Clinical and Experimental Pediatrics

Clinical Note

Gastroenterology

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 R. Yadav, Moinak Sen Sarma, Anshu Srivastava

Clin Exp Pediatr. 2025;68(12):1041-1044. Published online October 22, 2025

Button battery (BB) ingestion is an increasing hazard. Catastrophic gastrointestinal bleeding due to pseudoaneurysm rupture following BB impaction is often fatal. Here we report the case of an unwitnessed BB ingestion in an 18-month-old boy who presented with repeated massive UGIB due to a left CCA pseudoaneurysm that was successfully managed multidisciplinarily. BB ingestion should be considered in toddlers presenting with hematemesis.

DOI: https://doi.org/10.3345/cep.2025.01347

Original Article

General Pediatrics

Lipoprotein(a) prevalence trends in Portuguese children and adolescents: a real-world perspective

Isabel Morais Ribeiro, Susete Vieira, Miguel Saraiva, Mónica Tavares, José Carlos Oliveira, Isabel Mangas Palma, Helena Ferreira Mansilha

Clin Exp Pediatr. 2025;68(12):1031-1040. Published online November 24, 2025

Early lipid screening, including lipoprotein(a) (Lp(a)), in children/adolescents is key to identifying and managing dyslipidemia and reducing the risk of early-onset cardiovascular disease. This study shows that prevalence of elevated Lp(a) in high-risk Portuguese children is alarming, with over 30% at intermediate/high risk and nearly 1% at very high-risk (>430 nmol/L). Since Lp(a) is mostly genetically determined, one-time early screening in atrisk children is crucial for timely monitoring and prevention.

DOI: https://doi.org/10.3345/cep.2025.00339

Pulmonology

Ciclesonide shows a lung-protective effect in neonatal hyperoxia-exposed rats

Victoria Mielgo, Miguel A. Gomez-Solaetxe, Lara Olazar, Begoña Loureiro, Carmen Rey-Santano

Clin Exp Pediatr. 2025;68(12):1023-1030. Published online October 2, 2025

Question: Bronchopulmonary dysplasia (BPD) is the most prevalent chronic lung disease of prematurity. Numerous nonpharmacological/pharmacological interventions have been investigated without clear consensus. Can ciclesonide, a new synthetic glucocorticoid, effectively treat BPD?
Finding: Ciclesonide mitigated hyperoxia-induced lung injury and right ventricular hypertrophy in newborn rats.
Meaning: These findings suggest that postnatal ciclesonide may be an alternative to existing corticosteroids for the treatment of BPD.

DOI: https://doi.org/10.3345/cep.2025.01137

Critical Care Medicine

Cytokine profile of Post–cardiopulmonary bypass in children

Kantara Saelim, Kanokpan Ruangnapa, Jirayut Jarutach, Pongsanae Duangpakdee, Smonrapat Surasombatpattana, Pharsai prasertsan

Clin Exp Pediatr. 2025;68(12):1015-1022. Published online September 19, 2025

Question: Can cytokine levels predict low cardiac output syndrome (LCOS) in children post–cardiopulmonary bypass?
Finding: Elevated interleukin (IL)-6, IL-8, and tumor necrosis factor-α levels were associated with LCOS, with an increase in IL-8 of >56 pg/mL from baseline to immediately postoperative being the strongest predictor.
Meaning: Monitoring immediately postoperative IL-8 levels may help identify pediatric patients at risk of LCOS, enabling timely interventions to improve outcomes.

DOI: https://doi.org/10.3345/cep.2025.00836

Infection

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

Clin Exp Pediatr. 2025;68(12):1007-1014. Published online October 2, 2025

Question: How do clinical presentations, healthcare resource utilization, and outcomes differ between children hospitalized with influenza versus coronavirus disease 2019 (COVID-19)?
Finding: Patients with influenza were older, were more symptomatic, and required greater healthcare resources, including intravenous fluids, empirical antibiotics, respiratory support, and pediatric intensive care unit admission.
Meaning: Influenza involves greater severity and a higher healthcare burden than COVID-19, highlighting the need for preventive strategies such as vaccination and hospital resource planning during seasonal outbreaks.

DOI: https://doi.org/10.3345/cep.2025.00759

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

Clin Exp Pediatr. 2025;68(12):998-1006. Published online October 22, 2025

Question: Addressing crucial genetic variants within the vitamin D pathway and coronavirus disease 2019 (COVID-19) susceptibility, the vitamin D receptor, vitamin D binding protein, and CYP27B1-1260 polmorphisms might be associated with COVID-19 occurrence and severity in children.
Finding: The FokI FF genotype might be an independent risk factor for COVID-19 severity in childhood.
Meaning: This research may further elucidate genetic susceptibility to multisystem viral infections and establish genetic markers for severe clinical outcomes.

DOI: https://doi.org/10.3345/cep.2025.00577

Neonatology (Perinatology)

Less invasive surfactant administration versus intubation-surfactant-extubation: a single-center retrospective study

C.S. Jithin, A. Nalina, A. Shashidhar, P.N. Suman Rao

Clin Exp Pediatr. 2025;68(12):991-997. Published online October 2, 2025

Question: Does less invasive surfactant administration (LISA) (vs. intubation-surfactant-extubation) improve clinical outcomes in preterm infants with respiratory distress syndrome?
Finding: LISA significantly reduced intubation and invasive mechanical ventilation needs within the first 72 hours and shortened the overall invasive respiratory support duration without increasing other morbidities.
Meaning: LISA is a less invasive and safer surfactant delivery alternative. Larger multicenter trials are needed to confirm its long-term safety and efficacy, especially in low- and middle-income countries.

DOI: https://doi.org/10.3345/cep.2025.00332

Hematology

Assessment of natural killer cell subpopulations in pediatric patients with transfusion-dependent β-thalassemia major

Fathia Ibrahim Elbassal, Mohamed Abdel Rehim Soliman, Nourhan Hossam Eldin Mohamed, Mai El-Sayad Abd El-Hamid, Hanan Hassan El-Sheity

Clin Exp Pediatr. 2025;68(12):981-990. Published online September 12, 2025

Question: How does iron overload affect immunity in pediatric patients with transfusion-dependent β-thalassemia major?
Finding: Iron overload in these patients is associated with disrupted natural killer (NK) cell subpopulations, reflecting impaired innate immunity.
Meaning: This highlights the need to monitor immune profile alongside iron status during thalassemia management.

DOI: https://doi.org/10.3345/cep.2025.01046

Oncology

HLA‒B*58:01 and skin reactions in pediatric hematology and oncology patients treated with allopurinol

Parisa Maneechai, Cholada Ratanatharathron, Jassada Buaboonam, Kleebsabai Sanpakit

Clin Exp Pediatr. 2025;68(12):974-980. Published online October 2, 2025

Crossref 1

Question: Does human leukocyte antigen (HLA)–B*58:01 increase the risk of cutaneous reactions in pediatric patients with hematological and oncological diseases receiving allopurinol?
Finding: : Of 108 patients, 17.6% carried HLA–B*58:01 but none developed skin reactions. The only rash occurred in an HLA-B*58:01–negative patient.
Meaning: Short-duration allopurinol may mitigate severe cutaneous adverse reaction risk regardless of genotype. Routine HLA-B*58:01 screening may be unnecessary in pediatric patients with hematological and oncological diseases briefly receiving allopurinol.

DOI: https://doi.org/10.3345/cep.2025.01032

Editorial

Infection

Beyond COVID-19: meeting the challenge of evolving pediatric invasive group A streptococcal disease

Han Wool Kim

Clin Exp Pediatr. 2025;68(12):971-973. Published online November 26, 2025

Pediatric for invasive group A Streptococcus has resurged globally with increasing severity and toxin-mediated presentations. Beta-lactams remain the first-line treatment, but linezolid has emerged as a safe alternative in cases refractory to β-lactams. Early intravenous immunoglobulin use may improve outcomes in severe streptococcal toxic shock syndrome cases, while C-reactive protein and procalcitonin aid early risk stratification. Integrating global surveillance and individualized therapy is crucial in the postpandemic era.

DOI: https://doi.org/10.3345/cep.2025.02600

Review Article

Nutrition

Exploring nutritional screening tools for hospitalized children: a narrative review

Pankaj Soni, Amit Agrawal, Gaurav Jadon

Clin Exp Pediatr. 2025;68(12):963-970. Published online October 22, 2025

Malnutrition is frequently identified in hospitalized children, and the use of nutritional screening tools is crucial for assessing their nutritional status during their hospital admission and stay. Common tools include the Pediatric Yorkhill Malnutrition Score, Screening Tool for Assessment of Malnutrition in Pediatrics, and Screening Tool for Risk of Nutritional Status and Growth. However, these tools have varying sensitivities and specificities, and none is recommended for all hospitalized children.

DOI: https://doi.org/10.3345/cep.2025.00633

Oncology

Breaking the barrier: a guidelines-based review of antiangiogenesis drug resistance in pediatric cancer therapy

Nader Shakibazad, Mahdi Shahriari, Mani Ramzi

Clin Exp Pediatr. 2025;68(12):952-962. Published online November 24, 2025

Antiangiogenic therapy resistance in pediatric cancers involves alternative angiogenic pathways, microenvironmental support, hypoxia-driven signaling, metabolic reprogramming, and structural adaptations such as vascular co-option. Metabolic adaptation highlights tumor plasticity. Effective treatments combine immunotherapy with biomarkers. To address vascular endothelial growth factor limitations, emerging targets include hypoxia-inducible factor-2α, endoglin, CXCR4, angiopoietin/Tie2, and bispecific antibodies. In resource-constrained settings, the guidelines recommend low-dose chemotherapy plus oral multiantiangiogenic agents to ensure improved accessibility and treatment outcomes.

DOI: https://doi.org/10.3345/cep.2025.01809

Original Article

General Pediatrics

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

Clin Exp Pediatr. 2025;68(11):944-951. Published online September 12, 2025

Question: Although children with postacute sequelae of coronavirus disease 2019 (PASC) may experience persistent symptoms that affect their quality of life (QoL), a screening tool for identifying high-risk children is lacking.
Finding: Kinder Lebensqualität fragebogen (KINDL) and Children's Somatic Symptom Inventory-24 (CSSI-24) were significantly correlated. An optimal KINDL cutoff score (74.75) detected those at high risk of a reduced QoL.
Meaning: Integrating KINDL and CSSI-24 into routine pediatric outpatient care may enable timely identification and interventions for children at risk of PASC-related impairments.

DOI: https://doi.org/10.3345/cep.2025.00983

Gastroenterology

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

Clin Exp Pediatr. 2025;68(11):932-943. Published online August 20, 2025

Question: How does the gut microbiota profile of infants with biliary atresia (BA) differ from that of infants with non-BA cholestasis and healthy infants in the Indonesian population?
Finding: The unique fecal microbiome composition of the BA group differed significantly from that of the other 2 groups.
Meaning: There is an urgent need to improve dysbiosis in BA and non-BA cholestasis to prevent worsening liver injury in cholestasis.

DOI: https://doi.org/10.3345/cep.2025.00563

Infection

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

Clin Exp Pediatr. 2025;68(11):921-931. Published online August 11, 2025

Web of Science 1 Crossref 2

Question: What are the roles of linezolid, intravenous immunoglobulin (IVIG), and corticosteroids in pediatric invasive group A streptococcal infection (iGAS)? Can any improve outcomes beyond beta-lactams and clindamycin?
Finding: Two of 46 patients with iGAS died. Nearly all received beta-lactams plus clindamycin. Linezolid was effective in refractory cases. IVIG and corticosteroids had variable efficacies.
Meaning: Linezolid may be valuable in refractory cases. IVIG may be considered in severe presentations. The role of corticosteroids remains less clearly defined.

DOI: https://doi.org/10.3345/cep.2025.00479

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

Clin Exp Pediatr. 2025;68(11):909-920. Published online August 6, 2025

· A total of 159 children with autoimmune hepatitis (AIH; 60.3% female, 13.2% type 2 AIH) were identified. According to a global study, the estimated annual incidence of AIH in Egypt is 1.28 cases per 100,000 inhabitant-years.
· No studies to date have examined the serum levels of copper or ceruloplasmin in children with AIH. Therefore, here we investigated whether serum copper and ceruloplasmin levels are useful for identifying liver fibrosis in children with AIH.
· Serum copper and ceruloplasmin levels may provide important information for the identification of advanced liver fibrosis in children with AIH.

DOI: https://doi.org/10.3345/cep.2025.01011

Hematology

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

Clin Exp Pediatr. 2025;68(11):901-908. Published online August 6, 2025

The B-cell lymphoma protein 2 family proteins Bak and Bcl- Xl, important markers of apoptosis, may contribute to primary immune thrombocytopenia (ITP). Thus, their expression may serve as biomarkers for the diagnosis and monitoring of pediatric ITP. Targeting these pathways may improve platelet survival, particularly in treatment-resistant cases. Personalized treatments based on apoptotic profiles can optimize therapy and reduce the unnecessary use of immunosuppressive drugs.

DOI: https://doi.org/10.3345/cep.2025.00997

General Pediatrics

Comparative analysis of goal attainment for helmet therapy versus conservative management for positional plagiocephaly in infants

Bjoern Vogt, Ariane Deutschle, Georg Gosheger, Adrien Frommer, Andrea Laufer, Henning Tretow, Robert Roedl, Gregor Toporowski

Clin Exp Pediatr. 2025;68(11):892-900. Published online October 2, 2025

Question: Is helmet therapy more effective than conservative management in treating positional plagiocephaly?
Finding: Both approaches reduced cranial asymmetry with comparable correction speed. Helmet therapy showed a trend toward greater severity reduction.
Meaning: Early treatment initiation was the strongest predictor of improvement. Helmet therapy may offer additional benefit in more severe cases.

DOI: https://doi.org/10.3345/cep.2025.01102

Endocrinology

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

Clin Exp Pediatr. 2025;68(11):879-891. Published online August 20, 2025

Web of Science 1 Crossref 1

Question: What are the nationwide trends and mortality risk factors of nutritional versus hereditary rickets among children in Asia?
Finding: In 2012–2018, the incidence of rickets steadily increased, whereas mortality rates declined. Mortality is associated with a low household income, anemia, chronic kidney disease, secondary hyperparathyroidism, and a prolonged hospital stay.
Meaning: Early diagnosis and targeted interventions addressing social and medical vulnerabilities are critical to reducing ricket-related mortality.

DOI: https://doi.org/10.3345/cep.2025.00976

Nutrition

Success rates of conservative treatment and optimal surgical timing for pediatric chylothorax

Pakwan Kaewchusen, Narumon Densupsoontorn, Supaluck Kanjanauthai, Puthita Saengpanit

Clin Exp Pediatr. 2025;68(11):871-878. Published online August 6, 2025

Web of Science 1

Question: What is the success rate of conservative treatment for pediatric chylothorax, and when should surgical intervention be employed?
Finding: Overall success rate of conservative treatment was 83.3%. Surgically related etiologies and lower peak pleural fluid drainage rates were significantly associated with successful conservative management of pediatric chylothorax.
Meaning: If chylous drainage persists at ≥10 mL/kg/day beyond 2 weeks of optimal conservative treatment, surgical intervention should be considered.

DOI: https://doi.org/10.3345/cep.2025.00598

Editorial

Endocrinology

Rickets prevalence and treatment outcome: real-world data from Taiwan

Young Suk Shim

Clin Exp Pediatr. 2025;68(11):868-870. Published online October 23, 2025

Rickets should be recognized as a significant public health concern during infancy and childhood. Recent studies from Taiwan have demonstrated a steady increase in the prevalence of nutritional rickets, and a similar trend is likely to emerge in Korea. Therefore, comprehensive clinical evaluation and appropriate biochemical assessment are essential to prevent long-term skeletal and systemic complications. Prompt diagnosis and timely initiation of appropriate treatment are crucial.

DOI: https://doi.org/10.3345/cep.2025.01949

Review Article

Gastroenterology

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

Clin Exp Pediatr. 2025;68(11):858-867. Published online October 2, 2025

· Neonatal ichthyosis-sclerosing cholangitis (NISCH) syndrome is a rare autosomal recessive disorder characterized by cholestasis and manifestations such as generalized ichthyosis, alopecia, and dental anomalies.
· The clinical features of NISCH syndrome are distinct and necessitate an early genetic diagnosis.
· The disease phenotype can vary significantly, ranging from no liver involvement and transient neonatal cholestasis to end-stage liver disease.
· Management requires a multidisciplinary approach with long-term follow-up.

DOI: https://doi.org/10.3345/cep.2025.00906

General Pediatrics

Bridging the gap: autism spectrum disorder in children in the United States and worldwide: a narrative review

Sandhya J. Kadam, Malika Goel

Clin Exp Pediatr. 2025;68(11):852-857. Published online October 2, 2025

The prevalence of autism is increasing worldwide. The United States has the highest numbers, likely due to the availability of better treatment options. However, global disparities exist, especially in low-resource settings in which stigma, underdiagnosis, and limited services hinder care. A coordinated international approach emphasizing early screening, inclusive policies, and culturally sensitive support systems can bridge this gap and improve the outcomes for children with autism and their families worldwide.

DOI: https://doi.org/10.3345/cep.2025.00969

Endocrinology

Continuous glucose monitoring in Korean pediatric patients with type 1 diabetes: current landscape and clinical implications

Hwa Young Kim, Jaehyun Kim

Clin Exp Pediatr. 2025;68(11):842-851. Published online October 2, 2025

Continuous glucose monitoring (CGM) has transformed pediatric type 1 diabetes care by facilitating tighter glycemic control, reducing hypoglycemia, and improving quality of life.
Recent advances in CGM technology and the expansion of insurance coverage in Korea have led to its broader adoption.
Emerging metrics such as time in tight range offer refined tools for individualized glycemic assessment, highlighting CGM’s evolving role in personalized pediatric diabetes management.

DOI: https://doi.org/10.3345/cep.2025.01522

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.

DOI: https://doi.org/10.3345/cep.2025.01004

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.

DOI: https://doi.org/10.3345/cep.2025.00143

Hematology

Hyperhomocysteinemia in pediatric β-thalassemia: links to vitamin cofactor deficiencies and oxidative stress

Arzu Dadashova, Gunay Aliyeva, Rana Rahimova, Gulnara Azizova, Khayala Mammadova

Clin Exp Pediatr. 2025;68(10):819-830. Published online July 8, 2025

Web of Science 1 Crossref 2

Question: What are the biochemical and clinical correlates of hyperhomocysteinemia in pediatric β-thalassemia, and how does it relate to vitamin status, oxidative stress, and splenectomy?
Finding: Most pediatric β-thalassemia patients exhibited severe hyperhomocysteinemia, which was strongly associated with folate and B₁₂ deficiencies and influenced oxidative stress patterns, particularly in splenectomized individuals.
Meaning: These findings suggest that routine monitoring and correction of B-vitamin deficiencies may mitigate hyperhomocysteinemia-related risks in pediatric thalassemia.

DOI: https://doi.org/10.3345/cep.2025.00556

Gastroenterology

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

Clin Exp Pediatr. 2025;68(10):808-818. Published online May 29, 2025

Question: Is there an association between adenosine deaminase (ADA) G22A and interleukin-1 receptor antagonist (IL-1RN) genetic polymorphisms and pediatric metabolic dysfunction-associated fatty liver disease (MAFLD)?
Finding: The GG genotype and G allele of ADA G22A were significantly associated with obesity but not pediatric MAFLD, while the *1/*2 genotype of the IL-1RN gene was significantly associated with obesity and pediatric MAFLD.
Meaning: The IL-1RN gene may contribute to pediatric MAFLD.

DOI: https://doi.org/10.3345/cep.2025.00731

Other

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

Clin Exp Pediatr. 2025;68(10):801-807. Published online June 10, 2025

Question: Can neutrophil elastase (NE) levels predict infection— the primary cause of mortality—among children with hematological malignancies and febrile neutropenia (FN)?
Finding: Elevated levels of NE were found in children with chemotherapy-induced FN and a bacterial infection.
Meaning: Increased NE levels and prolonged FN are important factors associated with mortality risk.

DOI: https://doi.org/10.3345/cep.2025.00318

Critical Care Medicine

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

Clin Exp Pediatr. 2025;68(10):790-800. Published online May 30, 2025

Question: Does high-protein enteral nutrition better increase the average nitrogen balance (NB) and decrease the intestinal fatty acid-binding protein (I-FABP) level of critically ill postoperative children than standard-protein enteral nutrition?
Finding: The study demonstrated a significant increase in average NB but no significant decrease in I-FABP levels in the high- versus low-protein group.
Meaning: These findings suggest that high-protein enteral nutrition can improve NB in critically ill postoperative children, thereby supporting their recovery.

DOI: https://doi.org/10.3345/cep.2025.00227

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Cited By 28	Association of gut microbiota with obesity in children and adolescents

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