- 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
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- Original Article
- Neonatology (Perinatology)
- Evaluation of total serum bilirubin thresholds for discontinuing phototherapy in jaundiced neonates: a randomized study
- Ajay Kumar, Nidhi Jain
- Clin Exp Pediatr. 2025;68(7):539-545. Published online February 26, 2025
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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.
- Incidence of neural tube defects in tertiary care university hospital in Bangladesh
- 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
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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.
- 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
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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.
- Genetics and Metabolism
- Role of microRNA-498 and microRNA-410 in neonatal hypoxic-ischemic encephalopathy
- Eman Salah Eldeen Arafat, Hasnaa Hesham Abotaleb, Dina Abdel Razek Midan, Abdel Hamid Abdo Ismail, Zeinab Sabri Abouzouna
- Clin Exp Pediatr. 2025;68(7):512-521. Published online February 26, 2025
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Question: Is it role of microRNA-410 (miRNA-410) and microRNA-498 (miRNA-498) in neonatal hypoxic-ischemic encephalopathy (HIE)?
Findings: miRNA-498 and miRNA-410 can be auxiliary diagnostic and prognostic tools for neonatal HIE.
Meaning: we can use miRNA-498 and miRNA-410 as markers and indicator for HIE.
- Neonatology (Perinatology)
- Characterization of gut microbiota in very low birth weight infants with versus without bronchopulmonary dysplasia
- 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
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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.
- Pulmonology
- Clinical course of children with postinfectious bronchiolitis obliterans with versus without comorbid bronchopulmonary dysplasia
- Lamia Medghoul, Julien Grosjean, Christophe Marguet, Hortense Petat
- Clin Exp Pediatr. 2025;68(7):497-502. Published online April 1, 2025
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Question: Postinfectious bronchiolitis obliterans (PIBO) is a chronic respiratory disease that typically develops in children after a severe respiratory infection. Bronchopulmonary dysplasia (BPD) is often comorbid in patients with PIBO.
Finding: Corticosteroid pulse therapy effectively manages PIBO with or without comorbid BPD, significantly reducing exacerbations and decreasing the daily requirement for inhaled corticosteroids.
Meaning: Therapeutic effects of corticosteroid pulses are rapid and sustained over time, in both groups.
- Nonlinear association between neutrophil-to-lymphocyte ratio and asthma in children and adolescents in the United States: a cross-sectional study
- Chuhan Cheng, Liyan Zhang
- Clin Exp Pediatr. 2025;68(7):489-496. Published online March 11, 2025
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Question: Is there a nonlinear relationship between neutrophil-to-lymphocyte ratio (NLR) and asthma in children and adolescents?
Finding: NLR showed a nonlinear association with asthma, with an NLR threshold of 2.23 identifying individuals at higher risk.
Meaning: An NLR<2.23 may serve as a potential biomarker for asthma risk assessment and management in pediatric populations, thereby offering a simple tool for the early identification of at-risk individuals.
- 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
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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
- Immunology
- NLRP3 inflammasome: a key player in neonatal brain injury
- Cagla Kiser, Ilkcan Ercan, Defne Engur, Sermin Genc
- Clin Exp Pediatr. 2025;68(7):475-485. Published online April 1, 2025
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Hypoxic-ischemic encephalopathy is the major cause of neonatal brain injury. NOD-like receptor family pyrin domain containing 3 inflammasome activation leads to neuroinflammation, which significantly affects newborn mortality. The establishment of preventive and therapeutic strategies against brain damage requires a thorough understanding of the mechanisms underlying neuroinflammation and inflammasome activation in the neonatal brain.
- 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
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- 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
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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.
- 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
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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.
- 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
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· 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.
- 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
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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.
- 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
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· 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.
- 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
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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.
- 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
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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.
- 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
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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.
- 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
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· 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.
- 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
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· 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.
- 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
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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.
- 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
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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.
- 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
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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.
- 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
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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.
- 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
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· 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.
- 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
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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.
- 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
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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.
- 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
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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.
- 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
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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.
