- Clinical Note
- Gastroenterology
- Esophagopleural fistula following coin impaction in a female toddler: successful management using through-the-scope clips
- Sarthak Chakrabarti, Nikhil Sonthalia, Kaustabh Chaudhuri, Tamashis Mukherjee, Uday Chand Ghoshal, Mahesh Kumar Goenka
- Clin Exp Pediatr. 2026;69(6):527-530. Published online May 14, 2026
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- Ultrasonographic features of 5-aminosalicylic acid intolerance in pediatric ulcerative colitis
- Hirotoki Murashige, Yasufumi Sakata, Yoshihiro Azuma, Shunji Hasegawa
- Clin Exp Pediatr. 2026;69(6):524-526. Published online May 28, 2026
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- Original Article
- Endocrinology
- Intramuscular and subcutaneous gonadotropin-releasing hormone agonist tests for central precocious puberty in girls: a randomized controlled trial
- Worapimon Lerdrassameethad, Suttipong Wacharasindhu, Vichit Supornsilchai, Khomsak Srilanchakon
- Clin Exp Pediatr. 2026;69(6):518-523. Published online April 15, 2026
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Question: Did the intramuscular (IM) and subcutaneous (SC) administration of gonadotropin-releasing hormone (GnRH) agonists have comparable timing and diagnostic utility for evaluating central precocious puberty in girls?
Finding: Both the IM and SC GnRH stimulation tests demonstrated comparable times to peak luteinizing hormone levels.
Meaning: Clinicians may consider the IM route as a time-efficient alternative, as it offers similar diagnostic utility for central precocious puberty without compromising the detection of hypothalamic-pituitary-gonadal axis activation.
- Anthropometric trajectories of Korean children and adolescents with severe obesity
- Jeongho Han, Hakyung Lee, Dong Jun Ha, Jieun Lee, Yong Hee Hong, Hwa Young Kim, Jaehyun Kim
- Clin Exp Pediatr. 2026;69(6):508-517. Published online April 10, 2026
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Question: How do body mass index (BMI) and metabolic markers change over time in severely obese Korean children and adolescents receiving only lifestyle modifications?
Finding: Among 124 participants, BMI z scores decreased modestly over 2.6 years, primarily in younger prepubertal boys. However, most remained severely obese, with minimal improvement in body composition or metabolic markers.
Meaning: Lifestyle interventions alone have limited efficacy for severe pediatric obesity. Early and more intensive treatments are required.
- Pulmonology
- High-Risk CCL14 lineage drives severe Mycoplasma pneumoniae pneumonia in children: a study in central China
- Chunbo Hao, Zijie Li, Yanjuan Yu, Song Wang, Genhao Wang, Gaijing Jia, Tiantian Sun, Shouhang Chen, Yang Wu, Yu Tang, Fang Wang, Guangcai Duan, Yuefei Jin
- Clin Exp Pediatr. 2026;69(6):497-507. Published online April 10, 2026
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Question: Are the predominant circulating strains of Mycoplasma pneumoniae associated with disease severity and clinical indicators?
Finding: The common cluster label 14 (CCL14) lineage was a high-risk clone circulating in central China that demonstrated a strong association between severe pediatric pneumonia and a distinct hyperinflammatory profile.
Meaning: Targeted molecular surveillance of the CCL14 lineage may facilitate early risk stratification and guide clinical management to reduce the burden of severe disease.
- Endocrinology
- Thyroid peroxidase gene variants and susceptibility to congenital hypothyroidism and autoimmune thyroid disease among Egyptian pediatric cohort
- Hala M. Sakhr, Mohammed H. Hassan, Esraa Abbass Abdallah, Amira Mahmoud Ewis, Mohamed Hesham Mohamed, Shymaa Gaber Rizk
- Clin Exp Pediatr. 2026;69(6):486-496. Published online March 26, 2026
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Question: Which factors influence pediatric thyroid disorder susceptibility and severity?
Finding: Anemia, selenium deficiency, excess copper, and the thyroid peroxidase (TPO) Arg386His polymorphism, especially with the histidine/histidine genotype, are strongly associated with pediatric thyroid disease and high thyroid-stimulating hormone levels.
Meaning: Pediatric thyroid disorders are multifactorial. The TPO Arg386His variant may help identify children at higher risk of severe thyroid dysfunction, enabling earlier diagnosis, improved risk stratification, and more personalized clinical management.
- Editorial
- Cardiology
- Beyond morphometry: the atrial septal defect pressure gradient as a dynamic predictor of mitral valve growth in borderline left hearts
- Han Ki Park
- Clin Exp Pediatr. 2026;69(6):484-485. Published online May 27, 2026
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Traditional morphometric scores often fail to predict the success of biventricular repair of borderline left hearts. Wang et al. demonstrated that a low atrial septal defect (ASD) pressure gradient is a critical functional predictor of mitral valve growth. By integrating ASD hemodynamics with anatomical data, clinicians can better identify candidates for biventricular repair, proving that the "grey zone" is narrower than previously thought and improving outcomes for vulnerable neonates.
- Review Article
- Allergy
- Update on pediatric allergic rhinitis: narrative review based on guideline updates
- Jung Yeon Shim
- Clin Exp Pediatr. 2026;69(6):473-483. Published online May 28, 2026
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Intranasal corticosteroids remain the cornerstone treatment for moderate to severe allergic rhinitis. The 2024–2025 Allergic Rhinitis and its Impact on Asthma guideline update suggests that fixed intranasal antihistamine–intranasal corticosteroid combinations may provide greater symptom control in allergic rhinitis than either agent alone. A control-based patient-centered approach that incorporates real-world evidence is essential for optimizing treatment outcomes in children.
- Nutrition
- Dietary fiber in pediatric gastrointestinal health: a narrative review of evidence and challenges
- Rohit Das, Bipashna Thatal, Buddhiman Tamang
- Clin Exp Pediatr. 2026;69(6):456-472. Published online May 27, 2026
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Dietary fiber plays a critical role in pediatric gastrointestinal health by modulating gut microbiota, improving bowel function, and supporting immune development. Evidence consistently supports its benefit in functional constipation, while effects on abdominal pain, inflammatory bowel disease, and irritable bowel syndrome remain variable due to differences in fiber type, dosage, and study design. Clinically, fiber should be used as an adjunct therapy within individualized dietary and behavioral management strategies for children.
- Erratum: Authour correciton
- Author correction: Bifidobacterium animalis subsp. lactis BLa80 for preventing allergic, respiratory, and gastrointestinal diseases in young children in China: a randomized double-blind placebo-controlled trial
- Ke Chen, Xi Zhang, Kaihong Zeng, Jiayi Zhong, Shanshan Jin, Yang Nie, Ping Yang, Nianyang He, Haixia Chen, Yanmei Cao, Yunrong Fu, Ziji Fang, Wei Jiang, Changqi Lium
- Clin Exp Pediatr. 2026;69(5):455-455. Published online April 28, 2026
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- Original Article
- Neurology
- Classification of neurocognitive impairment in pediatric drug-resistant focal epilepsy by quantifying seizure-affected brain network abnormalities in clinical diffusion-weighted imaging connectome
- Jeong-Won Jeong, Min-Hee Lee, Yoon Ho Hwang, Michael Behen, Aimee Luat, Csaba Juhász, Eishi Asano
- Clin Exp Pediatr. 2026;69(5):443-454. Published online March 13, 2026
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Question: Does epilepsy affect neurocognitive functions in pediatric drug-resistant focal epilepsy?
Finding: Diffusion magnetic resonance imaging (MRI) connectome could identify new imaging markers for seizure-associated structural abnormalities. New markers reflect deviations of local efficiency in neurocognitive networks and provide outstanding discretionary capacity for neurocognitive impairments, achieving an accuracy range of 90%–98% in the independent test patients.
Meaning: Supplementary MRI-driven decisions could be performed for personalized interventions to mitigate long-term neurocognitive effects.
- Neonatology (Perinatology)
- Association between impaired renal function based on decline in serum creatinine level and brain injury in neonates with hypoxic-ischemic encephalopathy
- Mélaine Boget, William Rozalen, Jeanne Fayard, Mohamed Boucekine, Diane Gillot, Isabelle Grandvuillemin, Farid Boubred
- Clin Exp Pediatr. 2026;69(5):437-442. Published online April 27, 2026
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Question: The clinical relevance of impaired renal function (IRF), based on the rate of serum creatinine level decline during the week after birth, in neonates treated with therapeutic hypothermia for hypoxic-ischemic encephalopathy need further investigation.
Finding: In this study, neonates with IRF had 2-fold higher risk of early death or severe brain injury.
Meaning: IRF can be used as a marker of adverse neonatal outcomes.
- Nutrition
- Human milk macronutrient composition and intake in relation to preterm infant growth: a cohort study
- Eakkarin Mekangkul, Chonnikant Visuthranukul, Anongnart Sirisabya, Thaninee Chitsinchayakul, Santi Punnahitananda, Sirinuch Chomtho
- Clin Exp Pediatr. 2026;69(5):428-436. Published online April 22, 2026
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Question: Is macronutrient intake, particularly that from human milk, distinctly associated with the growth of preterm infants?
Finding: Total protein and fat intake derived from human milk and fortifiers showed distinct positive associations with weight gain velocity.
Meaning: Particular attention to protein and fat composition during individualized human milk fortification can optimize weight gain in preterm infants.
- Neurology
- Clinical application of whole exome and genome sequencing in pediatric neurodevelopmental disorders
- Keun Soo Lee, Seung Hwan Oh, Ja Young Lee, Go Hun Seo, Da Eun Roh, Ji Kyoung Park, Bo Lyun Lee
- Clin Exp Pediatr. 2026;69(5):417-427. Published online April 22, 2026
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Question: What is the diagnostic utility of whole exome sequencing (WES) and whole genome sequencing (WGS) in unexplained neurodevelopmental disorders (NDDs)?
Finding: WES and WGS achieved a combined diagnostic yield of 39.1% in children with NDDs. Novel variants accounted for over half the pathogenic findings, and trio-based or phenotype-driven testing improved the diagnostic rate.
Meaning: Comprehensive genomic sequencing integrated with clinical phenotyping enhances diagnostic yield among children with NDDs.
- Hematology
- Effects of induction-phase acute kidney injury and age at diagnosis on chronic kidney disease in pediatric acute lymphoblastic leukemia: a time-to-event cohort study
- Pongpak Phongphiew, Nuanpan Penboon, Kanhatai Chiengthong, Pornpimol Rianthavorn
- Clin Exp Pediatr. 2026;69(5):407-416. Published online March 5, 2026
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Question: In pediatric acute lymphoblastic leukemia (ALL), what are the incidence and causes of induction-phase acute kidney injury (AKI), and which factors predict chronic kidney disease (CKD)?
Finding: Induction AKI occurred in 43% of patients, while CKD developed in 1 of 8 patients. The 5-year CKD-free survival rate was 94%. Older age at diagnosis was a continuous independent determinant of CKD risk.
Meaning: Induction AKI is common and clinically relevant. Older children warrant closer kidney monitoring during and after therapy.
- Neonatology (Perinatology)
- Context-dependent features of transcriptomic landscapes in pregnant mother-neonate dyads of preeclampsia
- Yu-Chun Cheng, Yun-Ju Lai, Wei-Shiung Lian, Ching-Chang Tsai, Hsin-Hsin Cheng, Hong-Ren Yu, Mao-Meng Tiao, Jiunn-Ming Sheen, Ying-Lun Hsu, Feng-Sheng Wang, I-Chun Lin
- Clin Exp Pediatr. 2026;69(5):394-406. Published online February 19, 2026
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Question: What genes are commonly altered in mother-neonate dyads immediately after shared exposure to preeclampsia?
Finding: Perinatal/peripartum gene expression in preeclampsia is context-dependent, involves diverse signaling pathways, and is associated with some perinatal features.
Meaning: Our results may help build the fundamentals for managing future cardiometabolic risks in these populations. Further investigation of the long-term influence of these candidate genes on cardiometabolic phenotypes is required.
- Neurology
- Long-term outcome in children with infantile epileptic spasms syndrome: a multicenter retrospective study in Korea
- Sun Ah Choi, Minhye Kim, Hye Jin Kim, Woo Joong Kim, Byung Chan Lim, Ji Yeon Han, Hunmin Kim, Min-Jee Kim, Mi-Sun Yum, Jiwon Lee, Jeehun Lee, Hyewon Woo, Jon Soo Kim
- Clin Exp Pediatr. 2026;69(5):386-393. Published online February 19, 2026
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Question: How have epilepsy and cognitive outcomes of children with infantile epileptic spasms syndrome (IESS) evolved over the past 20 years?
Finding: Approximately 78% of children developed chronic epilepsy, and one-third progressed to drug-resistant epilepsy, while 90% of them exhibited intellectual disabilities.
Meaning: Given the poor outcomes associated with IESS, consensus guidelines tailored to Korean clinical practice are required to ensure timely treatment and improve outcomes.
- Editorial
- Neurology
- Limited improvement in outcomes of infantile epileptic spasms syndrome despite therapeutic advances
- Donghwa Yang
- Clin Exp Pediatr. 2026;69(5):384-385. Published online April 28, 2026
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· Despite advances in treatment, infantile epileptic spasms syndrome remains associated with poor long-term epilepsy and developmental outcomes.
· Improved seizure control alone may not be sufficient, underscoring the need for early diagnosis and etiology-driven management strategies.
- Review Article
- Gastroenterology
- Sarcopenia in pediatric gastroenterology and hepatology: an updated review
- Toshifumi Yodoshi
- Clin Exp Pediatr. 2026;69(5):366-383. Published online April 27, 2026
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Pediatric sarcopenia is common in chronic gastrointestinal and liver diseases, often hidden by normal body mass index or obesity, and predicts worse outcomes. Because growth and puberty alter body composition, assessment should use age- and sex-specific measures of muscle mass and, when feasible, function. Early multidisciplinary intervention—protein-adequate nutrition, resistance-based activity, and disease control—may improve prognosis.
- Correspondence and reply
- Nephrology (Genitourinary)
- Authors’ reply: a commentary on “Assessing kidney outcomes in childhood-onset lupus nephritis: role of National Institutes of Health-modified histological indices”
- Pornpimol Rianthavorn
- Clin Exp Pediatr. 2026;69(4):364-365. Published online March 6, 2026
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- Correspondence
- Nephrology (Genitourinary)
- A commentary on “Assessing kidney outcomes in childhood-onset lupus nephritis: role of National Institutes of Health-modified histological indices”
- Yanlan Ma, Yunyun Zhu
- Clin Exp Pediatr. 2026;69(4):362-363. Published online March 6, 2026
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- Original Article
- Cardiology
- Value of demographic factors in early identification of pediatric malignant vasovagal syncope in head-up tilt test
- Shuo Wang, Yuwen Wang, Hong Cai, Ping Liu, Fang Li, Chuan Wen, Liqun Liu, Runmei Zou, Cheng Wang
- Clin Exp Pediatr. 2026;69(4):353-361. Published online March 5, 2026
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Question: Can demographic factors identify pediatric malignant vasovagal syncope pre-head-up tilt test (HUTT)?
Finding: Age/body mass index are independent protectors; <12.9 years age cuts risk 20%/yr.
Meaning: Enables early risk stratification to optimize HUTT safety for children.
- Hematology
- Outcomes of hematopoietic stem cell transplantation for pediatric patients with transfusion-dependent thalassemia in Thailand
- Kleebsabai Sanpakit, Kamala Laohverapanich, Bunchoo Pongtanakul, Nattee Narkbunnam, Chayamon Takpradit, Usanarat Anurathapan, Samart Pakakasama, Supanun Lauhasurayotin, Kanhatai Chiengthong, Thirachit Chotsampancharoen, Pornpun Sripornsawan, Piya Rujkijyanont, Duantida Songdej, Nongnuch Sirachainan, Suradej Hongeng
- Clin Exp Pediatr. 2026;69(4):340-352. Published online March 13, 2026
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Question: Can hematopoietic stem cell transplantation (HSCT) cure pediatric transfusion-dependent thalassemia in Thailand? What influences its outcomes?
Finding: Among 266 HSCT procedures, 5-year overall survival and event-free survival rates were 91.3% and 81.0%, respectively. Outcomes were comparable between related and unrelated donors. Pre-HSCT ferritin >2,500 ng/mL, low CD34+ cell dose, and oral busulfan conditioning were associated with unfavorable survival. Longterm complications affected 22.7% of survivors.
Meaning: Optimizing pre-HSCT care, ensuring adequate grafting, and long-term surveillance are crucial.
- Neonatology (Perinatology)
- Hemodynamics and cerebral oxygenation in the neonatal transition: a prospective pilot study
- Daniel Pfurtscheller, Christoph Schlatzer, Nina Höller, Bernhard Schwaberger, Lukas P. Mileder, Nariae Baik-Schneditz, Magdalena Holter, Gerhard Pichler
- Clin Exp Pediatr. 2026;69(4):330-339. Published online January 13, 2026
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Question: How is arterial blood pressure related to cerebral oxygenation during the immediate postnatal transition in neonates?
Finding: Among preterm infants requiring respiratory support, cerebral oxygenation was associated with diastolic and mean arterial pressures, indicating passive pressure perfusion.
Meaning: Compromised preterm infants are vulnerable to impaired autoregulation with cerebral oxygenation fluctuations, highlighting the need for hemodynamic and cerebral monitoring plus routine monitoring of arterial oxygen saturation and heart rate.
- Cardiology
- Influence of atrial septal defect on mitral valve growth after repair of coarctation of the aorta or an interrupted aortic arch in infants
- Yi-Chia Wang, Heng-Wen Chou, Chi-Hsiang Huang, Hsing-Hao Huang, Yih-Sharng Chen, En-Ting Wu, Shyh-Jye Chen, Ming-Tai Lin, Shuenn-Nan Chiu, Shu-Chien Huang
- Clin Exp Pediatr. 2026;69(4):322-329. Published online January 13, 2026
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Question: Does atrial septal defect (ASD) physiology affect postrepair mitral valve growth in patients with coarctation of the aorta or an interrupted aortic arch?
Finding: Mitral valve growth occurred after biventricular repair but not single-ventricle palliation, particularly in patients with small valves and low ASD pressure gradients.
Meaning: The ASD pressure gradient determines mitral valve growth and should guide surgical strategies in patients with borderline hypoplastic left heart syndrome.
- Neonatology (Perinatology)
- Perinatal risk factors for hemodynamically significant patent ductus arteriosus in very low birth weight infants
- Jie Hee Jue, So Young Shin, Jae Hyun Park, Chun Soo Kim, Hee Joung Choi
- Clin Exp Pediatr. 2026;69(4):313-321. Published online December 22, 2025
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Question: What perinatal factors influence patent ductus arteriosus (PDA) in and improve outcomes of preterm infants?
Finding: Lower birth weight, frequent surfactant treatment, and maternal hypertension increased hemodynamically significant PDA risk in very low birth weight infants, whereas chorioamnionitis and premature rupture of membranes protected against it. A lower birth weight and incomplete antenatal steroid use increased the risk of surgical ligation, whereas small for gestational age reduced it.
Meaning: Recognizing these factors may enable early, targeted intervention and reduce the need for surgical management.
- Prolonged cerebral oxygenation surveillance with algorithm-based management: a neurocritical care bundle for extremely preterm infants
- Kai-Hsiang Hsu, Wei-Hung Wu, Shu-Yu Lin, Chih-Chen Chang, Mei-Yin Lai, I-Hsyuan Wu, Shih-Ming Chu, Ming-Chou Chiang, Reyin Lien
- Clin Exp Pediatr. 2026;69(4):304-312. Published online December 22, 2025
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Question: Is prolonged monitoring of regional cerebral oxygen saturation (rcSO2) and hemodynamic parameters a feasible approach? Can these measures predict the neurological outcomes in extremely preterm infants?
Finding: We used a neurocritical care bundle from birth to discharge or term-equivalent age. Infants with poor outcomes had significantly lower rcSO2 values.
Meaning: Understanding rcSO2 and hemodynamic parameters may help manage cerebral hypoxia and reduce neurological complications in extremely preterm infants.
- Editorial
- General Pediatrics
- Adiposity rebound in early childhood: understanding body mass index percentiles and monitoring on growth charts to be healthy
- Sochung Chung
- Clin Exp Pediatr. 2026;69(4):301-303. Published online April 1, 2026
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Height, weight, and body mass index percentiles should be tracked in routine childhood health checkups to address the age of adiposity rebound in early childhood. Comprehensive interventional lifestyle counselling in primary practice after growth and nutritional status assessments might be an early, effective strategy for preventing obesity and decreasing the double burden of disease in later life. Therefore, there is an urgent need for a cooperative and supportive health care system.
- Review Article
- Neonatology (Perinatology)
- Optimal postnatal corticosteroid regimens to prevent bronchopulmonary dysplasia with minimal adverse effects
- Ga Won Jeon
- Clin Exp Pediatr. 2026;69(4):293-300. Published online March 27, 2026
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Postnatal corticosteroids facilitate ventilator weaning and reduce the risk of bronchopulmonary dysplasia (BPD). Despite being commonly used in high-risk infants, administration guidelines have not been established. Early dexamethasone may cause neurodevelopmental harm, and the optimal dosing remains uncertain. Inhaled corticosteroids show inconclusive benefits, whereas intratracheal administration with surfactant appears promising. Thus, corticosteroids should be used cautiously in high-risk, ventilator-dependent infants with severe BPD, and further high-quality trials are needed.
- Moving toward meaningful shared decision-making in neonatal care: clinical practice and policy implications in Korea
- In Gyu Song, Trisha M. Prentice, Lynn Gillam
- Clin Exp Pediatr. 2026;69(4):282-292. Published online March 13, 2026
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Shared decision-making (SDM) offers an ethically grounded, relational approach to making difficult decisions in neonatal care. Its effective use depends on recognizing when its use is appropriate and enacted in clinical conversations. In Korea, while parents are often involved in decision-making, SDM is not yet consistently articulated or evaluated as a structured practice. Culturally grounded research, education, and institutional support are needed to strengthen family-centered neonatal care.
