- Review Article
- Endocrinology
- Effect of lifestyle interventions on pediatric obesity: a lifestyle medicine systematic review
- Jung Eun Choi, Hee Jeoung Lim, Kyung Hee Kim, Hae Soon Kim
- Clin Exp Pediatr. 2026;69(9):686-693. Published online August 27, 2026
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Lifestyle interventions effectively improve the anthropometric and cardiometabolic outcomes of children and adolescents with overweight or obesity. Multicomponent approaches integrating diet, physical activity, and behavioral strategies demonstrate the most consistent and comprehensive benefits. These findings strongly support the application of lifestyle medicine principles in pediatric obesity management. Long-term integrated interventions addressing multiple health behaviors are needed to ensure sustainable improvements.
- Emergency Medicine
- Reconciling conflicting evidence on stress ulcer prophylaxis in critically ill children: a systematic review and meta-analysis
- Hiroyuki Oikawa, Shotaro Nozaki, Munehiro Furuichi
- Clin Exp Pediatr. 2026;69(9):694-703. Published online August 24, 2026
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By appraising all nonrandomized studies using the ROBINS-I V2 (Risk Of Bias In Non-randomized Studies of Interventions, version 2) and finding them at critical risk of confounding, we restricted the synthesis to randomized trials. Stress ulcer prophylaxis (SUP) showed no demonstrated benefit; the previously reported mortality signal was not reproduced, and an exploratory signal of increased central line-associated bloodstream infection could not be excluded. With very low overall certainty, current evidence is insufficient to support routine SUP.
- Editorial
- Endocrinology
- A commentary on “Rising incidence of central precocious puberty in Thailand: a nationwide population-based study before, during, and after the COVID-19 pandemic (2018–2024)”
- Won Kyoung Cho
- Clin Exp Pediatr. 2026;69(9):704-705. Published online August 27, 2026
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Nationwide Thai data showed that central precocious puberty (CPP) incidence rose sharply during the COVID-19 pandemic and plateaued, whereas premature thelarche (PT) continued to increase postpandemic, particularly among girls aged 7-8 years. Because progression from PT to CPP cannot always be predicted at presentation, longitudinal follow up is preferable to reassurance after a single visit. Childhood obesity may further complicate diagnosis by blunting gonadotropin responses, warranting cautious interpretation of stimulation testing.
- Original Article
- Cardiology
- Red cell distribution width and reticulocyte hemoglobin content as predictors of iron depletion in children with cyanotic congenital heart disease
- Hanyudh Prichayudh, Kanhatai Chiengthong, Khwaunrat Whaidee, Navaporn Phiphattanatikanunt, Vidhavas La-orkhun, Pornthep Lertsapcharoen
- Clin Exp Pediatr. 2026;69(9):706-712. Published online July 29, 2026
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Question: Are red cell distribution width (RDW) and reticulocyte hemoglobin content (CHr) reliable alternative markers for detecting iron depletion in children with cyanotic congenital heart disease, whose status is often masked by compensatory polycythemia?
Finding: Multivariate analysis demonstrated that RDW (≥18.8%) and CHr (<28 pg) are strong independent predictors of iron depletion in this vulnerable population.
Meaning: Combined use of these accessible markers facilitates earlier diagnosis and improves clinical management in resource-limited healthcare facilities.
- Oncology
- Pediatric patients with cancer exhibit increased neutrophil extracellular traps and reduced active deoxyribonuclease I: diagnostic, prognostic, and therapeutic opportunities
- Nuria Benavent, Julia Oto, Patricia Verger, Alejandro Herreros-Pomares, Raquel Herranz, Bienvenida Argilés, Julia Balaguer, Antonio Juan-Ribelles, Santiago Bonanad, Pilar Medina, Adela Cañete
- Clin Exp Pediatr. 2026;69(9):713-725. Published online August 19, 2026
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· Circulating neutrophil extracellular trap (NET) markers are increased in pediatric cancer and correlate with disease risk and outcomes.
· Cell-free DNA and calprotectin levels show diagnostic and prognostic value, whereas impaired deoxyribonuclease I activity identifies a targetable mechanism.
· NEPs are promising biomarkers and therapeutic targets for high-risk pediatric tumors.
- Basic Research
- Longitudinal changes in serum soluble C5b-9 levels following immunomodulatory therapy for multisystem inflammatory syndrome in children
- Amrita Pattanaik, Prasad Varamballi, Srilatha Marate, Sushma Bhandarkar B., Shrikiran Aroor, Somashekar A.R., Suchetha S. Rao, Chiranjay Mukhopadhyay
- Clin Exp Pediatr. 2026;69(9):726-732. Published online August 19, 2026
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Question: Do serum soluble C5b-9 (sC5b-9) levels change following immunomodulatory therapy in children with multisystem inflammatory syndrome in children (MIS- C)?
Finding: In this longitudinal multicentric study of 100 children with MIS-C, serum sC5b-9 concentrations significantly decreased following treatment, although some patients showed persistently elevated levels at discharge.
Meaning: Serial sC5b-9 measurements may indicate treatment-associated immune activity and recovery in MIS-C.
- Endocrinology
- Rising incidence of central precocious puberty in Thailand: a nationwide population-based study before, during, and after the COVID-19 pandemic (2018–2024)
- Pattara Wiromrat, Preamrudee Poomthavorn, Ratikorn Chaisiwamongkol, Chaiyawat Suppasilp, Ouyporn Panamonta, Ratchaneewan Sinitkul
- Clin Exp Pediatr. 2026;69(9):733-742. Published online August 19, 2026
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Question: Did the incidence of central precocious puberty (CPP) and premature thelarche (PT) among Thai children change during 2018–2024?
Finding: CPP incidence in girls more than doubled during the COVID-19 pandemic and remained elevated thereafter, primarily at age 8 to <9 years. PT incidence increased progressively, particularly in girls aged 7 to <8 years.
Meaning: In peripubertal age groups, CPP and PT incidence increases may reflect pandemic-related factors, obesity, awareness, or earlier pubertal onset.
- Clinical Note
- Neurology
- Anti-GD1b-positive sensory ataxic Guillain-Barré syndrome with bulbar involvement and Bickerstaff brainstem encephalitis-like features in an adolescent: a case report
- Hamza Reaz Aziz, Kirsh Kumar, Nabiha Naveed, Saira Awan
- Clin Exp Pediatr. 2026;69(9):743-747. Published online August 27, 2026
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- Nephrology (Genitourinary)
- B4GALT1-related congenital disorder of glycosylation mimicking Ehlers-Danlos syndrome: a child with multisystem involvement and nephrotic syndrome
- Marifat Ganieva, Muqaddas Boltaboeva, Umida Ganiyeva, Oksana Efimenko, Abdulhamid Haydarov, Sherzod Toshboev
- Clin Exp Pediatr. 2026;69(9):748-750. Published online July 20, 2026
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- Letter to the Editor
- Pulmonology
- Telomere biology disorders in childhood interstitial lung disease: from genetic diagnosis to bedside suspicion – A commentary on “Telomere biology disorders associated with childhood interstitial lung disease”
- Weerapong Lilitwat
- Clin Exp Pediatr. 2026;69(9):751-752. Published online August 19, 2026
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