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Review Article
Neurology
Myelin oligodendrocyte glycoprotein antibody-associated disorders: clinical spectrum, diagnostic evaluation, and treatment options
Yun-Jin Lee, Sang Ook Nam, Ara Ko, JuHyun Kong, Shin Yun Byun
Clin Exp Pediatr. 2021;64(3):103-110.   Published online May 14, 2020
MOG antibody-associated disorder exhibits different pathophysiological and phenotypic findings than both aquaporin-4 antibody-associated neuromyelitis optica spectrum disorder and typical MS. MOG-antibody is of particular interest in pediatric patients with clinical or radiological non-MS typical findings. MOG-antibody was included in a diagnostic algorithm for children recommending for the first time a standardized use in clinical practice except in cases of typical MS.
General Pediatrics
Association between maternal smoking during pregnancy and risk of bone fractures in offspring: a systematic review and meta-analysis
Erfan Ayubi, Saeid Safiri, Kamyar Mansori
Clin Exp Pediatr. 2021;64(3):96-102.   Published online February 5, 2020
Question: What is the effect of maternal smoking during pregnancy (MSDP) on the risk of bone fractures in the offspring?
Finding: After the adjustment for misclassification, MSDP may be associated with a 27% increased risk of bone fracture in the offspring (pooled odds ratio, 1.27; 95% confidence interval, 1.00–1.62; I2=0%; P=0.537)
Meaning: Preventive measures and health education programs should be designed and implemented to encourage women to stop smoking, especially during.
Clinical note
Immunology
Salivary and lacrimal gland enlargement with serum immunoglobulin G4 elevation
Jinseok Lee, Da-Eun Kim, Jeong-Hwan Yang, Misun Lim, Hye Yung Yum, JoongGon Kim
Clin Exp Pediatr. 2021;64(2):93-95.   Published online December 8, 2020
Question: What diseases should be considered in a 15-year-old girl presenting enlarged lacrimal and salivary glands?
Finding: Laboratory tests revealed elevated IgG4 levels. A submandibular gland biopsy showed lymphoplasmacytic infiltration and more than 40 immunoglobulin G4 (IgG4)-positive cells per high-power field. The patient was diagnosed with IgG4-related disease.
Meaning: Although rare in children, IgG4-related disease should be considered a differential diagnosis in children with enlarged salivary and lacrimal glands.
Original Article
Hematology
Changes in the prevalence of anemia in Korean adolescents, 1998–2018
Jun Young An, Yoo Rha Hong, Seom Gim Kong
Clin Exp Pediatr. 2021;64(2):86-92.   Published online November 16, 2020
Question: Over the past 21 years, has the prevalence of anemia decreased among Korean adolescents?
Finding: The prevalence of anemia in boys aged 10–18 years decreased from 3.0% to 0.5% over the study period, whereas that in girls did not change significantly over time (increased from 7.9% to 8.5%).
Meaning: The prevalence of anemia in female adolescents remains high, requiring attention and efforts to improve it.
Gastroenterology
Value of the International Classification of Diseases code for identifying children with biliary atresia
Pornthep Tanpowpong, Chatmanee Lertudomphonwanit, Pornpimon Phuapradit, Suporn Treepongkaruna
Clin Exp Pediatr. 2021;64(2):80-85.   Published online August 24, 2020
Question: What is the value of the diagnostic code in identifying cases of biliary atresia in a large administrative database?
Finding: The diagnostic code’s accuracy and sensitivity are acceptable for identifying algorithm-defined cases. A history of pale stool and a presumed diagnosis of biliary atresia prior to referral added value.
Meaning: The addition of clinical data to the diagnostic code significantly increased the diagnostic yield.
Editorial
Hematology
Time to pay attention to anemia in female adolescents
Jae Min Lee
Clin Exp Pediatr. 2021;64(2):78-79.   Published online February 1, 2021
Cardiology
Where should we start to improve pediatric heart transplantation outcomes?
Jinyoung Song
Clin Exp Pediatr. 2021;64(2):76-77.   Published online November 25, 2020
· Pediatric heart transplantation is achieving better outcomes.
· The waitlist mortality is still high, especially in Korea, and should be reduced.
· The use of ventricular assist device is promising and might offer improved waitlist mortality rates.
Review Article
General Pediatrics
Clinical features, diagnosis, and outcomes of multisystem inflammatory syndrome in children associated with coronavirus disease 2019
Ji Hee Kwak, Soo-Young Lee, Jong-Woon Choi; the Korean Society of Kawasaki Disease
Clin Exp Pediatr. 2021;64(2):68-75.   Published online December 30, 2020
Hundreds of cases of children and adolescents with hyperinflammatory responses such as Kawasaki disease have been reported amid the coronavirus disease 2019 (COVID-19) pandemic, leading to coining of the new term COVID-19–associated multisystem inflammatory syndrome in children. In this review article, we introduce the illness and describe its case definitions, epidemiology, pathogenesis, clinical features, treatments, and outcomes.
Allergy
Eosinophils and childhood asthma
Bong Seok Choi
Clin Exp Pediatr. 2021;64(2):60-67.   Published online January 6, 2021
•In allergic eosinophilic asthma, eosinophils act as important effector cells and antigen-presenting cells, while in nonallergic eosinophilic asthma, type 2 innate lymphoid cells play an important role in eosinophil activation.
•Sputum eosinophil counts can be helpful for evaluating allergic airway inflammation in asthma.
• Anti-interleukin-5 has broadened the scope of asthma treatment.
Cardiology
Pediatric heart transplantation: how to manage problems affecting long-term outcomes?
Young Hwue Kim
Clin Exp Pediatr. 2021;64(2):49-59.   Published online April 8, 2020
Since the initial International Society of Heart Lung Transplantation registry was published in 1982, the number of pediatric heart transplantations has increased markedly, reaching a steady state of 500–550 transplantation annually and occupying up to 10% of total heart transplantations. Heart transplantation is considered an established therapeutic option for patients with end-stage heart disease. The long-term outcomes of pediatric heart...
Perspective
Infection
Addressing children’s health amid the coronavirus disease 2019 pandemic
Young June Choe, Bilal Aurang Zeb Durrani, Stefan Swartling Peterson
Clin Exp Pediatr. 2021;64(2):46-48.   Published online December 15, 2020
In the coronavirus disease 2019 (COVID-19) pandemic, children experience heightened barriers to health and protective services. Children may also be disproportionately affected due to their reliance on the education system for daily tasks and lack of access to remote learning options. Republic of Korea findings on how vaccination coverage could be sustained in children and schools could be reopened without aggravating COVID-19 underlie the need for coordinated efforts across sectors.
Letter to the Editor
Neonatology (Perinatology)
Role of neutrophil CD11b expression in diagnosis of earlyonset neonatal sepsis in full-term infant
Safaa ELMeneza, Walaa Mohamed, Iman Elbagoury, Karima Bahagat
Clin Exp Pediatr. 2021;64(1):44-45.   Published online April 14, 2020
Question: Can CD11b detect sepsis in full-term infants with suspected sepsis?
Finding: The percentage of neutrophils expressing CD11b was significantly upregulated in the sepsis and suspected sepsis groups versus the control group.
Meaning: CD11b is a sensitive marker for sepsis and suspected sepsis in full-term neonates and it may be added to sepsis markers. This information would allow the neonatologist to confidently discontinue antibiotic use as long as the neonate is clinically stable.
Original Article
Neonatology (Perinatology)
The protective effect of CXC chemokine receptor 2 antagonist on experimental bronchopulmonary dysplasia induced by postnatal systemic inflammation
Seung Hyun Lee, Chang Won Choi
Clin Exp Pediatr. 2021;64(1):37-43.   Published online July 15, 2020
Question: Can CXC chemokine receptor 2 (CXCR2) antagonist preserve alveolarization by attenuating the inflammation induced by systemic lipopolysaccharide (LPS) administration in a rat model of bronchopulmonary dysplasia (BPD)?
Finding: CXCR2 antagonist significantly decreased neutrophil counts in bronchoalveolar lavage fluid and peripheral blood induced by systemic LPS administration and restored alveolarization in newborn rats.
Meaning: CXCR2 antagonist protected the lungs from the inflammation in a rat model of BPD.
Gastroenterology
Noninvasive markers for esophageal varices in children with cirrhosis
Parisa Rahmani, Fatemeh Farahmand, Ghobad Heidari, Azadeh Sayarifard
Clin Exp Pediatr. 2021;64(1):31-36.   Published online July 21, 2020
Question: Can noninvasive biomarkers identify esophageal varices among children with esophageal cirrhosis?
Finding: The spleen size, platelet count, international normalized ratio, aspartate aminotransferase to platelet ratio index, platelet count to spleen size ratio, and risk score differed significantly between the patients with and those without esophageal varices.
Meaning: These biological parameters can predict esophageal varices among pediatric patients and indicate the need for esophagogastroduodenoscopy.
Editorial
Neonatology (Perinatology)
Neutrophil CD11b as a promising marker for early detection of neonatal sepsis
Ju Sun Heo
Clin Exp Pediatr. 2021;64(1):28-30.   Published online September 1, 2020
· Neonatal sepsis is a global problem and significant cause of neonatal mortality and adverse short- and long-term outcomes.
· Due to severe limitations diagnosing neonatal sepsis, there is a critical need to identify reliable specific biomarkers for early detection.
· nCD11b might be an accurate and rapid biomarker for the early detection of neonatal sepsis.
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