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Original Article
Assessing kidney outcomes in childhood-onset lupus nephritis: role of National Institutes of Health-modified histological indices
Nuanpan Penboon, Pornpimol Rianthavorn
Background: Childhood-onset lupus nephritis (cLN) is an aggressive disease. Although histological class has historically guided its treatment, its prognostic value remains limited. Although the National Institutes of Health (NIH)-modified activity index (AI) and chronicity index (CI) incorporate glomerular and tubulointerstitial changes and may provide better prognostic insight, their utility in cLN is not well established.
Purpose: Here we aimed to assess the utility of the NIH-modified-modified AI and CI...
Editorial
Rickets prevalence and treatment outcome: real-world data from Taiwan
Young Suk Shim
Original Article
Telemedicine outcome of mechanically ventilated children in Brazilian pediatric intensive care units
Aristóteles Almeida Pires, Luciano Remião Guerra, Luciane Gomes da Cunha, João Ronaldo Mafalda Krauzer, Mariana Motta Dias da Silva, Vanessa Cristina Jacovas, Hilda Maria Rodrigues Moleda, Tais de Campos Moreira, Paulo Márcio Pitrez, Felipe Cezar Cabral
Background: Pediatric intensive care units (PICUs) have undergone significant evolution, resulting in a reduction in patient morbidity and mortality rates. Telemedicine has emerged as a valuable resource for services that optimize the care processes in PICUs. Despite growing interest in telemedicine for pediatric critical care, its impact on mechanically ventilated (MV) children in public health settings in Brazil remains underexplored.
Purpose: This study aimed to evaluate the effect...
Associations of routine breakfast and napping habits with early adiposity rebound by age 3 years: a populationbased cohort study in Japan
Toshifumi Yodoshi
Background: Early adiposity rebound (AR) is a key predictor of later obesity and metabolic risk, yet modifiable factors related to early AR remain understudied in large populations.
Purpose: To quantify the prevalence of early AR at age 3 years and identify modifiable correlates in a population‑based cohort of Japanese preschool children. Methods: We retrospectively analyzed health-check records for 74,466 children who attended both 1.5- and 3-year examinations (2014–2019). Body mass...
Maternal sleep disorders during pregnancy and subsequent risk of allergic diseases in Japanese children: the TMM BirThree Cohort Study
Ami Uematsu, Masatsugu Orui, Mami Ishikuro, Keiko Murakami, Aoi Noda, Genki Shinoda, Taku Obara, Shinichi Kuriyama
Background: Associations have been suggested between prenatal exposure and allergic diseases in children as well as between respiratory allergies and maternal sleep disorders during pregnancy.
Purpose: This study aimed to examine the association between maternal sleep disorders during pregnancy and allergic diseases, including respiratory, skin, and ocular allergies, in their children. Methods: This study was based on the Tohoku Medical Megabank Project Birth and Three-Generation Cohort Study. Sleep disorders during...
Gut microbiota and metabolomic alterations in newborns of mothers with gestational diabetes mellitus
Wan-Hsin Su, Yi-Wei Wang, Chien-Chang Chen, Ming-Wei Lai, Hsun-Chin Chao, Ming-Chou Chiang, Ren-Huei Fu, Pai-Jui Yeh
Background: Gestational diabetes mellitus (GDM) is a common complication of pregnancy associated with various perinatal risks in mothers and heightened risks of long-term obesity and metabolic syndrome in their children. Understanding the effect of GDM on infant health is crucial. Infant gut colonization has generated significant interest owing to its profound impact on health and potential role in later disease development.
Purpose: Here we conducted a thorough analysis...
Review Article
Exploring nutritional screening tools for hospitalized children: a narrative review
Pankaj Soni, Amit Agrawal, Gaurav Jadon
Malnutrition is common among hospitalized children, especially those who are critically ill. Routine measures, such as anthropometric measurements, body composition, and nutritional assessment, comprise the basics of monitoring. This review discusses the adequacy of nutritional screening tools (NSTs) such as the SGNA (Subjective Global Nutritional Assessment), PYMS (Pediatric Yorkhill Malnutrition Score), STAMP (Screening Tool for the Assessment of Malnutrition in Paediatrics), and STRONGkids (Screening Tool for Risk of Nutritional Status...
Clinical note
Successful rescue after catastrophic bleeding of carotid artery pseudoaneurysm following button battery ingestion in a toddler
Manjit Kaur, Ujjal Poddar, Basant Kumar, Abdul Muzil Munshi, Rajanikant Yadav, Moinak Sen Sarma, Anshu Srivastava
Original Article
Recurrent immunoglobulin A vasculitis in children and adolescents: prevalence and associated risk factors
Nootsara Atchariyaphuk, Maynart Sukharomana, Thanaporn Chaiyapak, Sirirat Charuvanij
Background: Immunoglobulin A vasculitis (IgAV) is a systemic vasculitis characterized by potential recurrence.
Purpose: This study aimed to explore the prevalence of and factors associated with IgAV recurrence. The clinical phenotypes of childhood- and adolescent-onset IgAV were described and compared. Methods: This retrospective cohort analysis included patients aged ≤18 years and diagnosed with IgAV treated in a tertiary academic center between January 2010 and December 2022. Recurrence was classified...
High-dose methylprednisolone and tocilizumab improve survival of patients with high-risk pediatric acute necrotizing encephalopathy
Chaonan Fan, Fei Li, Kechun Li, Zheng Li, Yiyang Mao, Lijuan Wang, Gang Liu, Yingchao Liu, Quan Wang, Suyun Qian
Background: Acute necrotizing encephalopathy (ANE) is a rare but devastating neurological disorder in children that is typically triggered by viral infections such as influenza, sudden acute respiratory syndrome coronavirus 2, and human herpesvirus-6. ANE is characterized by cytokine storm and associated with high mortality; however, optimal immunomodulatory strategies remain undefined.
Purpose: To evaluate the effectiveness of multiple immunomodulatory strategies, including high-dose methylprednisolone (MP), plasma exchange (PLEX), and tocilizumab, at reducing short-term...
Association between vitamin D polymorphisms and binding protein and COVID-19 risk and severity in children
Victoria Giatraki, Helen Dimitriou, Georgia Martimianaki, Christos Tsatsanis, Emmanouil Galanakis, Chrysoula Perdikogianni
Background: The effects of genetic background on the biological effects of vitamin D on coronavirus disease 2019 (COVID-19) in children remain unclear.
Purpose: This study aimed to explore the association between vitamin D-related genetic background and 25- hydroxyvitamin D status and COVID-19 occurrence and severity in children. Here we explored key genetic variants within the vitamin D pathway in pediatric COVID-19 patients in relation to circulating vitamin D...
Ciclesonide shows a lung-protective effect in neonatal hyperoxia-exposed rats
Victoria Mielgo, Miguel A Gomez-Solaetxe, Lara Olazar, Begoña Loureiro, Carmen Rey-Santano
Background: Bronchopulmonary dysplasia (BPD), a chronic lung disease primarily observed in premature infants, is attributed to a lung injury–repair imbalance. Studies of postnatal corticosteroids have failed to identify clear candidates to help alleviate high BPD rates without risks or adverse effects.
Purpose: This study aimed to assess whether the systemic postnatal administration of an alternative glucocorticoid, ciclesonide, could attenuate alterations in lung structure and right ventricular hypertrophy in a...
Comparative analysis of goal attainment for helmet therapy versus conservative management for positional plagiocephaly in infants
Bjoern Vogt, Ariane Deutschle, Gerog Gosheger, Adrien Frommer, Andrea Laufer, Henning Tretow, Robert Roedl, Gregor Toporowski
Background: Positional plagiocephaly (PP) is a common cranial asymmetry of infancy. Its treatment options include conservative management and helmet therapy. However, the efficacy of each, particularly at achieving a normal cranial shape, remains uncertain.
Purpose: This study aimed to compare the efficacy of conservative management and helmet therapy for PP. Methods: We retrospectively analyzed 199 infants with PP treated in 2015–2024. A total of 72 patients with a...
Review Article
Neonatal ichthyosis-sclerosing cholangitis syndrome caused by a novel CLDN1 mutation: a case report and literature review
Upasana Ghosh, Ankit Agrawal, Varunvenkat M Srinivasan, Rani Manisha, Umesh Shukla, Vikas Jain, Mayank Nilay, Harish Kumar
Neonatal ichthyosis-sclerosing cholangitis syndrome (NISCH) is an autosomal recessive disorder characterized by cholestasis, generalized ichthyosis, alopecia, and dental anomalies. As this is a rare syndrome, here we present a case caused by a novel mutation followed by a literature review of all published cases. This retrospective review includes all original articles on the clinical profiles of all 37 cases published through December 2024 using a PubMed search. The...
Original Article
Less invasive surfactant administration versus intubation-surfactant-extubation: a single-center retrospective study
Jithin CS, Nalina A, shashidhar A, Suman Rao PN
Background: In recent years, minimally invasive methods have been increasingly utilized for surfactant administration in spontaneously breathing preterm infants with respiratory distress syndrome (RDS) managed with nasal continuous positive airway pressure owing to their feasibility and association with improved respiratory outcomes. However, data are limited from developing countries on the use and effectiveness of these techniques.
Purpose: The primary objective of...
Review Article
Bridging the gap: autism spectrum disorder in children in the United States and worldwide: a narrative review
Sandhya J Kadam, Malika Goel
Autism spectrum disorder (ASD) is a neurodevelopmental condition characterized by difficulty with communication and social interactions as well as restricted or repetitive behaviors. Over the last few decades, the prevalence of ASD has increased globally, with major differences in reporting, diagnosis, and interventions between developed and developing countries. The United States (U.S.) has seen a sharp rise in diagnosed ASD cases, with a current prevalence of approximately 1...
Original Article
HLA‒B*58:01 and skin reactions in pediatric hematology and oncology patients treated with allopurinol
Parisa Maneechai, Cholada Ratanatharathron, Jassada Buaboonnam, Kleebsabai Sanpakit
Background: Allopurinol is widely used to prevent hyperuricemia in patients with tumor lysis syndrome. However, its use can trigger severe cutaneous adverse reactions (SCARs) with a mortality rate of approximately 11.39%. The human leukocyte antigen (HLA)–B*58:01 genotype is a major risk factor for SCARs. Although most studies to date have examined HLA–B*58:01 in Thai adults, data on pediatric patients are limited.
Purpose: Here we aimed to evaluate the...
Review Article
Continuous glucose monitoring in Korean pediatric patients with type 1 diabetes: current landscape and clinical implications
Hwa Young Kim, Jaehyun Kim
Continuous glucose monitoring (CGM) has become a key component in the management of pediatric type 1 diabetes mellitus (T1DM) since it offers real-time glucose data that facilitate tighter glycemic control and reduce acute complications. Accumulating evidence and international guidelines highlight the clinical efficacy, safety, and feasibility of CGM use in children, particularly those with high adherence. Regular CGM use is associated with significant reductions in glycated hemoglobin, fewer hypo-...
Original Article
Clinical outcomes and healthcare utilization of hospitalized children with influenza versus COVID-19
David Chun-Ern Ng, Chuin-Hen Liew, Kah Kee Tan, Joanne Pereira, Muhammad Ihsan Roslan, Xiang Lin Cheng, Hui Yi Lim, Farah Nuruliayana A.Nazri, Asuwani Maran, Wan Fei Wong, Yasothai Chandran, Syaniza Shaharudin, Pon Ling Lau, Naveen Nair Gangadaran, Marlindawati Mohd Ali
Background: Influenza and coronavirus disease 2019 (COVID-19) are major causes of pediatric respiratory illness with overlapping clinical features but potentially differing impacts on healthcare utilization and outcomes.
Purpose: To compare the clinical presentations, healthcare resource utilization, and outcomes of children hospitalized with influenza and COVID-19 and address the gaps in pediatric data from Southeast Asia. Methods: This retrospective observational study included children aged ≤12 years hospitalized with laboratoryconfirmed influenza or...
Editorial
Basic Research
Stem cell mining: urine cells to biobanking
Yong Joo Ahn
Clin Exp Pediatr. 2025;68(10):761-762.   Published online September 24, 2025
· A safe and accessible source of somatic cell generating induced pluripotent stem cells (iPSCs) in pediatric neurogenic disorders
· A noninvasive and simple method for isolating urine cells, which can effectively reprogram into pluripotent stem cells using episomal vectors
· Establishing a urine-derived iPSC bank as a reliable and scalable resource for disease modeling, therapeutic testing, and personalized medicine in pediatric neurogenic disorders.
Review Article
General Pediatrics
Impact of screen exposure during pediatric ages including multifaceted aggravating factors: a literature review
Daniel González-Pérez, David Sebastián Huertas-Moreno, Manuela Granados-Pinilla, Sofía Hernandez-Rojas, Laura González-Rincon, Geraldine Hurtado-Garcia, Simón Grisales-Calle, María José González-Mariño, Luz Dary Gutierrez-Castañeda, Jhon Camacho-Cruz
Clin Exp Pediatr. 2025;68(10):751-760.   Published online September 24, 2025
Excessive screen time in children is linked to obesity, overweight, sedentary behavior, depression and mood disorders, myopia, behavioral changes, sleep disturbances, attention deficit hyperactivity disorder, among others. Polymorphisms in genes like FTO, CACNA1D, and DRD2 could further increase these risks. Implementing strategies such as limiting screen use, creating screen-free zones, and monitoring content is essential to mitigate adverse physical and mental health effects in the pediatric population.
Perspective
General Pediatrics
Parenting principles to combat attention-deficit/hyperactivity disorder and form resilient young minds
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.
Original Article
Other
Impact of thyroid hormones and serum endothelin levels on pediatric asthma control: a case-control study of an Indian population
Murugaiyan Sathishbabu, Sathiya Ramasamy, Niranjjan Ramachandran, Soundararajan Palanisamy, Arulvijayavani Subramaniam
Clin Exp Pediatr. 2025;68(10):831-837.   Published online September 22, 2025
Question: What are the roles of thyroid hormones and endothelin in South Indian children with asthma?
Finding: Thyroid hormone and endothelin levels were significantly elevated in South Indian children with asthma; poorly controlled cases exhibited the highest levels. Elevated thyroid-stimulating hormone and endothelin levels were correlated with asthma severity.
Meaning: Serum endothelin is a potential surrogate marker for asthma severity that could aid the assessment and management of childhood asthma.
Cytokine profile of Post–cardiopulmonary bypass in children
Kantara Saelim, Kanokpan Ruangnapa, Jirayut Jarutach, Pongsanae Duangpakdee, Smonrapat Surassombatpattana, Pharsai prasertsan
Background: Open cardiac surgery involving cardiopulmonary bypass (CPB) triggers a systemic inflammatory response that significantly affects clinical outcomes. However, the dynamics and specific roles of cytokine release after CPB in the pediatric population remain unclear.
Purpose: To evaluate the dynamics of cytokine levels and their association with low cardiac output syndrome (LCOS)-related outcomes. Methods: A prospective observational cohort study was conducted of 32 children who underwent elective open cardiac surgery...
Assessment of natural killer cell subpopulations in pediatric patients with transfusion-dependent β-thalassemia major
Fathia Elbassal, Mohamed Soliman, Nourhan Mohamed, Mai El-Hamid, Hanan El-Sheity
Background: Iron overload is a hallmark complication in patients with transfusion-dependent β-thalassemia major, primarily resulting from ineffective erythropoiesis, repeated blood transfusions, and increased gastrointestinal iron absorption. This iron accumulation, reflected in elevated serum ferritin levels, has been implicated in immune dysregulation. Natural killer (NK) cells are a pivotal component of the innate immune system, known for their cytotoxic activity and...
Effectiveness of Kinder Lebensqualität Fragebogen (KINDL) and Children’s Somatic Symptom Inventory-24 (CSSI-24) for measuring postacute sequelae of COVID-19 in children: a diagnostic validation study
Lawrence Shih-Hsin Wu, Pei-Chi Chen, Xiao-Ling Liu, Shu-Tsen Liu, Chi-Hung Wei, Yu-Lung Hsu, Kai-Sheng Hsieh, Huan-Cheng Lai, Chien-Heng Lin, Chieh-Ho Chen, An-Chyi Chen, I-Ching Chou, Wen-Jue Soong, Hui-Ju Tsai, Chung-Ying Lin, Jiu-Yao Wang
Background: The postacute sequelae of coronavirus disease 2019 (PASC), also known as pediatric long coronavirus disease (COVID), can significantly affect the quality of life (QoL) of affected children. Currently, there are no standardized screening tools to identify high-risk children. The Kinder Lebensqualität fragebogen (KINDL) is a psychometric method for measuring QoL in children.
Purpose: This study used the KINDL questionnaire and...
Review Article
Infection
Recommendation for use of a long-acting monoclonal antibody to prevent respiratory syncytial virus infection in infants and young children
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.
Editorial
General Pediatrics
Artificial intelligence in pediatric healthcare: bridging potential, clinical practice, and ethical considerations
Yoon Lee, Seohyun Hong, Dong Keon Yon
Clin Exp Pediatr. 2025;68(9):652-655.   Published online August 28, 2025
· Artificial intelligence (AI) holds transformative potential for pediatric healthcare, with applications spanning prevention, diagnosis, treatment, and follow-up across diverse subspecialties; however, ethical concerns, scarcity of pediatric- specific data, and limited funding remain significant challenges.
· International consensus on pediatric AI guidelines, expanding child-specific datasets, and incorporating explainable AI are essential to ensure safety and trust.
· Multicenter collaboration and increased investment can address these gaps, enabling equitable, reliable, and pediatric- centered AI solutions.
Original Article
Basic Research
Linezolid mitigates tissue injury in experimental model of pediatric testicular torsion: TLR-4/MAPK/NF-κB involvement
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.
Long-term epidemiological insights into rickets: a nationwide population-based retrospective study
Chun-Hao Chu, Ying-Chuan Chen, Pei-Yao Liu, Chun-Chieh Hu, Yu-Lung Lin, Feng-Chih Kuo, Chieh-Hua Lu, Tzu-Ju Hsu, Yu-Tung Hung, Fuu-Jen Tsai, Chien-Ming Lin
Background: Rickets is a growth disorder that imposes a global health burden and causes disability in affected children. However, issues related to the clinical epidemiology and mortality risk of nutritional versus hereditary rickets have not been fully investigated in large population studies, particularly in Asia.
Purpose: This study aimed to investigate the nationwide incidence, demographic characteristics, and mortality-related risk factors of...
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