Clinical and Experimental Pediatrics

Review Article

General Pediatrics

Prevalence of childhood overweight and obesity in Malaysia: a systematic review and meta-analysis (11,050 times)

Ker Yang Chua, Ker Yung Chua, Karuthan Chinna, Chooi Ling Lim, Maheeka Seneviwickrama

Clin Exp Pediatr. 2025;68(2):115-126. Published online November 13, 2024

The incidence of childhood obesity is increasing worldwide. National surveys in Malaysia have shown similar trends. This review aimed to increase our understanding of the prevalence and associated factors of childhood overweight, obesity, and excess weight in Malaysia. A systematic review and meta-analysis were conducted of studies reporting the prevalence of overweight and obesity in Malaysian children aged <18 years....

DOI: https://doi.org/10.3345/cep.2024.00899

Pulmonology

Evidence-based management guidelines for noncystic fibrosis bronchiectasis in children and adolescents (10,938 times)

Eun Lee, Kyunghoon Kim, You Hoon Jeon, In Suk Sol, Jong Deok Kim, Taek Ki Min, Yoon Ha Hwang, Hyun-Ju Cho, Dong In Suh, Hwan Soo Kim, Yoon Hee Kim, Sung-Il Woo, Yong Ju Lee, Sungsu Jung, Hyeon-Jong Yang, Gwang Cheon Jang

Clin Exp Pediatr. 2024;67(9):418-426. Published online January 23, 2024

Web of Science 2 Crossref 2

· We suggest offering long-term macrolides to children with noncystic fibrosis bronchiectasis with frequent exacerbations (conditional recommendation, moderate quality of evidence).
· We do not recommend the routine use of mucolytic agents, inhaled corticosteroids, or nonsteroidal anti-inflammatory drugs to prevent exacerbation of bronchiectasis in children (inconclusive, very low quality of evidence).
· We recommend the use of nebulized hypertonic saline to prevent exacerbations and improve the lung function of children with noncystic fibrosis bronchiectasis (weak recommendation, moderate quality of evidence).

DOI: https://doi.org/10.3345/cep.2023.00871

Original Article

Pulmonology

Efficacies of different treatment strategies for infants hospitalized with acute bronchiolitis (10,675 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

Web of Science 1 Crossref 1

· 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.

DOI: https://doi.org/10.3345/cep.2023.01676

Review Article

Cardiology

Heart failure in children and adolescents: an update on diagnostic approaches and management (10,592 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

Web of Science 10 Crossref 13

· 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.

DOI: https://doi.org/10.3345/cep.2023.00528

Critical Care Medicine

Recent updates on systemic treatment of atopic dermatitis (10,371 times)

Jiyoung Ahn

Clin Exp Pediatr. 2024;67(11):580-588. Published online November 1, 2024

Web of Science 4 Crossref 5

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.

DOI: https://doi.org/10.3345/cep.2024.00339

Perspective

Gastroenterology

Metabolic dysfunction-associated steatotic liver disease in children: a practical update based on Indian Society of Pediatric Gastroenterology, Hepatology and Nutrition (ISPGHAN) 2024 guidelines (10,284 times)

Ankit Agrawal, Arghya Samanta

Clin Exp Pediatr. 2025;68(7):546-550. Published online May 12, 2025

Web of Science 5 Crossref 5

DOI: https://doi.org/10.3345/cep.2025.00157

Original Article

Hematology

Treatment and clinical outcomes of pediatric autoimmune hemolytic anemia: real-world single-center data from Korea (10,149 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.

DOI: https://doi.org/10.3345/cep.2024.02026

Review Article

Gastroenterology

Ingestion of foreign bodies and caustic substances in children: a narrative review on clinical evaluation and management update (10,009 times)

Maria Rogalidou

Clin Exp Pediatr. 2026;69(1):11-21. Published online December 10, 2025

Web of Science 1 Crossref 2

Foreign body and caustic substance ingestion in children aged 1–5 years can feature to severe and, sometimes life-threatening complications. High-risk items include batteries, magnets, and corrosive chemicals. Severity depends on object type, location, and ingestion timing. Prompt diagnosis and early endoscopic intervention are crucial. Individualized management, high clinical suspicion, and parental education are essential to improving outcomes and preventing immediate and long-term complications affecting a child’s quality of life.

DOI: https://doi.org/10.3345/cep.2025.01823

Practical concepts and strategies for early diagnosis and management of eosinophilic gastrointestinal disorders in East-Asian children (10,006 times)

Byung-Ho Choe

Clin Exp Pediatr. 2025;68(3):185-198. Published online November 13, 2024

Web of Science 2 Crossref 2

Eosinophilic gastrointestinal disorders (EGIDs) often coexist with functional gastrointestinal disorders (FGIDs) and other IgE or non-IgE mediated GI diseases. Diagnosing EGIDs requires a high index of suspicion and a comprehensive approach to differentiate them from conditions like inflammatory bowel disease. Tests such as fecal calprotectin and biopsies aid in severe cases. Maintaining a food diary helps identify triggers for long-term elimination. Awareness and education are key to effective management.

DOI: https://doi.org/10.3345/cep.2024.01165

Neurology

Sacral dimple: clinical perspectives of lesions hidden beneath the skin (9,859 times)

Jin Eun, Kwan Sung Lee, Seung Ho Yang

Clin Exp Pediatr. 2026;69(2):103-113. Published online November 26, 2025

· Most sacral dimples are benign, but atypical features may indicate occult spinal dysraphism.
· Simple dimples meeting strict criteria require no imaging, whereas atypical dimples require targeted ultrasonography or magnetic resonance imaging.
· The early diagnosis and surgical management of highrisk cases prevents irreversible neurological, orthopedic, and urological deficits.

DOI: https://doi.org/10.3345/cep.2025.01802

Hematology

Promising role of voxelotor in managing sickle cell disease in children: a narrative review (9,727 times)

Amit Agrawal, Gaurav Jadon, Japna Singh, Dalwinder Janjua

Clin Exp Pediatr. 2025;68(2):106-114. Published online November 13, 2024

Web of Science 1 Crossref 1

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.

DOI: https://doi.org/10.3345/cep.2024.00500

General Pediatrics

Metabolic complications of obesity in children and adolescents (9,583 times)

Hyunjin Park, Jung Eun Choi, Seunghee Jun, Hyelim Lee, Hae Soon Kim, Hye Ah Lee, Hyesook Park

Clin Exp Pediatr. 2024;67(7):347-355. Published online November 16, 2023

Web of Science 33 Crossref 36

· Pediatric obesity increases the risk of metabolic complications (insulin resistance, dyslipidemia, nonalcoholic fatty liver disease) and long-term cardiovascular diseases.
· A new obesity definition and various indicators (continuous metabolic syndrome score, pediatric simple metabolic syndrome score, fatty liver index) have been proposed to evaluate children’s susceptibility to metabolic disorders.
· Laboratory and body composition tests in pediatric screenings can identify groups at high risk of metabolic complications of obesity.

DOI: https://doi.org/10.3345/cep.2023.00892

Original Article

Pulmonology

Effect of vitamin C supplement in treatment of childhood pneumonia requiring hospitalization: a randomized controlled trial (9,440 times)

Chutima Phuaksaman, Katechan Jampachaisri, Klaita Srisingh

Clin Exp Pediatr. 2025;68(9):690-699. Published online April 1, 2025

This study assessed the effects of vitamin C on children with community-acquired pneumonia (CAP). Vitamin C supplementation improved clinical symptoms within 48–72 hours compared to placebo but did not reduce the length of hospital stay (LOS). These findings suggest that vitamin C is beneficial for managing CAP severity, but does not affect LOS.

DOI: https://doi.org/10.3345/cep.2025.01970

Review Article

Genetics and Metabolism

Development of orphan drugs for rare diseases (9,404 times)

Han-Wook Yoo

Clin Exp Pediatr. 2024;67(7):315-327. Published online June 28, 2023

Web of Science 21 Crossref 23

· 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.

DOI: https://doi.org/10.3345/cep.2023.00535

Original Article

General Pediatrics

Comparative analysis of goal attainment for helmet therapy versus conservative management for positional plagiocephaly in infants (9,207 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.

DOI: https://doi.org/10.3345/cep.2025.01102

Review Article

Cardiology

Lifelong impact of elevated blood pressure from childhood to adulthood (9,196 times)

Junhyun Kwon, Eunji Kim

Clin Exp Pediatr. 2025;68(4):278-286. Published online November 28, 2024

Web of Science 7 Crossref 7

· Childhood blood pressure (BP) is significantly associated with adult hypertension and cardiovascular disease.
· Despite ongoing debate regarding the need for regular BP screening and early pharmacotherapy in children, the benefits of optimizing BP throughout childhood are clear.
· Childhood presents a critical window for normalizing BP through lifestyle modifications such as reducing sodium intake and increasing physical activity to promote lifelong cardiovascular health and prevent longterm complications.

DOI: https://doi.org/10.3345/cep.2024.01445

Neonatology (Perinatology)

Influence of infant microbiome on health and development (9,151 times)

Noelle Younge

Clin Exp Pediatr. 2024;67(5):224-231. Published online August 21, 2023

Web of Science 5 Crossref 8

· The infant gut microbiome is highly dynamic and individualized.
· Microbes are vertically transmitted from mother to infant during delivery and throughout infancy.
· Delivery mode, gestational age, diet, and antibiotic use influence infant microbiome composition and function.
· In animal studies, the microbiome played critical roles in the structural and functional development of the infant gastrointestinal and immune systems.
· Microbiome-targeted therapies have great potential to reduce infant morbidity and mortality.

DOI: https://doi.org/10.3345/cep.2023.00598

Endocrinology

A review of vitamin D deficiency and vitamin D receptor polymorphisms in endocrine-related disorders (9,130 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

Web of Science 4 Crossref 6

· 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.

DOI: https://doi.org/10.3345/cep.2024.00227

Hidden link between endocrine-disrupting chemicals and pediatric obesity (9,040 times)

Min Won Shin, Shin-Hye Kim

Clin Exp Pediatr. 2025;68(3):199-222. Published online November 28, 2024

Web of Science 4 Crossref 4

Studies indicate potential connections between exposure to endocrine-disrupting chemicals (EDCs) and childhood obesity. Variations in the impact of EDCs in epidemiological studies may result from differences in exposure concentrations and timing, measurement methods, and interactive effects of multiple EDCs. Longitudinal studies on exposure to multiple EDCs are crucial to elucidating their contribution to pediatric obesity and minimize the adverse health consequences of EDC exposure.

DOI: https://doi.org/10.3345/cep.2024.00556

Original Article

General Pediatrics

Bifidobacterium animalis subsp. lactis BLa80 for preventing allergic, respiratory, and gastrointestinal diseases in young children in China: a randomized double-blind placebo-controlled trial (8,608 times)

Ke Chen, Xi Zhang, Kaihong Zeng, Jiayi Zhong, Shanshan Jin, Yang Nie, Ping Yang, Nianyang He, Haixia Chen, Yanmei Cao, Yunrong Fu, Ziji Fang, Wei Jiang, Changqi Lium

Clin Exp Pediatr. 2026;69(2):150-162. Published online October 30, 2025

Web of Science 1

Question: Can probiotic BLa80 bring long-term benefits to the health of young children?
Finding: This trial demonstrated that the daily administration of s BLa80 at 5×109 colony-forming units for 3 months in children can reduce the risk of eczema, upper respiratory tract infections, and acute tracheitis/bronchitis as well as beneficially improve the gut microbiome without any adverse effect.
Meaning: Bla80 can bring definite health benefits to young children.

DOI: https://doi.org/10.3345/cep.2025.01256

Review Article

Infection

Recommendation for use of a long-acting monoclonal antibody to prevent respiratory syncytial virus infection in infants and young children (8,582 times)

Soo-Han Choi, Dong Hyun Kim, Jong Gyun Ahn, Ki Wook Yun, Byung-Wook Eun, Jin Lee, Jina Lee, Taek-Jin Lee, Hyunju Lee, Dae Sun Jo, Eun Young Cho, Hye-Kyung Cho, Young June Choe, Ui Yoon Choi, Yun-Kyung Kim; The Committee on Infectious Diseases of the Korean Pediatric Society

Clin Exp Pediatr. 2025;68(10):742-750. Published online September 3, 2025

To prevent respiratory syncytial virus (RSV)-associated lower respiratory tract infections, a single dose of nirsevimab, a long-acting monoclonal antibody, is recommended for all neonates born during the RSV season (October to March) and all infants younger than 6 months old at the start of the RSV season. Nirsevimab should be administered shortly after birth to neonates and just before or early in the season to infants entering their first RSV season.

DOI: https://doi.org/10.3345/cep.2025.01067

Original Article

Allergy

Regional differences in diagnosis and management of cow's milk allergy (8,335 times)

Fabian Hendricx, Emma Robert, Jaime A. Ramirez-Mayans, Karen Rubi Ignorosa Arellano, Erick M. Toro Monjaraz, Yvan Vandenplas

Clin Exp Pediatr. 2024;67(11):601-607. Published online October 28, 2024

Crossref 1

· Although there is broad consensus on many aspects regarding the symptoms, diagnosis, and treatment of cow's milk allergy, the impact of geographical, cultural, and socioeconomic factors remains unestablished.
· Availability and cost of formula for the management of cow's milk allergy have a major impact on the therapeutic choice.
· Region-specific guidelines for the treatment of cow's milk allergy are required.

DOI: https://doi.org/10.3345/cep.2023.01550

Review Article

Allergy

Skin and oral intervention for food allergy prevention based on dual allergen exposure hypothesis (8,260 times)

Kiwako Yamamoto-Hanada, Yukihiro Ohya

Clin Exp Pediatr. 2024;67(10):477-485. Published online June 14, 2023

Web of Science 12 Crossref 14

To prevent food allergy in infants, based on the dual allergen exposure hypothesis, we recommend a personalized approach consisting of both skin intervention (eczema treatment to achieve early remission and well-controlled skin without eczema to prevent percutaneous immunoglobulin E sensitization) and oral intervention (early allergenic food introduction).

DOI: https://doi.org/10.3345/cep.2023.00045

Moderate to severe atopic dermatitis in children: focus on systemic Th2 cytokine receptor antagonists and Janus kinase inhibitors (8,103 times)

Jeong Hee Kim, Mona Salem Samra

Clin Exp Pediatr. 2024;67(2):64-79. Published online June 14, 2023

Web of Science 7 Crossref 9

· Atopic dermatitis (AD) is characterized by a strong T helper (Th)2 response, although the extents of Th22, Th17/ interleukin (IL)-23, and Th1 responses vary among disease subtypes.
· Children with moderate to severe AD may require early systemic therapy to reduce the systemic inflammation caused by increased Th2 cytokine levels.
· Dupilumab, which blocks IL-4/IL-13 receptor, has equivalent efficacy for extrinsic and intrinsic AD and a favorable safety profile in infants and children aged 6 months and older.

DOI: https://doi.org/10.3345/cep.2022.00346

Critical Care Medicine

Protocolized sedation may reduce ventilation and sedation requirements in the pediatric intensive care unit: a systematic review and meta-analysis (7,967 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

Crossref 1

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.

DOI: https://doi.org/10.3345/cep.2024.01711

Editorial

Nutrition

Zinc as a treatment modality for acute infectious diarrhea in children (7,894 times)

Ji Sook Park

Clin Exp Pediatr. 2025;68(3):223-224. Published online October 31, 2024

Web of Science 1 Crossref 1

· Prevention and management of dehydration is the major goal of treatment in acute infectious diarrhea in children.
· Zinc could be effective as an adjuvant therapy in reducing the duration of acute infectious diarrhea in malnourished children.

DOI: https://doi.org/10.3345/cep.2024.00381

Original Article

Infection

Serum copper and ceruloplasmin levels as biomarkers reflecting liver fibrosis in children with autoimmune hepatitis (7,829 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

Crossref 1

· 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.

DOI: https://doi.org/10.3345/cep.2025.01011

Nutrition

Energy drink consumption among Korean adolescents: prevalence and associated factors (7,712 times)

Jee-Seon Shim, Jeong Mi Lee

Clin Exp Pediatr. 2024;67(10):531-539. Published online September 24, 2024

Web of Science 4 Crossref 8

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.

DOI: https://doi.org/10.3345/cep.2024.00171

Perspective

General Pediatrics

Parenting principles to combat attention-deficit/hyperactivity disorder and form resilient young minds (7,462 times)

Jandy Le, Sandhya J. Kadam

Clin Exp Pediatr. 2025;68(10):838-841. Published online September 22, 2025

The prevalence of attention-deficit/hyperactivity disorder, conduct disorder, and other related behavioral problems is increasing among children, likely due to less interaction with their parents and the real world and more time spent on screens, on social media, and in the virtual world. This article highlights several simple, basic parenting principles to facilitate the growth of healthy, resilient minds and combat the symptoms of opposition, hyperactivity, and distractibility.

DOI: https://doi.org/10.3345/cep.2025.01004

Review Article

Endocrinology

Pubertal induction in prepubertal males with hypogonadotropic hypogonadism: testosterone or gonadotropins? (7,210 times)

Paolo Cavarzere, Riccardo Battiston, Valentina Lupieri, Valentina Mancioppi, Claudio Maffeis

Clin Exp Pediatr. 2026;69(1):1-10. Published online December 18, 2025

The pubertal induction process in males still poses a challenge for pediatric endocrinologists. The existing literature is limited, and it is not yet possible to make definitive recommendations. We described the various treatment for this condition and tried to analyze the unresolved questions to address the question posed in the title of our manuscript.

DOI: https://doi.org/10.3345/cep.2025.02355

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