Clinical and Experimental Pediatrics

Letter to the Editor

Endocrinology

Accuracy of predicted adult height using the Greulich-Pyle method and artificial intelligence medical device

Dongho Cho, Yun Sun Choi, Hayun Oh, Young min Ahn, Ji-Young Seo

Clin Exp Pediatr. 2023;66(3):145-147. Published online January 25, 2023

DOI: https://doi.org/10.3345/cep.2022.01116

Clinical Note

Genetics and Metabolism

Biallelic POLR3A variants cause Wiedemann-Rautenstrauch syndrome with atypical brain involvement

Byungseung Moon, Minhye Kim, Hye Jin Kim, Jae So Cho, Hey Joon Son, Byung Chan Lim, Ki Joong Kim, Jong Hee Chae, Soo Yeon Kim

Clin Exp Pediatr. 2023;66(3):142-144. Published online December 30, 2022

DOI: https://doi.org/10.3345/cep.2022.01144

Original Article

Infection

Clinical characteristics of pediatric patients infected with SARS-CoV-2 versus common human coronaviruses: a national multicenter study

In Suk Sol, Eun Lee, Hyeon-Jong Yang, Yong Ju Lee, Hye Yung Yum, Mi-Hee Lee, Mi Ae Chu, Hui Jeong Moon, Hyo-Bin Kim, Ju Hee Seo, Jung Yeon Shim, Ji Young Ahn, Yoon Young Jang, Hai Lee Chung, Eun Hee Chung, Kyunghoon Kim, Bong-Seong Kim, Cheol Hong Kim, Yang Park, Meeyong Shin, Kyung Suk Lee, Man Yong Han, Soo-Jong Hong, Eun Kyeong Kang, Chang Keun Kim; on behalf of The Pneumonia & Respiratory Disease Study Group of Korean Academy of Pediatric Allergy and Respiratory Disease

Clin Exp Pediatr. 2023;66(3):134-141. Published online December 22, 2022

Question: The clinical differences between severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) and human coronaviruses (HCoV) in children remain unknown.
Finding: This study compared the clinical findings of children infected with SARS-CoV-2 versus HCoV. Its findings suggest that children and adolescents with SARS-CoV-2 have a milder clinical course than those with HCoV.
Meaning: The clinical course of children and adolescents with SARS-CoV-2 should be closely monitored during the coronavirus disease 2019 pandemic.

DOI: https://doi.org/10.3345/cep.2022.00703

Hematology

Changes and correlations of T-cell coinhibitory molecule programmed death-1 and interferon-γ in pediatric immune thrombocytopenia

Fady Mohamed El-Gendy, Amira M.F. Shehata, Esam Awad Abd El-Kawy, Mahmoud Ahmed El-Hawy

Clin Exp Pediatr. 2023;66(3):127-133. Published online February 24, 2023

Question: What are the PD-1⁺ CD4⁺ T cells percentages and serum interferon gamma (IFN-γ) levels of pediatric patients with immune thrombocytopenia (ITP)?
Finding: Compared with healthy controls, the PD-1⁺ CD4⁺ T cells percentages and IFN-γ levels were significantly higher in ITP patients before and 1 month after therapy.
Meaning: Our findings suggest that PD-1⁺ CD4⁺ T cells and IFN-γ are involved in the pathophysiological process of ITP.

DOI: https://doi.org/10.3345/cep.2022.00920

Editorial

Nephrology (Genitourinary)

Optimal hemodialysis treatment for pediatric kidney failure patients

Yo Han Ahn

Clin Exp Pediatr. 2023;66(3):125-126. Published online February 15, 2023

· Although the basic concept of hemodialysis (HD) is similar in adults and children, specific factors must be considered in the latter, including the small dialyzer and circuit, difficult vascular access, and frequent complications.
· HD-associated complications include catheter-related problems, hemodynamic instability, and neurodevelopmental and cognitive dysfunction.
· Pediatric HD is challenging, and steady efforts are needed to perform it safely and reduce its complications, thereby improving clinical outcomes.

DOI: https://doi.org/10.3345/cep.2022.01431

Review Article

Gastroenterology

Liver fibrosis in children: a comprehensive review of mechanisms, diagnosis, and therapy

Elif Ozdogan, Cigdem Arikan

Clin Exp Pediatr. 2023;66(3):110-124. Published online December 19, 2022

· Chronic liver diseases in children are heterogenous but converge in the common pathway of fibrosis.
· Much of the literature on mechanisms of fibrogenesis focus on adults but pediatric physiology has documented differences.
· Understanding of these distinctions are necessary to define, treat, and prevent fibrosis.
· Current management of liver fibrosis relies heavily on liver biopsy. Multiple tools have shown high diagnostic performance in pediatric and adult populations. Large, multicenter studies are needed for validation.

DOI: https://doi.org/10.3345/cep.2022.00367

Critical Care Medicine

Ferritin in pediatric critical illness: a scoping review

Ivy Cerelia Valerie, Anak Agung Sagung Mirah Prabandari, Dyah Kanya Wati

Clin Exp Pediatr. 2023;66(3):98-109. Published online September 16, 2022

The number of studies on ferritin predictive ability in pediatric critical illness has grown exponentially over the past 2 decades. However, among the 66 of 1,580 studies analyzed here, summary statistics for overall and condition-specific studies were only reported in 45.4% and 71.2%, respectively. In contrast, ferritin as a categorical variable with a preset threshold was a significant predictor in 84.6% of studies.

DOI: https://doi.org/10.3345/cep.2022.00654

Neurology

Pediatric syncope: pearls and pitfalls in history taking

Jung Sook Yeom, Hyang-Ok Woo

Clin Exp Pediatr. 2023;66(3):88-97. Published online February 15, 2023

An accurate diagnosis depends on correct history taking and its interpretation. An in-depth understanding of the symptoms of syncope in connection with its pathophysiology can lead to avoiding critical pitfalls in the diagnostic process of history taking.

DOI: https://doi.org/10.3345/cep.2022.00451

Letter to the Editor

Critical Care Medicine

Role of serum bilirubin-to-albumin ratio as a prognostic index in critically ill children

You Min Kang, Ga Eun Kim, Mireu Park, Jong Deok Kim, Min Jung Kim, Yoon Hee Kim, Kyung Won Kim, Myung Hyun Son, Soo Yeon Kim

Clin Exp Pediatr. 2023;66(2):85-87. Published online December 5, 2022

DOI: https://doi.org/10.3345/cep.2022.01207

Clinical Note

Rheumatology

Haploinsufficiency A20 misdiagnosed as PFAPA (periodic fever, aphthous stomatitis, pharyngitis, and cervical adenitis) syndrome with Kikuchi disease

Kyo Jin Jo, Su Eun Park, Chong Kun Cheon, Seung Hwan Oh, Seong Heon Kim

Clin Exp Pediatr. 2023;66(2):82-84. Published online June 22, 2022

Cited By 1

DOI: https://doi.org/10.3345/cep.2022.00500

Original Article

Gastroenterology

Association between maternal weight gain during pregnancy and child’s body mass index at preschool age

Jeewon Shin, Yoowon Kwon, Ju Hee Kim, Su Jin Jeong

Clin Exp Pediatr. 2023;66(2):76-81. Published online November 30, 2022

Question: What are the risk factors of newborn birth weight? Does gestational weight gain and prepregnancy body mass index affect childhood weight?
Finding: Excess maternal weight gain increases the risk of overweight/obesity, newborn birth weight, and child body mass index at 4–6 years.
Meaning: Maternal weight control before and during pregnancy should be well controlled.

DOI: https://doi.org/10.3345/cep.2022.01158

Neurobehavior

Association between previous abortion history and risk of autism spectrum disorders among offspring: a meta-analysis

Ensiyeh Jenabi, Erfan Ayubi, Saeid Bashirian, Mahdieh Seyedi, Mohammad Rezaei

Clin Exp Pediatr. 2023;66(2):70-75. Published online August 17, 2022

Cited By 1

Question: This study aimed to determine whether there is an association between previous abortion history and the risk of autism spectrum disorders (ASDs) among children.
Finding: We found that the risk of ASD associated with previous abortion history had an odds ratio of 1.64 (95% confidence interval, 1.28–2.0; I²=61.7%).
Meaning: These findings suggest a positive and significant association between history of previous abortion and risk of ASD in children.

DOI: https://doi.org/10.3345/cep.2022.00108

Editorial

Neurology

Lumbar puncture or not: when does febrile seizure require a neurodiagnostic evaluation?

Seung Soo Kim

Clin Exp Pediatr. 2023;66(2):68-69. Published online December 9, 2022

· A neurodiagnostic evaluation (lumbar puncture, blood tests, electroencephalography, and neuroimaging) is not indicated in most patients with simple febrile seizures.
· A lumbar puncture is indicated when a central nervous system infection is suspected in any patient with febrile seizures.
· Blood tests (glucose, electrolytes, and complete blood count) are indicated in patients with persistent seizure after benzodiazepine treatment, prolonged loss of consciousness, poor general condition, or signs of dehydration.

DOI: https://doi.org/10.3345/cep.2022.01081

Emergency Medicine

Current diagnosis and image-guided reduction for intussusception in children: teamwork approach

Ji-Hyun Seo

Clin Exp Pediatr. 2023;66(2):66-67. Published online September 1, 2022

· The successful and safe enema reduction of intussusception depends primarily on the experience and preference of the radiologists and the availability of resources.
· The establishment of a standardized manual or protocol for reduction and pre-reduction treatment of intussusception, along with the collaboration of pediatricians, radiologists, and surgeons, is expected to improve the treatment success rate.

DOI: https://doi.org/10.3345/cep.2022.00927

Review Article

Nutrition

Total energy expenditure measured by doubly labeled water method in children and adolescents: a systematic review

Nahyun Kim, Jonghoon Park

Clin Exp Pediatr. 2023;66(2):54-65. Published online October 17, 2022

This systematic review summarizes convincing evidence that total energy expenditure (TEE) measured using the doubly labeled water technique increased with age from 1 to 18 years, while fat-free mass (FFM) increased with growth. TEE and in normal-weight participants, while physical activity level did not differ from that of normal-weight participants.

DOI: https://doi.org/10.3345/cep.2022.00472

Infection

Pathogenetic and etiologic considerations of febrile seizures

Ji Yoon Han, Seung Beom Han

Clin Exp Pediatr. 2023;66(2):46-53. Published online January 13, 2023

· Inflammatory responses accompanying fever increase neuronal excitability in the central nervous system, which in turn provokes seizures.
· Fever in children with febrile seizures is usually caused by common respiratory viruses, the distributions of which match those of seasonal community-acquired respiratory tract infections.
· Several genetic variations in ion channels seem associated with neuronal hyperexcitability in children with febrile seizures.

DOI: https://doi.org/10.3345/cep.2021.01039

Original Article

Neurology

Long-term neurological cognitive, behavioral, functional, and quality of life outcomes after fetal myelomeningocele closure: a systematic review

Andre Marolop Pangihutan Siahaan, Martin Susanto, Sarma Nursani Lumbanraja, Dwi Herawati Ritonga

Clin Exp Pediatr. 2023;66(1):38-45. Published online November 30, 2022

· Fetal myelomeningocele closure significantly improved long-term neurological cognitive, behavioral, functional, and quality of life outcomes, most likely by reducing hydrocephalus rates.
· However, fetal myelomeningocele closure is associated with a significant risk of pregnancy complications, especially premature rupture of membranes and preterm delivery.

DOI: https://doi.org/10.3345/cep.2022.01102

Neonatology (Perinatology)

A thickened formula reduces feeding-associated oxygen desaturation and bradycardia in preterm infants

Gayoung Lee, Juyoung Lee, Ga Won Jeon, Yong Hoon Jun

Clin Exp Pediatr. 2023;66(1):32-37. Published online December 15, 2022

Question: Is a commercial thickened formula able to alleviate oral feeding-associated desaturation and bradycardia in preterm infants?
Finding: Thickened formula feeding significantly reduced oral feeding-associated desaturation and bradycardia in preterm infants.
Meaning: Thickened formula feeding stabilizes oxygen saturation and heart rate during oral feeding among preterm infants with feeding difficulties.

DOI: https://doi.org/10.3345/cep.2022.00780

Nutrition

Not breastfeeding and risk of autism spectrum disorders among children: a meta-analysis

Ensiyeh Jenabi, Saeid Bashirian, Amir Mohammad Salehi, Salman Khazaei

Clin Exp Pediatr. 2023;66(1):28-31. Published online July 19, 2022

This study aimed to determine whether there is an association between not breastfeeding (versus breastfeeding) and the risk of autism spectrum disorders (ASD) among children. We found that the risk of ASD associated with not breastfeeding had an odds ratio of 1.81 (95% confidence interval, 1.35–2.27; I²=0 %). These findings suggest the importance of breastfeeding in decreasing the risk of ASD among children.

DOI: https://doi.org/10.3345/cep.2021.01872

Editorial

Pulmonology

Wheezing in infants and preschoolers: phenotypes and treatment options

Jung Yeon Shim

Clin Exp Pediatr. 2023;66(1):26-27. Published online December 6, 2022

· Knowing who will develop into asthma or who will not is important to impose proper treatment and early intervention in a child with the first episode of wheezing.
· Phenotypes of severe bronchiolitis in less than 2-year-old children with first episode of wheezing were suggested for different treatment options
· RV-induced and/or atopy-associated severe wheezing in preschool children may benefit from early intervention of asthma treatment.

DOI: https://doi.org/10.3345/cep.2022.00619

Neonatology (Perinatology)

Does cord blood cortisol have a mediating effect on maternal prepregnancy body mass index and birth weight?

Gyu Hong Shim

Clin Exp Pediatr. 2023;66(1):24-25. Published online November 30, 2022

· A high prepregnancy body mass index (pre-BMI) is associated with large for gestational age (LGA) and macrosomia, whereas a low pre-BMI is associated with small for gestational age (SGA) and low birth weight (LBW).
· The identification of the role of the hypothalamus-pituitary-adrenal axis in the effect of pre-BMI and maternal gestational weight gain on birth weight could reduce the frequency of LGA, macrosomia, SGA, or LBW through maternal diet optimization.

DOI: https://doi.org/10.3345/cep.2022.00955

Pulmonology

Community-acquired pneumonia in Korean children: time to read between the lines

Dong In Suh

Clin Exp Pediatr. 2023;66(1):22-23. Published online November 10, 2022

· Various studies have reported the etiology of community-acquired pneumonia (CAP) in Korean children
· Factors other than etiology are equally important to a compre hensive understanding of CAP
· Knowledge from archived reports is no longer directly applicable to the current CAP and requires careful modification

DOI: https://doi.org/10.3345/cep.2022.00941

Review Article

Gastroenterology

Current diagnosis and image-guided reduction for intussusception in children

Jisun Hwang, Hee Mang Yoon, Pyeong Hwa Kim, Ah Young Jung, Jin Seong Lee, Young Ah Cho

Clin Exp Pediatr. 2023;66(1):12-21. Published online July 4, 2022

· Intussusception, the most common cause of small bowel obstruction in young children, has an overall incidence in Korea of 28.3 cases per 100,000 person-years.
· Its cause is idiopathic inmost cases, although viral or bacterial gastroenteritis has beenpostulated as a cause. Approximately 4% of children have pathological lead points for intussusception, and Meckel’s diverticulum is the most common cause.
· Intussusception in preterm infants is extremely rare. Older children (>5 years of age) are at increased risk of pathological lead points.

DOI: https://doi.org/10.3345/cep.2021.01816

Cardiology

Research trends on causes of Kawasaki disease in the COVID-19 era: focus on viral infections

Young Hwan Lee

Clin Exp Pediatr. 2023;66(1):1-11. Published online June 22, 2022

· The etiology of Kawasaki disease (KD) is unclear, but its clinical, epidemiological, and pathophysiological characteristics are strongly associated with infectious diseases.
· In the coronavirus disease 2019 pandemic era, viruses are attracting the most attention. Sudden acute respiratory syndrome coronavirus 2 infection causes various hyperinflammation in children that require differentiation from KD.
· Immune responses in patients with KD may be induced by host cell damage. To effectively prevent and treat KD, the genetic background and immune responses of KD patients and triggering pathogens require identification.

DOI: https://doi.org/10.3345/cep.2022.00150

Clinical Note

Endocrinology

Graves’ disease: an uncommon cause of late sequelae following DRESS (drug reaction with eosinophilia and systemic symptoms)

Therdpong Tempark, Amatanun Tangthanapalakul, Tawatchai Deekajorndech, Susheera Chatproedprai, Vichit Supornsilchai, Siriwan Wananukul

Clin Exp Pediatr. 2022;65(12):602-604. Published online June 22, 2022

Cited By 1

DOI: https://doi.org/10.3345/cep.2022.00381

Original Article

Pulmonology

Predictors of high-flow nasal cannula failure in pediatric patients with acute respiratory distress

Kantara Saelim, Busawan Thirapaleka, Kanokpan Ruangnapa, Pharsai Prasertsan, Wanaporn Anuntaseree

Clin Exp Pediatr. 2022;65(12):595-601. Published online November 1, 2022

SpO₂/FiO₂ ratio ≤166, pediatric respiratory rate-oxygenation index <132, and clinical respiratory score ≥6 at 12 hours after high-flow nasal cannula (HFNC) initiation were useful bedside predictors for HFNC failure in pediatric patients.

DOI: https://doi.org/10.3345/cep.2022.00241

Gastroenterology

Ability of polymicrobial probiotic and mono-strain probiotic to reduce functional abdominal pain in children: a randomized clinical trial

Seyed Sajad Jafari, Seyed Mojtaba Hashemi, Bahman Sadeghi, Amir Almasi-Hashiani

Clin Exp Pediatr. 2022;65(12):589-594. Published online October 31, 2022

· This study compared the ability of 2 probiotics to reduce and improve functional abdominal pain (FAP) in children.
· In the polymicrobial probiotic (PMP) group, 10.34% of children reported no pain; in the mono-strain probiotic (MSP) group, all patients reported low-degree pain. The mean pain score decreased significantly over time in both groups.
· The use of both PMP and MSP is recommended to reduce pain in patients with FAP.

DOI: https://doi.org/10.3345/cep.2022.00339

Editorial

Allergy

Clinical considerations and practical issues of allergic diseases in COVID-19 era

Sungsu Jung

Clin Exp Pediatr. 2022;65(12):587-588. Published online November 29, 2022

The risk of sudden acute respiratory syndrome coronavirus 2 infection and severe coronavirus disease 2019 (COVID-19) outcomes is not elevated in patients with the type 2 phenotype and well-controlled asthma. Inhaled corticosteroids, intranasal corticosteroids, and topical steroids can be safely used in COVID-19 patients. Biologics can be safely used by patients with allergic diseases without concern about antibody responses.

DOI: https://doi.org/10.3345/cep.2022.01123

Gastroenterology

Ability of probiotics to reduce functional abdominal pain in children

Ji Sook Park

Clin Exp Pediatr. 2022;65(12):585-586. Published online October 6, 2022

· The ability of probiotics to relieve pain caused by functional abdominal pain disorders (FAPD) in children is unclear.
· Lactobacillus reuteri may effectively reduce pain caused by childhood FAPD.
· Since the routine use of probiotics cannot be recommended due to a lack of clinical evidence, research into probiotic mixtures or symbiotics remains necessary.

DOI: https://doi.org/10.3345/cep.2022.00913

Review Article

Allergy

Diagnosis and management of asthma in infants and preschoolers

Hai Lee Chung

Clin Exp Pediatr. 2022;65(12):574-584. Published online April 19, 2022

Cited By 2

· Asthma in infants and preschoolers involves heterogeneous phenotypes.
· Asthma diagnosis is based on symptom patterns, therapeutic responses, and the presence of risk factors with careful consideration of differential diagnosis.
· Daily inhaled corticosteroid therapy remains the most effective strategy for managing persistent asthma symptoms irrespective of phenotype.
· Future research, including genetic and molecular studies, is needed to develop a clear definition of asthma and personalized therapeutic approaches.

DOI: https://doi.org/10.3345/cep.2021.01746

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