Clinical and Experimental Pediatrics

Original Article

General Pediatrics

Global and regional burden of neonatal disorders (preterm birth, encephalopathy, jaundice, and sepsis), 1990–2021 and projections to 2050

Yuseon Kang, Jeongseon Oh, Dongjin Yeo, Jaeyu Park, Sooji Lee, Na Yun Kim, Jungmin Park, Seung Ha Hwang, Tae Hyeong Kim, Dong Keon Yon

Clin Exp Pediatr. 2026;69(2):171-181. Published online October 30, 2025

Web of Science 1 Crossref 1

This study provides the first comprehensive estimated global burden of neonatal disorders attributable to risk factors in 1990–2021 stratified by sex, cause, sociodemographic index (SDI), and region. We identified persistent disparities across SDI levels, with low birthweight and short gestation contributing most to the age-standardized disability-adjusted life year rate of neonatal disorders. These findings highlight the urgent need for targeted context-specific interventions to reduce infant mortality and improve neonatal health equity.

DOI: https://doi.org/10.3345/cep.2025.01480

Associations of routine breakfast and napping habits with early adiposity rebound by age 3 years: a population-based cohort study in Japan

Toshifumi Yodoshi

Clin Exp Pediatr. 2026;69(2):163-170. Published online October 22, 2025

In a population‑based cohort of 74,466 children, 25% experienced early adiposity rebound (AR) by age 3. Daily breakfast and routine napping at 1.5 years were independently associated with lower odds of AR, while obesity at 1.5 years was a strong predictor. These modifiable routines could help delay AR and enable early identification during routine child health checks.

DOI: https://doi.org/10.3345/cep.2025.01998

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(2):150-162. Published online October 30, 2025

Question: Can probiotic BLa80 bring long-term benefits to the health of young children?
Finding: This trial demonstrated that the daily administration of s BLa80 at 5×109 colony-forming units for 3 months in children can reduce the risk of eczema, upper respiratory tract infections, and acute tracheitis/bronchitis as well as beneficially improve the gut microbiome without any adverse effect.
Meaning: Bla80 can bring definite health benefits to young children.

DOI: https://doi.org/10.3345/cep.2025.01256

Critical Care Medicine

Telemedicine outcome of mechanically ventilated children in Brazilian pediatric intensive care units

Aristóteles de Almeida Pires, Luciano Remião Guerra, João Ronaldo Mafalda Krauzer, Luciane Gomes da Cunha, Mariana Motta Dias da Silva, Vanessa Cristina Jacovas, Hilda Maria Rodrigues Moleda Constant, Taís de Campos Moreira, Paulo Márcio Pitrez, Felipe Cezar Cabral

Clin Exp Pediatr. 2026;69(2):140-149. Published online October 23, 2025

Question: Telemedicine interventions in Brazilian public pediatric intensive care units effectively address the challenges related to specialized care provision in resource-limited settings.
Finding: The implementation of telemedicine significantly reduced overall mortality rates among mechanically ventilated children (from 20.7% to 10.4%) and increased ventilator-free days from 3 (interquartile range, 0–7) to 4 (interquartile range, 2–8) days.
Meaning: These findings support telemedicine as a viable strategy for enhancing pediatric critical care in public health systems, particularly by improving patient outcomes.

DOI: https://doi.org/10.3345/cep.2025.01270

Nephrology (Genitourinary)

Assessing kidney outcomes in childhood-onset lupus nephritis: role of National Institutes of Health-modified histological indices

Nuanpan Penboon, Pornpimol Rianthavorn

Clin Exp Pediatr. 2026;69(2):130-139. Published online October 23, 2025

Question: In children with proliferative lupus nephritis, do National Institutes of Health-modified indices and treatment choices predict long-term kidney function?
Finding: Higher chronicity index scores, especially tubular atrophy and interstitial fibrosis, predicted kidney impairment. Additionally, the use of mycophenolate mofetil (MMF) for maintenance therapy was associated with a lower risk of kidney function decline.
Meaning: The early recognition of chronic lesions and MMF-based maintenance therapy may improve kidney outcomes in childhood-onset lupus nephritis.

DOI: https://doi.org/10.3345/cep.2025.01277

Gastroenterology

Progression from acute to chronic pancreatitis in children: a systematic review and meta-analysis

Endre Botond Gagyi, Mahmoud Obeidat, Edina Tari, Szilárd Váncsa, Dániel Sándor Veres, Peter Banovcin, Péter Jenő Hegyi, Péter Hegyi, Bálint Erőss

Clin Exp Pediatr. 2026;69(2):117-129. Published online December 4, 2025

Approximately 1 in 5 children with acute pancreatitis develops recurrent attacks, and over one-third of such cases progress to chronic pancreatitis. Progression is closely linked to genetic mutations, particularly PRSS1, and anatomical abnormalities, whereas demographic and routine clinical factors lack predictive value. These results support early genetic and anatomical assessments, enabling targeted follow-ups and timely interventions in highrisk pediatric patients.

DOI: https://doi.org/10.3345/cep.2025.01879

Other

Comparing ethyl chloride and 10% lignocaine spray for pediatric intravenous cannulation pain relief

Susmitha Vellanki, Malavika Kulkarni, H.D. Arun Kumar, Deepali Shetty, Nikhil Karthik B, Mathew Tom

Clin Exp Pediatr. 2026;69(1):65-72. Published online November 21, 2025

Background: Intravenous cannulation (IVC) is a routine yet distressing procedure in pediatric patients, often provoking significant anxiety and procedural pain. Although eutectic mixtures such as eutectic mixture of local anesthetic cream are widely used, their delayed onset limits their applicability in time-sensitive settings. Ethyl chloride vapocoolant spray and 10% lignocaine spray have been proposed as rapid-onset alternatives, yet direct comparative...

DOI: https://doi.org/10.3345/cep.2025.00010

Critical Care Medicine

High-dose methylprednisolone and tocilizumab improve survival of patients with high-risk pediatric acute necrotizing encephalopathy

Chaonan Fan, Fei Li, Kechun Li, Zheng Li, Yiyang Mao, Lijuan Wang, Gang Liu, Yingchao Liu, Quan Wang, Suyun Qian

Clin Exp Pediatr. 2026;69(1):56-64. Published online October 22, 2025

Web of Science 1 Crossref 1

Question: Which immunomodulatory strategies can reduce mortality in children with acute necrotizing encephalopathy (ANE)?
Finding: High-dose methylprednisolone (30 mg/kg/day) significantly improved the survival of high-risk patients, particularly when combined with tocilizumab.
Meaning: These findings support the use of a severity-based immunotherapy approach to optimize the outcomes of pediatric ANE.

DOI: https://doi.org/10.3345/cep.2025.01431

Rheumatology

Recurrent immunoglobulin A vasculitis in children and adolescents: prevalence and associated risk factors

Nootsara Atchariyaphuk, Maynart Sukharomana, Thanaporn Chaiyapak, Sirirat Charuvanij

Clin Exp Pediatr. 2026;69(1):46-55. Published online October 22, 2025

Question: What can predict immunoglobulin A vasculitis (IgAV) recurrence, and when does it occur? How do childhood- and adolescent-onset IgAV compare?
Finding: The IgAV recurrence rate was 35.6%. It usually occurred within 12 months and was associated with corticosteroids treatment.
Meaning: Childhood-onset IgAV more commonly featured gastrointestinal and musculoskeletal manifestations and required hospitalization. Adolescent-onset IgAV more commonly featured renal involvement. Vigilant monitoring for recurrence is necessary, particularly with corticosteroids treatment.

DOI: https://doi.org/10.3345/cep.2025.01158

Allergy

Maternal sleep disorders during pregnancy and subsequent risk of allergic diseases in Japanese children: the TMM BirThree Cohort Study

Ami Uematsu, Masatsugu Orui, Mami Ishikuro, Keiko Murakami, Aoi Noda, Genki Shinoda, Taku Obara, Shinichi Kuriyama

Clin Exp Pediatr. 2026;69(1):36-45. Published online October 22, 2025

Web of Science 1 Crossref 1

Question: Associations have been made between maternal sleep disorders during pregnancy and allergic diseases including bronchial asthma, atopic dermatitis, food allergy, and allergic conjunctivitis/rhinitis/hay fever in their children.
Finding: In the crude model, sleep disorders during pregnancy were associated with all examined allergic diseases in children. After adjustment, significant associations remained for atopic dermatitis and allergic conjunctivitis/rhinitis/hay fever.
Meaning: The study highlights associations between maternal sleep and child allergic diseases.

DOI: https://doi.org/10.3345/cep.2025.01165

Gastroenterology

Gut microbiota and metabolomic alterations in newborns of mothers with gestational diabetes mellitus

Wan-Hsin Su, Yi-Wei Wang, Chien-Chang Chen, Ming-Wei Lai, Hsun-Chin Chao, Ming-Chou Chiang, Ren-Huei Fu, Pai-Jui Yeh

Clin Exp Pediatr. 2026;69(1):26-35. Published online October 22, 2025

Question: Does maternal gestational diabetes mellitus (GDM) affect newborn gut microbiota and metabolomic profiles?
Finding: Neonates born to mothers with diet-controlled GDM exhibited reduced gut microbiota α-diversity, altered β-diversity, and metabolic shifts, including changes in fumarate and succinate levels, with peroxisome proliferator-activated receptor and adipocytokine signaling pathway activation.
Meaning: Maternal GDM affects early microbial colonization and metabolism in newborns and may have long-term health implications.

DOI: https://doi.org/10.3345/cep.2025.01074

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

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 2 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 2

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

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 3

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

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Original article