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Original Article
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...
Fecal microbiome profiles in infants with biliary atresia versus nonbiliary atresia cholestasis: a pilot study
Nur Azizah, Fadilah Fadilah, Silvia Werdhy Lestari, Muzal Kadim, Fithriyah Sjatha, Hanifah Oswari
Background: Cholestasis is characterized by disrupted bile flow and can lead to severe liver disease in newborns, of which biliary atresia (BA) is a common cause. The gut microbiome plays a crucial role in aggravating liver injury in BA and non-BA cholestasis. However, information is lacking regarding the differences in gut microbiome composition between patients with BA and non-BA cholestasis.
Purpose:...
Evolving treatment strategies for invasive Streptococcus pyogenes in children in the postpandemic era
Laura Buricchi, Giuseppe Indolfi, Marco Renni, Elisabetta Venturini, Luisa Galli, Elena Chiappini
Background: Streptococcus pyogenes (group A Streptococcus [GAS]) is a common cause of bacterial pharyngitis and skin infections in children that can lead to severe and invasive GAS (iGAS) infections. The sudden acute respiratory syndrome coronavirus 2 pandemic coincided with an increase in iGAS cases, with emerging serotypes and risk factors like age, reduced postpandemic immunity, and viral coinfections. The treatment...
Vasovagal syncope and postural orthostatic tachycardia syndrome in adolescents: transcranial doppler versus autonomic function test results
Dong Won Lee
Background: Syncope is a temporary loss of consciousness due to cerebral hypoperfusion associated with autonomic dysfunction. Vasovagal syncope (VVS) and postural orthostatic tachycardia syndrome (POTS) are the most common causes of syncope in adolescents.
Purpose: Here we conducted a comparative analysis of VVS and POTS in adolescents using transcranial doppler (TCD) and autonomic function tests to identify the mechanisms underlying the...
Evaluation of Bak and Bcl-Xl gene expression among pediatric patients with acute primary immune thrombocytopenia
Amira Zaki Badawy, Samia Hassan Kandel, Iman Aly Ahmedy, Mahmoud Ahmed Elhawy, Sally Mohamed El-Hefnawy, Dina Fouad Sief El-Nasr Zidan, Hanan Hassan El-sheity
Background: Immune thrombocytopenia (ITP) is an autoimmune disorder characterized by a low platelet counts and an increased risk of bleeding. Moreover, the apoptotic mechanisms of platelets may influence their production and lifespan.
Purpose: To assess the involvement of apoptotic markers—specifically the B-cell lymphoma protein 2 family proteins Bak and Bcl-Xl in the pathogenesis of acute primary ITP in pediatric patients, and...
Original Article - Clinical trial
Dual-strain probiotics Bifidobacterium bifidum and Lactobacillus acidophilus reverse gut dysbiosis in preterm neonates: a randomized controlled trial
Setthawut Sittiwong, Pornthep Tanpowpong, Pisut Pongchaikul, Pracha Nuntnarumit
Background: Preterm neonates exhibit gut dysbiosis, characterized by increased numbers of pathogenic bacteria and decreased Bifidobacterium and Lactobacillus levels. Supplementation with the probiotic Bifidobacterium bifidum/Lactobacillus acidophilus (BB/LA) may reverse gut dysbiosis.
Purpose: To study the effects of BB/LA on the gut microbiota of preterm neonates. Methods: We enrolled neonates born between July 2022 and September 2023 with a gestational age of <33...
Original Article
Serum copper and ceruloplasmin levels as biomarkers reflecting liver fibrosis in children with autoimmune hepatitis
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
Background: Clinical, biochemical, histological, and immunological indicators are frequently used to diagnose autoimmune hepatitis (AIH), a chronic inflammatory liver disease affecting children. Wilson disease, which resembles AIH, is mainly evaluated using serum ceruloplasmin and copper levels. However, changes in these biomarkers have also been observed in AIH, raising the question of whether they could be useful for evaluating children with...
Success rates of conservative treatment and optimal surgical timing for pediatric chylothorax
Pakwan Kaewchusen, Narumon Densupsoontorn, Supaluck Kanjanauthai, Puthita Saengpanit
Background: Pediatric chylothorax poses management challenges, with conservative treatment as the first-line approach and surgery reserved for persistent cases. However, data remain limited on factors related to conservative treatment success and optimal surgical timing.
Purpose: This study aimed to evaluate the success rate of conservative treatment, identify the associated factors, and determine the optimal timing for surgical intervention. Methods: We retrospectively reviewed...
Unsustainable and overworked: unpacking the challenges faced by pediatric cardiologists and cardiac surgeons in Korea
Soo In Jeong, Gi Beom Kim, Sung Hye Kim, Jae Yoon Na, Hong Ju Shin, Sin Weon Yun, Lucy Youngmin Eun, Sang-Yun Lee, Chang-Ha Lee, Kwang Ho Choi, Seul Gi Cha, Mi Young Han
Background: Pediatric cardiologists (PCs) and pediatric cardiac surgeons (PedCSs) in Korea face growing workforce shortages due to declining birth rates, decreasing interest among trainees, and increasing burnout.
Purpose: This study investigated the working conditions, job satisfaction, and burnout levels among Korean PCs and PedCSs. Methods: In June 2023, the Korean Pediatric Heart Society distributed a structured questionnaire via email to 149 members...
Correspondence
Nephrology (Genitourinary)
Authors' reply: a commentary on “COVID-19 vaccine hesitancy among parents of children with systemic lupus erythematosus”
Karnchanit Sausukpaiboon, Nuanpan Penboon, Pornpimol Rianthavorn
Clin Exp Pediatr. 2025;68(8):626-627.   Published online July 18, 2025
Original Article
General Pediatrics
Liposomal SunActive versus conventional iron for treatment of iron-deficiency anemia in children aged 2–12 years: a prospective randomized controlled trial
Wael A. Bahbah, Yasmin A.H.S. Younis, Hanan Salama Elbelouny, Asmaa A. Mahmoud
Clin Exp Pediatr. 2025;68(8):608-615.   Published online July 18, 2025
Background: Liposomal iron, a novel oral formulation of ferric pyrophosphate that demonstrates improved gastrointestinal absorption and bioavailability with fewer side effects than conventional iron, represents a significant advancement in the treatment of iron-deficiency anemia (IDA).
Purpose: To conduct an in-depth comparative study of liposomal SunActive and conventional iron supplements (iron polymaltose complex) for treating IDA in children aged 2–12 years Methods: This...
Editorial
Other
Beyond the eye: a multidisciplinary perspective on managing pediatric myopia
Eoi Jong Seo
Clin Exp Pediatr. 2025;68(8):566-568.   Published online July 18, 2025
Myopia is a growing global public health concern because of its association with irreversible vision loss such as myopic traction maculopathy, rhegmatogenous retinal detachment, and glaucoma. The effective prevention of myopia in childhood requires a multidisciplinary approach that integrates ophthalmologic care with lifestyle, nutrition, and sleep interventions. Early detection through regular visual screening in schools and primary care settings and timely ophthalmology referrals are critical to preventing high myopia.
Original Article
Respiratory severity score-guided postnatal systemic corticosteroid therapy for bronchopulmonary dysplasia in extremely preterm infants
Gyeong Eun Yeom, Ju Sun Heo, Baek Sup Shin, Seh Hyun Kim, Seung Han Shin, Ee-Kyung Kim, Han-Suk Kim
Background: Bronchopulmonary dysplasia (BPD) is a major complication in extremely preterm (EP) infants. Postnatal systemic corticosteroids reduce inflammation and may help prevent or treat BPD. However, their use is limited because of concerns regarding neurodevelopmental outcomes. However, the optimal timing and criteria for steroid therapy initiation remain unclear.
Purpose: This study aimed to evaluate the effect of a respiratory severity score...
Hyperhomocysteinemia in pediatric β-thalassemia: links to vitamin cofactor deficiencies and oxidative stress
Arzu Dadashova, Gunay Aliyeva, Rana Rahimova, Gulnara Azizova, Khayala Mammadova
Background: Homocysteine metabolism is crucial to maintaining vascular and metabolic homeostasis, yet its dysregulation in pediatric β-thalassemia major (β-TM) remains poorly understood.
Purpose: This study investigated the prevalence and determinants of hyperhomocysteinemia in pediatric β-TM with a focus on vitamin B9 (folate), B12, and B6 deficiencies, oxidative stress marker levels, and the impact of splenectomy. Methods: A cross-sectional study was conducted of...
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
Ghea Mangkuliguna, Edi Setiawan Tehuteru, Reganedgary Jonlean, Nicholas Adrianto, Stella Kallista
Background: Allogeneic stem cell transplantation (allo-SCT) and chimeric antigen receptor (CAR) T-cell therapy offer potential complementary benefits.
Purpose: This study aimed to ascertain whether incorporating consolidative allo-SCT after CAR T-cell therapy can augment the therapeutic outcomes of child and young adult patients with relapsed/refractory hematologic malignancy. Methods: A comprehensive literature search of PubMed, ScienceDirect, Cochrane Library, EBSCOHost, ProQuest, and the grey literature...
Trends and determinants in breastfeeding among Korean infants (2007–2021): a nationwide study using the National Health Screening Program for Infants and Children
Minwoong Kang, Eui Kyung Choi, Jeung Min Lee, Hye-Jung Shin, Woo Ryoung Lee, Son Moon Shin, Korean Society of Breastfeeding Medicine
Background: Breastfeeding has nutritional, immunolo­gical, and psychological benefits for infants. However, breastfeeding rates have recently declined in South Korea.
Purpose: This study aimed to investigate the breastfeed­ing trends and determinants in a nationwide birth cohort. Methods: This retrospective cohort study used claims data from the National Health Insurance Service from 2007–2022. Infants born between 2007 and 2021 who underwent at least one...
Review Article
Artificial Intelligence in Pediatric Healthcare: current applications, potentials and implementation considerations
Taejin Park, In-Hee Lee, Seung Wook Lee, Sek Won Kong
Artificial intelligence (AI) has transformed pediatric healthcare by supporting diagnostics, personalized treatment strategies, and prognosis predictions. Although it offers significant promise in these areas, its application in pediatric settings poses distinct challenges compared with that in adults due to variable developmental status, the limited availability of pediatric data, and ethical concerns regarding bias and transparency. This narrative review summarizes the...
Original Article
Treatment targeting pediatric inflammatory bowel disease-associated anemia: experience from a single tertiary center
Ana S.C. Fernandes, Sara Azevedo, Ana Rita Martins, Ana Isabel Lopes
Question: Does treating iron deficiency (ID) using intravenous iron in pediatric inflammatory bowel disease (IBD) feature long-term safety and efficacy?
Finding: Intravenous iron supplementation was safe and effective. However, the ID recurrence rate was higher than expected.
Meaning: Proactive screening and treatment of ID in pediatric IBD are essential. The Ganzoni formula likely underestimates the iron requirements of pediatric patients. Prospective trials are needed to optimize iron treatment dosing.
DOI: https://doi.org/10.3345/cep.2025.00640    [Epub ahead of print]
Role of neutrophil elastase in predicting infection among children with chemotherapy-induced febrile neutropenia
Mahmoud A. El-Hawy, Doaa M. Elian, Mai El-Sayad Abd El-Hamid, Esraa T. Allam, Mariam S. Kandeel, Asmaa A. Mahmoud
Background: Infection is a significant cause of death following chemotherapy-induced febrile neutropenia (FN). Neutropenia and compromised neutrophil function are the primary reasons for the decreased defense against infections.
Purpose: This study aimed to evaluate the significance of neutrophil elastase (NE) in predicting the outcomes of childhood hematological malignancies with FN. Methods: The study included 64 patients with FN and 64 healthy children...
DOI: https://doi.org/10.3345/cep.2025.00318    [Epub ahead of print]
Effect of postoperative enteral protein supplementation on nitrogen balance in critically ill children
Irene Yuniar, Kadek Apik Lestari, Antonius Hocky Pudjiadi, Fatima Safira Alatas, Yoga Devaera
Background: Critically ill children are at risk of postoperative malnutrition. Thus, optimal nutritional therapy is essential for preventing morbidity development and reducing mortality rates among this population. An adequate protein intake increases anabolism. However, data on the effect of enteral protein supplementation on nitrogen balance and intestinal fatty acid–binding protein (I-FABP) levels in postoperative critically ill children remain limited.
Purpose: This...
Adenosine deaminase and interleukin-1 receptor antagonist genetic polymorphisms among obese children with versus without metabolic dysfunction–associated fatty liver disease
Hala M. Sakhr, Mohammed H. Hassan, Azza Mohamed Taha, Ali Helmi Bakri
Background: Metabolic disorder–associated fatty liver disease (MAFLD) in children is an emerging global health concern, particularly in terms of obesity and metabolic disturbances. Inflammation plays a crucial role in the pathogenesis of MAFLD, with adenosine deaminase (ADA) and interleukin-1 receptor antagonist (IL-1Ra) being potential contributors.
Purpose: This study aimed to assess the association between ADA G22A and IL-1Ra single...
Perspective
General Pediatrics
Navigating the complex behavioral landscape of children in foster care and adopted families
Anisha Choi, Sandhya J. Kadam
Clin Exp Pediatr. 2025;68(8):620-623.   Published online May 12, 2025
Clinical Note
Genetics and Metabolism
Expanding genotype-phenotype correlation of Kenny-Caffey syndrome type 1
Manuela Lo Bianco, Federica Sipala, Xena Giada Pappalardo, Gaia Fusto, Roberta Rizzo, Federico Favata, Carla Cimino, Silvia Marino, Martino Ruggieri, Agnese Suppiej, Simone Ronsisvalle, Raffaele Falsaperla
Clin Exp Pediatr. 2025;68(8):616-619.   Published online May 12, 2025
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
Ankit Agrawal, Arghya Samanta
Clin Exp Pediatr. 2025;68(7):546-550.   Published online May 12, 2025
Review Article
Allergy
Global burden of asthma among children and adolescents with projections to 2050: a comprehensive review and forecasted modeling study
Tae Hyeon Kim, Hyunjee Kim, Jiyeon Oh, Soeun Kim, Michael Miligkos, Dong Keon Yon, Nikolaos G Papadopoulos
Clin Exp Pediatr. 2025;68(5):329-343.   Published online April 22, 2025
Pediatric asthma can persist to adulthood and must be effectively managed. This review examined the prevalence of asthma among individuals younger than 20 years and revealed a decline from 1990 to 2021, higher rates in males, and a peak in children aged 5–9 years. Despite a projected continued decrease in prevalence by 2050, asthma will remain a significant health concern for children and adolescents.
Correspondence
Infection
A commentary on "COVID-19 vaccine hesitancy among parents of children with systemic lupus erythematosus"
Hinpetch Daungsupawong, Viroj Wiwanitkit
Clin Exp Pediatr. 2025;68(8):624-625.   Published online April 16, 2025
Original Article
Hematology
Treatment and clinical outcomes of pediatric autoimmune hemolytic anemia: real-world single-center data from Korea
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.
Editorial
Neonatology (Perinatology)
Intermittent sigh breaths during high-frequency oscillatory ventilation among newborn infants
Ga Won Jeon
Clin Exp Pediatr. 2025;68(7):486-488.   Published online April 16, 2025
Intermittent sigh breaths during high-frequency oscillatory ventilation can improve ventilation and oxygenation by enhancing lung recruitment. Although research on this approach in newborn infants is limited, some published studies suggest that sigh breaths are generally applied at a rate of 2–3 breaths/min with an inspiratory time of 0.5–1 second and pressure of current mean airway pressure + 5 cmH2O (maximum, 30 cmH2O).
Review Article
Cost-effectiveness of newborn screening for severe combined immunodeficiency: a systematic review
Rezwanul Rana, Syed Afroz Keramat, Moin Ahmed
Severe combined immunodeficiency (SCID) is a rare genetic disorder that causes severe infections and death in early childhood. Newborn bloodspot screening (NBS) for SCID using the T-cell receptor excision circle assay can revolutionize the early detection and treatment of infants with SCID, leading to improved quality of life and life expectancy. This systematic review aimed to examine the cost-effectiveness of...
Original Article
Factors associated with thiamin deficiency in pediatric patients with heart disease and receiving diuretics: a single-center study
Phakwan Laohathai, Rathaporn Sumboonnanonda, Puthita Saengpanit, Chodchanok Vijarnsorn, Chatchawan Srisawat, Kwanjai Chotipanang, Sarawut Junnu, Supawan Kunnangja, Hathaichanok Rukprayoon, Phakkanan Phuangphan, Sompong Liammongkolkul, Arthima Phaokong, Narumon Densupsoontorn
Background: Thiamin deficiency (TD) manifesting clinically as wet beriberi can significantly impair a patient's cardiac function. Children with heart disease who are receiving diuretic treatment may be at increased risk for severe clinical manifestations of TD.
Purpose: This study aimed to determine the prevalence of TD and evaluate the association between various factors with thiamin status in pediatric patients with heart...
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