong Han
Clin Exp Pediatr. 2024;67(11):608-618.   Published online October 28, 2024
· This study analyzed 45 randomized controlled trials (5,061 participants, 13 interventions) of the comparative efficacies of treatments for acute bronchiolitis in infants.
· Inhalation therapy with epinephrine and hypertonic saline significantly reduced the length of hospital stay compared with normal saline.
· Hypertonic saline had the greatest ability to improve the clinical severity score of bronchiolitis in infants younger than 2 years of age.
Critical Care Medicine
Cytokine profile of Post–cardiopulmonary bypass in children   (12,786 times)
Kantara Saelim, Kanokpan Ruangnapa, Jirayut Jarutach, Pongsanae Duangpakdee, Smonrapat Surasombatpattana, Pharsai prasertsan
Clin Exp Pediatr. 2025;68(12):1015-1022.   Published online September 19, 2025
Question: Can cytokine levels predict low cardiac output syndrome (LCOS) in children post–cardiopulmonary bypass?
Finding: Elevated interleukin (IL)-6, IL-8, and tumor necrosis factor-α levels were associated with LCOS, with an increase in IL-8 of >56 pg/mL from baseline to immediately postoperative being the strongest predictor.
Meaning: Monitoring immediately postoperative IL-8 levels may help identify pediatric patients at risk of LCOS, enabling timely interventions to improve outcomes.
Nutrition
Energy drink consumption among Korean adolescents: prevalence and associated factors   (12,281 times)
Jee-Seon Shim, Jeong Mi Lee
Clin Exp Pediatr. 2024;67(10):531-539.   Published online September 24, 2024
Question: How prevalent is energy drink consumption among Korean adolescents and what are the associated factors?
Findings: The prevalence of energy drink consumption among Korean adolescents increased from 3.2% in 2014 to 12.2% in 2019. Energy drink consumption varies according to sociode-mographic and individual factors.
Meaning: Policies and educational strategies are needed to reduce energy drink consumption in adolescents.
Review Article
Cardiology
Heart failure in children and adolescents: an update on diagnostic approaches and management   (11,993 times)
Amit Agrawal, Dalwinder Janjua, Abdulrahman Ahmed Alsayed Ali Zeyada, Ahmed Taher Elsheikh
Clin Exp Pediatr. 2024;67(4):178-190.   Published online June 19, 2023
· Pediatric heart failure (PHF) is a clinical syndrome featuring various symptoms (shortness of breath, ankle swelling, fatigue) and signs (pulmonary crackles, peripheral edema).
· Congenital heart diseases are the most common underlying etiology of PHF, whereas myocarditis and primary cardio-myopathies are common in children without structural ab-normalities.
· PHF pathophysiology is complex and multifactorial and varies by etiology and age.
· PHF management includes decongestive therapy, treatment of underlying causes, preventing progression, and managing pulmonary or systemic obstructions.
· Drugs should be chosen based on pharmacodynamics, clinical manifestations, hemodynamic state, and renal function.
Endocrinology
Association between pre- and postnatal exposure to endocrine-disrupting chemicals and birth and neurodevelopmental outcomes: an extensive review   (11,208 times)
Ozge Yesildemir, Mensure Nur Celik
Clin Exp Pediatr. 2024;67(7):328-346.   Published online November 16, 2023
· Sensitivity to endocrine-disrupting chemical (EDC) exposure increases during critical developmental periods (in embryos, fetuses, and neonates).
· Pre- and postnatal exposure to EDCs is associated with fetal growth restriction, preterm birth, and low birth weight.
· Exposure to EDCs during fetal and early postnatal life can have lasting and lifelong neurodevelopmental outcomes, including autism spectrum, attention deficit hyperactivity, and other cognitive and behavioral disorders.
Critical Care Medicine
Recent updates on systemic treatment of atopic dermatitis   (10,634 times)
Jiyoung Ahn
Clin Exp Pediatr. 2024;67(11):580-588.   Published online November 1, 2024
Atopic dermatitis (AD) is a complex disease with multifactorial pathogenesis and variable clinical presentation. Up to one-fifth of patients with AD develop moderate to severe disease that is often refractory to classical therapies and can compromise quality of life. This review summarizes recent clinical evidence on biological agents and small-molecule immunotherapies for the treatment of AD.
Original Article
Hematology
Treatment and clinical outcomes of pediatric autoimmune hemolytic anemia: real-world single-center data from Korea   (9,992 times)
Young Dai Kwon, Eun Sun Jung, Yeon Jung Lim
Clin Exp Pediatr. 2025;68(7):522-529.   Published online April 16, 2025
Question: Can pediatric autoimmune hemolytic anemia (AIHA) be effectively managed using first-line steroids?
Finding: In this single-center study, pediatric patients with AIHA achieved normal hemoglobin levels within 16.5 days (range, 9.0–22.0 days) of first-line steroid treatment and maintained effective responses for 2 months.
Meaning: These outcomes highlight the efficacy of steroid treatment in pediatric versus adult AIHA and underscore the need for multicenter trials to establish standardized treatment guidelines.
Review Article
Genetics and Metabolism
Development of orphan drugs for rare diseases   (9,935 times)
Han-Wook Yoo
Clin Exp Pediatr. 2024;67(7):315-327.   Published online June 28, 2023
· Orphan disease is a rare disease, primarily affecting newborn and children. Vast majority of orphan diseases has genetic background.
· Orphan disease is individually rare. But as a whole, it is not rare, becoming a great socioeconomic burden.
· The diagnosis of rare genetic disease has been problematic, but recent progress of genome analysis technologies makes it faster and more precise.
· There are many unmet needs as to the curative treatment. However, the number of treatable rare diseases is growingly increasing owing to the development of biotechnology.
· Most orphan drugs are extremely expensive because of numer ous hurdles during the process of drug development as well as small number of patients.
Original Article
Neonatology (Perinatology)
Evaluation of total serum bilirubin thresholds for discontinuing phototherapy in jaundiced neonates: a randomized study   (9,710 times)
Ajay Kumar, Nidhi Jain
Clin Exp Pediatr. 2025;68(7):539-545.   Published online February 26, 2025
Question: What are the outcomes of jaundiced neonates when phototherapy is discontinued at 2 different total serum bilirubin (TSB) thresholds?
Findings: The study involved 80 neonates, comparing a recommended TSB threshold and a lower threshold for phototherapy discontinuation. Results showed a 14.3% reinstitution rate of treatment, with no adverse outcomes.
Meaning: Careful posttreatment monitoring is essential when discontinuing phototherapy, and future research should consider updated guidelines like those from the American Academy of Pediatrics.
Editorial
Neonatology (Perinatology)
The predetermined future: tackling South Korea’s total fertility rate crisis   (9,487 times)
Jin Kyu Kim
Clin Exp Pediatr. 2025;68(3):225-227.   Published online November 6, 2024
· South Korea faces a severe demographic crisis with the lowest global fertility rate. Despite significant investments, the total fertility rate continues to decline.
· It is necessary to fully mobilize national capabilities and execute comprehensive strategies that focus on both intangible and tangible values.
· Immediate and decisive action is essential to addressing these challenges effectively.
Review Article
Hematology
Promising role of voxelotor in managing sickle cell disease in children: a narrative review   (9,436 times)
Amit Agrawal, Gaurav Jadon, Japna Singh, Dalwinder Janjua
Clin Exp Pediatr. 2025;68(2):106-114.   Published online November 13, 2024
Voxelotor has promising ability to increase hemoglobin levels and reduce hemolysis markers in patients with sickle cell disease (SCD). Several preclinical and phase II/III trials have demonstrated its efficacy, dose-dependent responses, and tolerability in children. Ongoing trials are assessing its safety and effectiveness in various populations, including children younger than 12 years. These findings suggest its potential as a disease-modifying drug, warranting further exploration of its role in SCD management.
Neonatology (Perinatology)
Neonatal family-centered care: evidence and practice models   (9,401 times)
Juyoung Lee
Clin Exp Pediatr. 2024;67(4):171-177.   Published online June 14, 2023
· Concrete evidence exists of early parent-infant attachment supported by family-centered care (FCC) in the neonatal intensive care unit.
· FCC involves the parents’ presence and participation in the infant’s care and decision-making.
· A private and comfortable space should be provided. A single-family room is ideal; however, a quiet space with a recliner can be a good alternative.
· Care culture changes and staff training are required.
Original Article
General Pediatrics
Trends and determinants in breastfeeding among Korean infants (2007–2021): a nationwide study using the National Health Screening Program for Infants and Children   (9,006 times)
Minwoong Kang, Eui Kyung Choi, Jeung Min Lee, Hye-Jung Shin, Woo Ryoung Lee, Son Moon Shin; Korean Society of Breastfeeding Medicine
Clin Exp Pediatr. 2025;68(10):772-780.   Published online July 4, 2025
Question: What are the recent trends and determinants of breastfeeding in South Korea?
Finding: Breastfeeding rates in South Korea declined significantly from 2007 to 2021, with lower rates observed in preterm, low-birthweight, and multiple-birth infants as well as rural or lower-income households.
Meaning: Targeted interventions, including prenatal education, postnatal support, and community-based programs, are required to address disparities and improve breastfeeding rates.
Review Article
Critical Care Medicine
Protocolized sedation may reduce ventilation and sedation requirements in the pediatric intensive care unit: a systematic review and meta-analysis   (8,902 times)
Ambrus Szemere, Alíz Fazekas, Anna Réka Sebestyén, Rani Ezzeddine, Veronika Upor, Marie Anne Engh, Péter Hegyi, Zsolt Molnár, Klára Horváth
Clin Exp Pediatr. 2025;68(6):406-416.   Published online February 19, 2025
Protocolized sedation may reduce ventilation requirements, pediatric intensive care unit length of stay, and sedative exposure. However, it may increase the likelihood of unplanned extubation, highlighting the importance of incorporating preventive measures to mitigate this risk.
Endocrinology
A review of vitamin D deficiency and vitamin D receptor polymorphisms in endocrine-related disorders   (8,781 times)
Nur Faten Hafizah Rosli, Noor Shafina Mohd Nor, Rose Adzrianee Adnan, Siti Hamimah Sheikh Abdul Kadir
Clin Exp Pediatr. 2025;68(1):30-52.   Published online November 6, 2024
· The prevalence of vitamin D deficiency is high among children and adolescents and mainly attributed to changes in environmental factors.
· Vitamin D hormone-like properties are associated with many endocrine-related disorders.
· The effect of vitamin D is modulated by the vitamin D receptor, polymorphisms of which are reportedly associated with an increased risk of disease development in children and adolescents.
Original Article
Neonatology (Perinatology)
Effect of vitamin E supplementation on bilirubin levels in infants with hyperbilirubinemia: a double-blind randomized clinical trial   (8,720 times)
Mojtaba Cheraghi, Maziar Nikouei, Majid Mansouri, Siros Hemmatpour, Yousef Moradi
Clin Exp Pediatr. 2024;67(5):249-256.   Published online March 26, 2024
Question: Is vitamin E a viable therapeutic option for managing neonatal hyperbilirubinemia?
Finding: This randomized clinical trial examined the effects of oral vitamin E supplementation on bilirubin reduction (primary outcome), phototherapy duration, and length of hospital stay (secondary outcome) in 138 infants.
Meaning: Infants administered vitamin E versus placebo demonstrated similar reductions in bilirubin levels and length of hospital stay.
General Pediatrics
Comparative analysis of goal attainment for helmet therapy versus conservative management for positional plagiocephaly in infants   (8,675 times)
Bjoern Vogt, Ariane Deutschle, Georg Gosheger, Adrien Frommer, Andrea Laufer, Henning Tretow, Robert Roedl, Gregor Toporowski
Clin Exp Pediatr. 2025;68(11):892-900.   Published online October 2, 2025
Question: Is helmet therapy more effective than conservative management in treating positional plagiocephaly?
Finding: Both approaches reduced cranial asymmetry with comparable correction speed. Helmet therapy showed a trend toward greater severity reduction.
Meaning: Early treatment initiation was the strongest predictor of improvement. Helmet therapy may offer additional benefit in more severe cases.
Oncology
Allogeneic stem-cell transplantation following chimeric antigen receptor T-cell therapy for treatment of relapsed/refractory hematologic malignancy in children and young adults: a systematic review and meta-analysis   (8,646 times)
Ghea Mangkuliguna, Edi Setiawan Tehuteru, Reganedgary Jonlean, Nicholas Adrianto, Stella Kallista
Clin Exp Pediatr. 2025;68(9):712-721.   Published online July 4, 2025
Question: Does consolidative allogeneic stem cell transplantation (allo-SCT) after chimeric antigen receptor (CAR) T-cell therapy improve outcomes of children and young adult patients with relapsed/refractory hematologic malignancies?
Finding: The meta-analysis showed reduced relapse rates and favorable survival trends with allo-SCT despite low evidence quality.
Meaning: Consolidative allo-SCT after CAR T-cell therapy may enhance survival; however, further clinical studies are needed.
Review Article
Nephrology (Genitourinary)
Effects of diethylene glycol contamination of pharmaceutical products on unexplained acute kidney injury in children: a systematic review   (8,626 times)
Sani Rachman Soleman, Muhammad Luthfi Adnan, Hilmi Ardian Sudiarto, Satria Bintang Mahathma, Alya Ayu Tazkia, Hana Afifah Firdaus, Alfreda Amelia Khotijah, Miranti Dewi Pramaningtyas, Emi Azmi Choironi
Clin Exp Pediatr. 2024;67(8):395-402.   Published online January 4, 2024
A recent unexplained acute kidney injury (AKI) outbreak due to pharmaceutical product contamination with diethylene glycol (DEG) raises public attention. Our study revealed that DEG-contaminated paracetamol causes unexplained AKI in children. However, paracetamol is not the only contaminated drug. Other drugs, such as cough expectorants, antihistamines, and sedatives, can also be affected. Other chemicals, such as ethylene glycol and propylene glycol, can also contribute to poisonings.
Nutrition
The Korea Infant Physical Growth Examination Survey (KIPGroS): a study protocol   (8,502 times)
Jong Woo Hahn, MinSoo Shin, Jin Gyu Lim, Yoon-Joo Kim, Ki Soo Kang, Narae Lee, Seong Hee Jeong, Mun Hui Jeong, Yeoun Joo Lee, Eui Kyung Choi, Jung Ok Shim, Jee Yoon Park, Chan-Wook Park, Joo Young Kim, Su Jin Jeong, Young Hwa Jung, Jaehyun Kim, Chang Won Choi, Ju Whi Kim, Seung Han Shin, Yun Jeong Lee, Young Ah Lee, Choong-Ho Shin, Seung-sik Hwang, Young Eun Kim, Youn Ha Kang, Kyungwon Oh, Sungha Yun, Jae Sung Ko, Jin Soo Moon
Clin Exp Pediatr. 2025;68(5):352-358.   Published online February 13, 2025
The suitability of World Health Organization (WHO) growth charts for assessing the growth of children under 3 years of age in all countries remains controversial, and their applicability must be evaluated based on country-specific growth data. The Korea Infant Physical Growth Examination Survey evaluated the suitability of WHO growth charts to contribute to the next revision of growth charts in Korea.
Original Article
Neonatology (Perinatology)
Characterization of gut microbiota in very low birth weight infants with versus without bronchopulmonary dysplasia   (8,391 times)
Anucha Thatrimontrichai, Manapat Praditaukrit, Gunlawadee Maneenil, Supaporn Dissaneevate, Kamonnut Singkhamanan, Komwit Surachat
Clin Exp Pediatr. 2025;68(7):503-511.   Published online February 26, 2025
Question: Does the gut microbiota differ between very low birth weight (VLBW) infants with versus without bronchopulmonary dysplasia (BPD)?
Finding: Common respiratory pathogens were notably elevated in the BPD group, whereas anaerobic and butyrate-producing taxa, key components of postbiotics, were dominant in the non-BPD group.
Meaning: In gut-lung communication, the interplay between the intestinal and respiratory systems may implicate pro- and postbiotics in VLBW infants with BPD.
Incidence of neural tube defects in tertiary care university hospital in Bangladesh   (8,165 times)
Ismat Jahan, Arif Hossain, Shah Nizam Uddin Shaon, Sadeka Choudhury Moni, Mohammad Kamrul Hassan Shabuj, Sanjoy Kumer Dey, Mohammad Abdul Mannan, Mohammod Shahidullah
Clin Exp Pediatr. 2025;68(7):530-538.   Published online April 1, 2025
Question: What is the burden of neural tube defects (NTDs) in a tertiary care neonatal intensive care unit in Bangladesh?
Finding: The overall incidence of NTD was 6.4 (range, 4.59–11.2) per 1,000 live births, and the meningomyelocele complex was the most frequent location.
Meaning: The high incidence of NTD found in a leading tertiary care multidisciplinary referral hospital in Bangladesh may not reflect that of the wider population.
Basic Research
Linezolid mitigates tissue injury in experimental model of pediatric testicular torsion: TLR-4/MAPK/NF-κB involvement   (8,091 times)
Moein Ghasemi, Abolfazl Basiri, Houman Kazemzadeh, Mohammad Amin Manavi, Seyed Mohammad Tavangar, Ahmad Reza Dehpour, Hamed Shafaroodi
Clin Exp Pediatr. 2025;68(9):700-711.   Published online August 26, 2025
Question: What pharmacological strategies can limit ischemia-reperfusion injury in pediatric patients with testicular torsion?
Finding: In a rat model of testicular torsion, linezolid reduced oxidative stress, inflammation, and tissue injury via the Toll-like receptor 4/mitogen-activated protein kinase/nuclear factor kappa beta pathway.
Meaning: Linezolid may offer a pharmacological approach to attenuate testicular damage in pediatric patients with testicular torsion, warranting further clinical investigation.
Review Article
Neonatology (Perinatology)
Updates in neonatal resuscitation: routine use of laryngeal masks as an alternative to face masks   (7,999 times)
Eun Song Song, Ga Won Jeon
Clin Exp Pediatr. 2024;67(5):240-246.   Published online July 11, 2023
In neonatal resuscitation:
· Laryngeal masks are recommended when endotracheal intubation or positive-pressure ventilation fails.
· Laryngeal masks are useful even during chest compressions.
· Laryngeal masks aid neonates >34 weeks’ gestation and/or with a birth weight >2 kg.
· Main usage barriers include limited experience (81%), preference for endotracheal tubes (57%), and lack of awareness (56%).
· Second-generation laryngeal masks have a built-in esophageal drainage tube that prevents regurgitation into the glottis, and an orogastric tube can be inserted within the esophageal drainage tube to protect against gastric inflation.
Letter to the Editor
General Pediatrics
Debate around and impact of digital screen time and media parenting on children’s development   (7,969 times)
Gowda Parameshwara Prashanth
Clin Exp Pediatr. 2025;68(7):551-553.   Published online March 11, 2025
Original Article
Infection
Serum copper and ceruloplasmin levels as biomarkers reflecting liver fibrosis in children with autoimmune hepatitis   (7,932 times)
Salma Abdel Megeed Nagi, Mai Ibrahim Elashmawy, Amany E. Elashkar, Mohamed Zaeim Hafez, Ashraf A.E. Emara, Osama Mohammad Abdelhay, Albayoumi A.B. Fouda, Mohamed AbdelAziz Doma, Ahmad Mohamed Awad, Ahmed Mohammed Saba, Hesham Abdelrahman Ahmed, Ahmed Mohamed Gad Allah, Fatma Mahmoud Abdelraheem, Mohamed A. Gad, Mohamad A. Soliman, Tamer I. Abdalrhman, Khaled Hassaan Awad, Ismael A.K.M. El-lebedy, Mostafa M. Abdelnaser, Mohammed Z. Abdel Kareem, Marwa Fekry Hassan, Shymaa Sobhy Menshawy Khalifa
Clin Exp Pediatr. 2025;68(11):909-920.   Published online August 6, 2025
· A total of 159 children with autoimmune hepatitis (AIH; 60.3% female, 13.2% type 2 AIH) were identified. According to a global study, the estimated annual incidence of AIH in Egypt is 1.28 cases per 100,000 inhabitant-years.
· No studies to date have examined the serum levels of copper or ceruloplasmin in children with AIH. Therefore, here we investigated whether serum copper and ceruloplasmin levels are useful for identifying liver fibrosis in children with AIH.
· Serum copper and ceruloplasmin levels may provide important information for the identification of advanced liver fibrosis in children with AIH.


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