Clinical and Experimental Pediatrics

Clinical Note

General Pediatrics

Aplasia cutis congenita with unique vascular malformation and cranial hypoplasia: a case in a preterm infant

Yasufumi Sakata, Natsumi Fujii, Sadahiro Nomura, Yoshihiro Azuma, Hiroki Hamano, Hidenobu Kaneyasu, Seigo Okada, Kazumasa Takahashi, Shunji Hasegawa

Clin Exp Pediatr. 2025;68(6):472-474. Published online March 11, 2025

DOI: https://doi.org/10.3345/cep.2024.01998

Original Article

Neonatology (Perinatology)

Differential roles of interleukin-6 and adrenomedullin in early diagnosis and mortality predictions in late-onset neonatal sepsis

Emilly Henrique dos Santos, Gabriel Acca Barreira, Mariana Okay Saippa, Maria Carolina Pires Cruz, Karen Alessandra Rodrigues, Ronaldo Arkader, Thelma Suely Okay

Clin Exp Pediatr. 2025;68(6):463-471. Published online December 23, 2024

Question: Can adrenomedullin (ADM) or interleukin-6 (IL-6) detect late-onset neonatal sepsis (LOS) at admission (area under the curve [AUC]>0.90) as an early diagnostic marker?
Finding: Only IL-6 consistently distinguished survivors from nonsurvivors (AUC>0.90) on admission and antibiotic treatment days 3 and 7. C-reactive protein level identified infections from day 3 but failed to predict outcomes (AUC<0.70).
Meaning: IL-6 level can improve LOS diagnosis and prognosis.

DOI: https://doi.org/10.3345/cep.2024.01543

Nephrology (Genitourinary)

COVID-19 vaccine hesitancy among parents of children with systemic lupus erythematosus

Karnchanit Sausukpaiboon, Nuanpan Penboon, Pornpimol Rianthavorn

Clin Exp Pediatr. 2025;68(6):454-462. Published online February 3, 2025

Question: What is the acceptance rate for coronavirus disease 2019 vaccination among parents of children with systemic lupus erythematosus (SLE)?
Finding: One-third of parents were hesitant to vaccinate their child. Parental willingness to vaccinate themselves, older patient age, and belief in the vaccine's potency were associated with vaccine acceptance.
Meaning: These findings highlight the need for targeted interventions to improve vaccine acceptance among parents of children with SLE.

DOI: https://doi.org/10.3345/cep.2024.01340

Oncology

Prognostic role of mid-regional pro-adrenomedullin in predicting infection in pediatric cancer with febrile neutropenia

Seham M. Ragab, Sara Mahmoud El-Deeb, Ahmed Saeed, Asmaa A. Mahmoud

Clin Exp Pediatr. 2025;68(6):445-453. Published online January 13, 2025

· Infection remains a leading cause of death in febrile neutropenia (FN).
· Mid-regional pro-adrenomedullin (MR-ProADM) levels are higher among patients with FN and a bacterial infection.
· A longer FN duration and hospital stay length as well as elevated C-reactive protein, procalcitonin, and MR-ProADM levels are significant risk factors for mortality.

DOI: https://doi.org/10.3345/cep.2024.01620

Hematology

Impact of Xmn1 polymorphism on hydroxyurea therapy in children with HbE-β non-transfusion dependent thalassemia: a cohort study

Saheli Roy, Paramita Bhattacharya, Atanu Kumar Dutta, Mrinal Kanti Das

Clin Exp Pediatr. 2025;68(6):437-444. Published online February 3, 2025

Question: Does the T allele of Xmn1 polymorphism favorably influence hydroxyurea efficacy in children of Eastern descent with fetal hemoglobin (HbE)-β nontransfusion dependent thalassemia (NTDT)?
Finding: Decrease in transfusion requirement and increase in height following hydroxyurea therapy was noted in both groups, however, change in CT was more critical than that in CC genotype.
Meaning: T allele of Xmn1 polymorphism favorably influences hydroxyurea efficacy in children with HbE-β NTDT.

DOI: https://doi.org/10.3345/cep.2024.01284

Editorial

Neurology

Screen time and neurodevelopment in preschoolers: addressing a growing concern in pediatric practice

Soongang Park, Hyewon Woo

Clin Exp Pediatr. 2025;68(6):434-436. Published online January 13, 2025

· Excessive screen time in preschoolers is associated with neurodevelopmental delays, particularly during the early years of life.
· Parental supervision and national guidelines are critical in mitigating the negative impacts of excessive screen time and fostering healthy media habits in preschoolers.

DOI: https://doi.org/10.3345/cep.2024.01536

Review Article

Other

Peripheral nerve sheath tumors in the head and neck in patients with APC gene deletion mutations: a case report and scoping review of the literature

Koral M. Blunt, Monirah Albathi, Miriam Conces, Tendy Chiang

Clin Exp Pediatr. 2025;68(6):428-433. Published online January 13, 2025

In this report, we describe our experience with a patient with an APC-related genetic syndrome who presented with a rare palatal lesion with characteristics of a schwannoma. We discuss the role of immunohistochemical staining in discerning the differential diagnosis.

DOI: https://doi.org/10.3345/cep.2024.01375

Endocrinology

Impact of hematopoietic stem cell transplantation on growth outcomes in mucopolysaccharidosis: a systematic review

Farzaneh Abbasi, Asal Khalili Dehkordi, Reihaneh Mohsenipour

Clin Exp Pediatr. 2025;68(6):417-427. Published online March 11, 2025

Hematopoietic stem cell transplantation (HSCT) enhances the growth outcomes of pediatric patients with mucopolysaccharidosis, with early intervention leading to improved height, weight, and body mass index. However, achieving a standard adult height remains uncommon among these patients, even in cases of early HSCT. Growth hormone therapy provides short-term benefits but does not address long-term height deficits. Pubertal development is generally normal; however, precocious puberty and pubertal arrest may occur.

DOI: https://doi.org/10.3345/cep.2024.01725

Critical Care Medicine

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

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.

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

Allergy

Eosinophil-derived neurotoxin levels can predict allergic disease development and atopic march in children

Zak Callaway, Chang-Keun Kim

Clin Exp Pediatr. 2025;68(6):398-405. Published online February 3, 2025

· Allergic march occurs in a subset of children, beginning with atopic dermatitis and progressing to food allergies, allergic rhinitis, and/or asthma. Its early diagnosis is important to slowing its progression.
· Eosinophil-derived neurotoxin (EDN), an excellent biomarker of eosinophil activity, is often elevated in allergic diseases.
· EDN levels have been used to predict allergic disease development and diagnose, treat, and monitor allergic diseases.

DOI: https://doi.org/10.3345/cep.2024.01382

Clinical Note

Gastroenterology

Abdominal pain in a young girl: a twist in the tale

Upasana Ghosh, Ankit Agrawal, Umesh Shukla, Vikas Jain, Deeksha Bhalla

Clin Exp Pediatr. 2025;68(5):395-397. Published online March 11, 2025

· Chronic abdominal pain caused by a gastric trichobezoar is extremely rare among children.
· An indentable epigastric mass is characteristic and upper gastrointestinal endoscopy is diagnostic of a gastric trichobezoar.
· Symptomatic large trichobezoars usually require surgery.
· Neuropsychiatric disorders are often associated with gastric trichobezoar, making a psychiatric evaluation of paramount importance.

DOI: https://doi.org/10.3345/cep.2024.01949

Original Article

General Pediatrics

The role of serum zinc and selenium levels in etiology of febrile seizures

Yavuz Ataş, Hatice Gamze Poyrazoğlu

Clin Exp Pediatr. 2025;68(5):388-394. Published online January 13, 2025

Zinc may play a key role in preventing febrile seizures by increasing the seizure threshold and reducing oxidative stress. Incorporating zinc supplements into treatment could help protect children from the adverse effects of febrile seizures and improve their overall outcomes.

DOI: https://doi.org/10.3345/cep.2024.01410

Infection

Enteric pathogens implicated in acute infectious diarrhea among young children in resource-limited region with rapidly growing population: a hospital-based cross-sectional study

Aseel Mahmood Ibrahim Al-Mashahedah, Randa Mohammed Dhahi

Clin Exp Pediatr. 2025;68(5):379-387. Published online December 23, 2024

Question: What are the most common enteric pathogens in acute diarrhea among children younger than 5 years of age, and which age group is most susceptible?
Finding: Bacteria were the most common causative microorganisms of diarrhea, followed by viruses, parasites, and fungi. The 1–2-year age group was the most commonly affected.
Meaning: There is a need to formulate preventive strategies targeting children exposed to enteric pathogens to limit diarrhea.

DOI: https://doi.org/10.3345/cep.2024.01333

Nutrition

Differential effects of dietary and physical activity interventions on adiposity of children with obesity

Anekchoke Tangtongsoong, Chonnikant Visuthranukul, Yuda Chongpison, Sirinuch Chomtho

Clin Exp Pediatr. 2025;68(5):370-378. Published online February 3, 2025

Question: How do dietary intake and physical activity affect body mass index (BMI) z scores and adiposity among children with obesity?
Finding: Higher dietary protein and fiber intakes were significantly associated with a decrease in BMI z scores and adiposity among children with obesity.
Meaning: Optimizing dietary interventions by focusing on protein and fiber intakes could be an effective strategy for managing childhood obesity.

DOI: https://doi.org/10.3345/cep.2024.01347

Immunology

Serum bactericidal activity against meningococcus in patients with systemic lupus erythematosus

Soyoung Lee, Kyung-Hyo Kim, Ji Hyen Lee, Han Wool Kim

Clin Exp Pediatr. 2025;68(5):362-369. Published online January 13, 2025

Question: What is the level of immunity against meningococcal infections in patients with systemic lupus erythematosus (SLE) under the age of 19, and is vaccination against meningococcus necessary for these patients, given their susceptibility to infections due to immunosuppressive treatments and disease characteristics?
Finding: Although some of our study patients exhibited serum bactericidal activity against meningococci, most remained seronegative.
Meaning: These findings suggest that patients with SLE who are at risk of meningococcal infection receive appropriate vaccinations.

DOI: https://doi.org/10.3345/cep.2024.01151

Editorial

Other

Further research on impact of microplastics on children's health is essential to protecting future generations

Jongin Lee, Dong-Wook Lee

Clin Exp Pediatr. 2025;68(5):359-361. Published online November 13, 2024

· The ecological impacts of microplastics have been documented. It was recently recognized that they can directly or indirectly cause diseases in humans.
· There are few established methods for assessing human exposure to microplastics.
· Standardization of exposure assessments and large-scale epidemiological studies are required to explore the human effects of microplastics.

DOI: https://doi.org/10.3345/cep.2024.01459

Review Article

Nutrition

The Korea Infant Physical Growth Examination Survey (KIPGroS): a study protocol

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.

DOI: https://doi.org/10.3345/cep.2024.00297

Gastroenterology

Anxiety disorders presenting as gastrointestinal symptoms in children – a scoping review

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.

DOI: https://doi.org/10.3345/cep.2024.01732

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

Crossref 1

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.

DOI: https://doi.org/10.3345/cep.2025.00423

Perspective

Other

Telemedicine in pediatrics: things to consider

Sandhya J. Kadam, Archana Reddy Bongurala

Clin Exp Pediatr. 2025;68(4):326-328. Published online February 3, 2025

This article highlights the benefits, challenges, and current significance of telemedicine. Future research is needed, primarily to address the challenges of optimizing the implementation of telehealth. To use telemedicine effectively and efficiently for the timely diagnosis and management of patients, an evaluation of current telemedicine practice is needed. Analysis of shortcomings and advantages can help enhance healthcare delivery to pediatric patients, making it more accessible for future use.

DOI: https://doi.org/10.3345/cep.2024.01788

Original Article

Pulmonology

Impact of obesity on pulmonary function of preschool children: an impulse oscillometry study

Anuvat Klubdaeng, Kanokporn Udomittipong, Apinya Palamit, Pawinee Charoensittisup, Khunphon Mahoran

Clin Exp Pediatr. 2025;68(4):319-325. Published online November 13, 2024

Question: Does obesity in preschool children affect lung function, and which obesity indices can predict such alterations?
Finding: Preschool children with obesity exhibit impaired lung function characterized by elevated total and peripheral airway resistance. Waist-to-height ratio was the strongest predictor of such changes.
Meaning: Early obesity prevention and treatment are needed. Monitoring waist-to-height ratio, body weight, and body mass index may help identify children at risk of altered lung function.

DOI: https://doi.org/10.3345/cep.2024.01053

Nephrology (Genitourinary)

C3 glomerulopathy in children: experience at a resource-limited center

Soumya Reddy, Abhishek Ghante, Mahesha Vankalakunti, Anil Vasudevan

Clin Exp Pediatr. 2025;68(4):311-318. Published online November 28, 2024

Question: What are the clinicopathological features and outcomes of pediatric C3 glomerulopathy (C3G) in resource-limited settings?
Finding: Children with C3G in resource-limited settings have significant morbidities, and most experience kidney sequelae despite treatment. Electron microscopy was performed in only 50% of our patients, while none received complement assays or genetic testing.
Meaning: Pediatric C3G presentation, management, and kidney outcomes vary. Its thorough evaluation and management are challenging in resource-limited settings.

DOI: https://doi.org/10.3345/cep.2024.01256

Neurology

Occurrence of stroke in children and young adults in Indonesia: a multicenter private hospital study

Jeanne Leman, Veli Sungono, Yosua Timotius Haryono, Muhammad Adam Mudzakir, Dewi Lestari Rahmawati, Callistus Bruce Henfry Sulay, Gilbert Sterling Octavius

Clin Exp Pediatr. 2025;68(4):303-310. Published online November 13, 2024

Question: What is the occurrence of pediatric stroke in Indonesia?
Finding: This multicenter study identified 1,074 stroke cases, predominantly hemorrhagic (83.4%), with males and older children at higher risk. Accidents were the primary cause (73.2%).
Meaning: Pediatric stroke in Indonesia shows critical epidemiological trends, highlighting the need for targeted prevention efforts, particularly for high-risk groups like males and accident victims.

DOI: https://doi.org/10.3345/cep.2024.01214

Editorial

General Pediatrics

Global breastfeeding efforts: a long way to go

Hye-Jung Shin

Clin Exp Pediatr. 2025;68(4):300-302. Published online November 13, 2024

· Despite much effort, breastfeeding practices remain unsatisfactory worldwide.
· Effective breastfeeding-promoting interventions are needed that are appropriate for age, culture, and social environment.
· Interventions can promote breastfeeding, especially in younger populations such as adolescent mothers.

DOI: https://doi.org/10.3345/cep.2024.01361

Neonatology (Perinatology)

Advancements and challenges in neonatal resuscitation: embracing laryngeal mask airways for improved outcomes

Jang Hoon Lee

Clin Exp Pediatr. 2025;68(4):298-299. Published online November 28, 2024

Positive pressure ventilation (PPV) is the most critical intervention provided during delivery room resuscitation. In the new guidelines, this recommendation has been expanded to suggest the use of laryngeal mask airyway (LMA) versus face masks for PPV. Evidence-based information and hands-on training related to this practice will help more healthcare providers become familiar with and appropriately use LMA during delivery room resuscitations.

DOI: https://doi.org/10.3345/cep.2024.01088

Review Article

Neonatology (Perinatology)

Recent advances in understanding pathophysiology of non-nutritional stunting in very preterm infants

Eduardo Cuestas, Alina Rizzotti

Clin Exp Pediatr. 2025;68(4):287-297. Published online December 23, 2024

· Previous reviews of extrauterine growth restriction focused mainly on weight growth restriction caused by nutritional factors or pathological conditions.
· This review summarizes recent developments in the pathophysiology of nonnutritional length growth restriction in very preterm infants with focus on the impact of sustained neonatal inflammation on their short- and long-term outcomes.
· Further research is needed to investigate optimal strategies to improve length growth restriction in very preterm infants.

DOI: https://doi.org/10.3345/cep.2024.01354

Cardiology

Lifelong impact of elevated blood pressure from childhood to adulthood

Junhyun Kwon, Eunji Kim

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

· 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

Neurology

Cerebral organoid research for pediatric patients with neurological disorders

Jin Eun, Jung Eun Lee, Seung Ho Yang

Clin Exp Pediatr. 2025;68(4):269-277. Published online November 28, 2024

Cerebral organoids obtained from human induced pluripotent stem cells are transforming the study of pediatric neurological diseases by providing more accurate models of human brain development and pathology. These advancements have improved pathology modeling and the potential for novel therapeutic approaches despite existing challenges such as reproducibility and vascularization.

DOI: https://doi.org/10.3345/cep.2024.01235

Clinical Note

Gastroenterology

Congenital antral web: rare cause of gastric outlet obstruction successfully managed with endoscopic balloon dilatation

Upasana Ghosh, Ujjal Poddar, Srinivas Srinidhi Vadlapudi, Moinak Sen Sarma, Anshu Srivastava

Clin Exp Pediatr. 2025;68(3):266-268. Published online January 13, 2025

DOI: https://doi.org/10.3345/cep.2024.01242

Original Article

Genetics and Metabolism

Long-term follow-up of neurocognitive function in patients with citrin deficiency and cholestasis

Meng-Ju Melody Tsai, Jung-Chi Chang, Heng-Yu Lu, Susan Shur-Fen Gau, Yin-Hsiu Chien, Wuh-Liang Hwu, Yen-Hsuan Ni, Huey-Ling Chen, Ni-Chung Lee

Clin Exp Pediatr. 2025;68(3):257-265. Published online November 28, 2024

Question: Do transient metabolic disturbances in early childhood due to citrin deficiency have lasting effects on neurocognitive function?
Finding: Children with citrin deficiency have a higher prevalence of ADHD compared to the general population, with elevated ammonia levels in infancy associated with increased hyperactivity-impulsivity risk.
Meaning: Metabolic disturbances in early childhood due to citrin deficiency may contribute to long-term neurocognitive impacts, particularly ADHD, while IQ and life outcomes generally remain normal.

DOI: https://doi.org/10.3345/cep.2024.01102

Cited By 25	Neurodevelopmental outcomes of preterm infants
Cited By 20	Association of gut microbiota with obesity in children and adolescents
Cited By 20	Long COVID in children and adolescents: prevalence, clinical manifestations, and management strategies
Cited By 19	Prevalence of anxiety, depression, and stress among parents of neonates admitted to neonatal intensive care unit: a systematic review and meta-analysis
Cited By 18	Nonalcoholic fatty liver disease and insulin resistance in children

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