Clinical and Experimental Pediatrics

Review Article

General Pediatrics

Systematic review of influence of ethnicity on efficacy and safety of pharmacotherapy for childhood and adolescent obesity (85 times)

Surendra Gupta, Purushottam Lal, Abhishek Gupta, Brajesh Raj Chaudhary

Clin Exp Pediatr. 2026;69(2):84-102. Published online January 26, 2026

Ethnic variations may influence the response of children and adolescents to obesity pharmacotherapy. Current evidence does not show consistent differences in efficacy or safety among ethnic groups; however, available data are limited. Larger, ethnically diverse trials are needed to develop personalized obesity treatment strategies.

DOI: https://doi.org/10.3345/cep.2025.02838

Immunology

Multiomics approaches in Kawasaki disease: insights into pathogenesis and emerging directions for diagnosis and treatment (84 times)

Jong Gyun Ahn, Insoo Kang

Clin Exp Pediatr. 2026;69(3):197-210. Published online February 25, 2026

Crossref 1

Kawasaki disease (KD) is an acute febrile vasculitis and the leading cause of acquired heart disease in children. Despite decades of research, the etiology remains unknown and key mechanisms linking systemic inflammation to coronary artery lesions are incompletely defined. High-throughput technologies—including genomics, transcriptomics, proteomics, metabolomics, epigenomics, and immunomics—have enabled systems-level profiling of KD and highlighted reproducible inflammatory and vascular pathways....

DOI: https://doi.org/10.3345/cep.2025.02901

Original Article

Hematology

Outcomes of hematopoietic stem cell transplantation for pediatric patients with transfusion-dependent thalassemia in Thailand (82 times)

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

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.

DOI: https://doi.org/10.3345/cep.2025.02173

Gastroenterology

Progression from acute to chronic pancreatitis in children: a systematic review and meta-analysis (81 times)

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

Web of Science 1 Crossref 1

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

Review Article

Critical Care Medicine

Protocolized sedation may reduce ventilation and sedation requirements in the pediatric intensive care unit: a systematic review and meta-analysis (80 times)

Ambrus Szemere, Alíz Fazekas, Anna Réka Sebestyén, Rani Ezzeddine, Veronika Upor, Marie Anne Engh, Péter Hegyi, Zsolt Molnár, Klára Horváth

Clin Exp Pediatr. 2025;68(6):406-416. Published online February 19, 2025

Crossref 1

Protocolized sedation may reduce ventilation requirements, pediatric intensive care unit length of stay, and sedative exposure. However, it may increase the likelihood of unplanned extubation, highlighting the importance of incorporating preventive measures to mitigate this risk.

DOI: https://doi.org/10.3345/cep.2024.01711

Original Article

Pulmonology

Effect of vitamin C supplement in treatment of childhood pneumonia requiring hospitalization: a randomized controlled trial (77 times)

Chutima Phuaksaman, Katechan Jampachaisri, Klaita Srisingh

Clin Exp Pediatr. 2025;68(9):690-699. Published online April 1, 2025

This study assessed the effects of vitamin C on children with community-acquired pneumonia (CAP). Vitamin C supplementation improved clinical symptoms within 48–72 hours compared to placebo but did not reduce the length of hospital stay (LOS). These findings suggest that vitamin C is beneficial for managing CAP severity, but does not affect LOS.

DOI: https://doi.org/10.3345/cep.2025.01970

Review Article

Neurology

Sacral dimple: clinical perspectives of lesions hidden beneath the skin (76 times)

Jin Eun, Kwan Sung Lee, Seung Ho Yang

Clin Exp Pediatr. 2026;69(2):103-113. Published online November 26, 2025

· Most sacral dimples are benign, but atypical features may indicate occult spinal dysraphism.
· Simple dimples meeting strict criteria require no imaging, whereas atypical dimples require targeted ultrasonography or magnetic resonance imaging.
· The early diagnosis and surgical management of highrisk cases prevents irreversible neurological, orthopedic, and urological deficits.

DOI: https://doi.org/10.3345/cep.2025.01802

Neonatology (Perinatology)

Moving toward meaningful shared decision-making in neonatal care: clinical practice and policy implications in Korea (74 times)

In Gyu Song, Trisha M. Prentice, Lynn Gillam

Clin Exp Pediatr. 2026;69(4):282-292. Published online March 13, 2026

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.

DOI: https://doi.org/10.3345/cep.2025.02929

Original Article

Pulmonology

Efficacies of different treatment strategies for infants hospitalized with acute bronchiolitis (71 times)

Hyeri Jeong, Dawon Park, Eun Kyo Ha, Ju Hee Kim, Jeewon Shin, Hey-Sung Baek, Hyunsoo Hwang, Youn Ho Shin, Hye Mi Jee, Man Yong Han

Clin Exp Pediatr. 2024;67(11):608-618. Published online October 28, 2024

Web of Science 1 Crossref 1

· This study analyzed 45 randomized controlled trials (5,061 participants, 13 interventions) of the comparative efficacies of treatments for acute bronchiolitis in infants.
· Inhalation therapy with epinephrine and hypertonic saline significantly reduced the length of hospital stay compared with normal saline.
· Hypertonic saline had the greatest ability to improve the clinical severity score of bronchiolitis in infants younger than 2 years of age.

DOI: https://doi.org/10.3345/cep.2023.01676

Hematology

Granulocyte transfusion improves survival in pediatric febrile neutropenia: a 15-year cohort study (71 times)

Witsanu Phetsai, Kleebsabai Sanpakit, Jassada Buaboonnam, Kamon Phuakpet, Nassawee Vathana, Nattee Narkbunnam, Fon Kladed, Chayamon Takpradit

Clin Exp Pediatr. 2026;69(3):236-246. Published online January 12, 2026

Question: Does granulocyte transfusion improve survival and clinical recovery in pediatric febrile neutropenia?
Finding: In this 15-year real-world cohort, granulocyte transfusion significantly increased 30-day survival (92.3 % vs. 65.4%; adjusted odds ratio, 0.105; P=0.020) and accelerated fever and neutrophil recovery without serious adverse events.
Meaning: Granulocyte transfusion may be an effective adjunctive therapy for severe neutropenic infections in children, particularly in low- and middle-income settings.

DOI: https://doi.org/10.3345/cep.2025.01186

Review Article

Gastroenterology

High-resolution anorectal manometry in children (70 times)

Yogesh Waikar

Clin Exp Pediatr. 2024;67(2):57-63. Published online June 14, 2023

Web of Science 2 Crossref 5

· Anorectal manometry is safe in children.
· Defecation Dyssynergia is one of the commonest cause of chronic constipation.
· Positive Rectoanal inhibiory reflex rules out Hirschsprung's Disease

DOI: https://doi.org/10.3345/cep.2022.01242

General Pediatrics

Bridging the gap: autism spectrum disorder in children in the United States and worldwide: a narrative review (70 times)

Sandhya J. Kadam, Malika Goel

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

Crossref 1

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

Developmental and Behavioral Medicine

Screen time among preschoolers: exploring individual, familial, and environmental factors (68 times)

Sangha Lee, Donghee Kim, Yunmi Shin

Clin Exp Pediatr. 2024;67(12):641-650. Published online September 12, 2024

Web of Science 8 Crossref 13

This systematic review examined the correlation between screen time and various factors in preschoolers. Findings suggest that media parenting, including setting appropriate media limits, is crucial in protecting against excessive screen exposure. However, limited research has been done on the impact of family and personal factors, particularly with the increasing use of portable devices among young children.

DOI: https://doi.org/10.3345/cep.2023.01746

Other

Microplastic and human health with focus on pediatric well-being: a comprehensive review and call for future studies (68 times)

Rogers Wainkwa Chia, Ntegang Venant Atem, Jin-Yong Lee, Jihye Cha

Clin Exp Pediatr. 2025;68(1):1-15. Published online November 6, 2024

Web of Science 29 Crossref 33

· Milk and formula are common sources of microplastic in infants.
· Water and air are the most common sources of microplastic pollution from infancy to adolescence.
· Microplastic use by children of all ages can cause cell damage and affect their health.
· Microplastics present in children can be quantified using a stereomicroscope and characterized using micro- Fourier transform infrared spectroscopy.

DOI: https://doi.org/10.3345/cep.2023.01739

Original Article

Gastroenterology

Longitudinal analysis of gut microbiota dysbiosis and bacterial signatures predictive of postoperative enterocolitis in children with Hirschsprung disease (68 times)

Sireekarn Chantakhow, Chanon Kunasol, Jiraporn Khorana, Kanokkan Tepmalai, Nipon Chattipakorn, Siriporn C. Chattipakorn

Clin Exp Pediatr. 2026;69(3):214-227. Published online December 10, 2025

Question: Do gut microbiota differ between patients with Hirschsprung disease (HSCR) and healthy children, and can specific bacterial taxa predict postoperative HSCRassociated enterocolitis (HAEC)?
Finding: Patients with HSCR showed gut dysbiosis with reduced diversity. Postoperative microbial changes included increased alpha diversity. Certain taxa, such as Eubacterium and Collinsella, were associated with recovery or HAEC.
Meaning: Distinct microbial signatures may help identify HAEC risk and guide microbiota-based strategies to improve outcomes.

DOI: https://doi.org/10.3345/cep.2025.01886

Review Article

Gastroenterology

Sarcopenia in pediatric gastroenterology and hepatology: an updated review (68 times)

Toshifumi Yodoshi

Clin Exp Pediatr. 2026;69(5):366-383. Published online April 27, 2026

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.

DOI: https://doi.org/10.3345/cep.2026.00234

Allergy

Practical issues of oral immunotherapy for egg or milk allergy (67 times)

Sukyung Kim, Kangmo Ahn, Jihyun Kim

Clin Exp Pediatr. 2024;67(3):140-148. Published online June 19, 2023

Web of Science 8 Crossref 6

· Oral immunotherapy should be supervised by pediatricians with experience administering oral food challenge tests and managing allergic reactions.
· Food allergen intake is gradually increased and maintained for years.
· Patients may experience allergic reactions and psychological problems.
· Adjunctive therapies (biologics, antihistamines, and leukotriene receptor antagonists) may improve efficacy and safety.
· Contraindications include uncontrolled asthma, malignancy, active autoimmune disorders, and beta-blocker usage.

DOI: https://doi.org/10.3345/cep.2023.00234

Endocrinology

Growth plate closure and therapeutic interventions (66 times)

Ja Hyang Cho, Hae Woon Jung, Kye Shik Shim

Clin Exp Pediatr. 2024;67(11):553-559. Published online October 28, 2024

Web of Science 5 Crossref 4

Height gains result from longitudinal bone growth. Upon adequate growth, growth plate closure limits longitudinal bone growth. To date, gonadotropin-releasing hormone analogs, aromatase inhibitors, C-type natriuretic peptide analogs, and fibroblast growth factor receptor 3 inhibitors have been studied or used as therapeutic interventions to delay growth plate closure and increase human height. The development of more effective therapeutic modalities for short stature, precocious puberty, and skeletal dysplasia is anticipated.

DOI: https://doi.org/10.3345/cep.2023.00346

Nutrition

Dietary fiber in pediatric gastrointestinal health: a narrative review of evidence and challenges (66 times)

Rohit Das, Bipashna Thatal, Buddhiman Tamang

Clin Exp Pediatr. 2026;69(6):456-472. Published online May 27, 2026

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.

DOI: https://doi.org/10.3345/cep.2026.00276

General Pediatrics

Metabolic complications of obesity in children and adolescents (65 times)

Hyunjin Park, Jung Eun Choi, Seunghee Jun, Hyelim Lee, Hae Soon Kim, Hye Ah Lee, Hyesook Park

Clin Exp Pediatr. 2024;67(7):347-355. Published online November 16, 2023

Web of Science 31 Crossref 34

· Pediatric obesity increases the risk of metabolic complications (insulin resistance, dyslipidemia, nonalcoholic fatty liver disease) and long-term cardiovascular diseases.
· A new obesity definition and various indicators (continuous metabolic syndrome score, pediatric simple metabolic syndrome score, fatty liver index) have been proposed to evaluate children’s susceptibility to metabolic disorders.
· Laboratory and body composition tests in pediatric screenings can identify groups at high risk of metabolic complications of obesity.

DOI: https://doi.org/10.3345/cep.2023.00892

Original Article

Endocrinology

Intramuscular and subcutaneous gonadotropin-releasing hormone agonist tests for central precocious puberty in girls: a randomized controlled trial (65 times)

Worapimon Lerdrassameethad, Suttipong Wacharasindhu, Vichit Supornsilchai, Khomsak Srilanchakon

Clin Exp Pediatr. 2026;69(6):518-523. Published online April 15, 2026

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.

DOI: https://doi.org/10.3345/cep.2026.00052

Editorial

Nutrition

Zinc as a treatment modality for acute infectious diarrhea in children (62 times)

Ji Sook Park

Clin Exp Pediatr. 2025;68(3):223-224. Published online October 31, 2024

Web of Science 1 Crossref 1

· Prevention and management of dehydration is the major goal of treatment in acute infectious diarrhea in children.
· Zinc could be effective as an adjuvant therapy in reducing the duration of acute infectious diarrhea in malnourished children.

DOI: https://doi.org/10.3345/cep.2024.00381

Original Article

Nephrology (Genitourinary)

Assessing kidney outcomes in childhood-onset lupus nephritis: role of National Institutes of Health-modified histological indices (62 times)

Nuanpan Penboon, Pornpimol Rianthavorn

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

Web of Science 2 Crossref 2

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

Neonatology (Perinatology)

Perinatal risk factors for hemodynamically significant patent ductus arteriosus in very low birth weight infants (62 times)

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

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.

DOI: https://doi.org/10.3345/cep.2025.01893

Endocrinology

Thyroid peroxidase gene variants and susceptibility to congenital hypothyroidism and autoimmune thyroid disease among Egyptian pediatric cohort (62 times)

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

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.

DOI: https://doi.org/10.3345/cep.2025.02957

Nutrition

Success rates of conservative treatment and optimal surgical timing for pediatric chylothorax (61 times)

Pakwan Kaewchusen, Narumon Densupsoontorn, Supaluck Kanjanauthai, Puthita Saengpanit

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

Web of Science 2 Crossref 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

Clinical Note

Gastroenterology

Ultrasonographic features of 5-aminosalicylic acid intolerance in pediatric ulcerative colitis (60 times)

Hirotoki Murashige, Yasufumi Sakata, Yoshihiro Azuma, Shunji Hasegawa

Clin Exp Pediatr. 2026;69(6):524-526. Published online May 28, 2026

Web of Science 1

DOI: https://doi.org/10.3345/cep.2025.02446

Review Article

Pulmonology

Evidence-based management guidelines for noncystic fibrosis bronchiectasis in children and adolescents (59 times)

Eun Lee, Kyunghoon Kim, You Hoon Jeon, In Suk Sol, Jong Deok Kim, Taek Ki Min, Yoon Ha Hwang, Hyun-Ju Cho, Dong In Suh, Hwan Soo Kim, Yoon Hee Kim, Sung-Il Woo, Yong Ju Lee, Sungsu Jung, Hyeon-Jong Yang, Gwang Cheon Jang

Clin Exp Pediatr. 2024;67(9):418-426. Published online January 23, 2024

Web of Science 2 Crossref 2

· We suggest offering long-term macrolides to children with noncystic fibrosis bronchiectasis with frequent exacerbations (conditional recommendation, moderate quality of evidence).
· We do not recommend the routine use of mucolytic agents, inhaled corticosteroids, or nonsteroidal anti-inflammatory drugs to prevent exacerbation of bronchiectasis in children (inconclusive, very low quality of evidence).
· We recommend the use of nebulized hypertonic saline to prevent exacerbations and improve the lung function of children with noncystic fibrosis bronchiectasis (weak recommendation, moderate quality of evidence).

DOI: https://doi.org/10.3345/cep.2023.00871

Allergy

Comparison and review of international guidelines for treating asthma in children (59 times)

Eui Jeong Roh

Clin Exp Pediatr. 2024;67(9):447-455. Published online August 20, 2024

Web of Science 6 Crossref 5

Asthma is the most common chronic disease among children. Although asthma in children may spontaneously improve, it continues into adulthood in many cases. Therefore, appropriate disease management and medication are essential. Consistent and objective guidelines are needed to manage pediatric asthma and related adverse reactions.

DOI: https://doi.org/10.3345/cep.2022.01466

Endocrinology

Pubertal induction in prepubertal males with hypogonadotropic hypogonadism: testosterone or gonadotropins? (59 times)

Paolo Cavarzere, Riccardo Battiston, Valentina Lupieri, Valentina Mancioppi, Claudio Maffeis

Clin Exp Pediatr. 2026;69(1):1-10. Published online December 18, 2025

The pubertal induction process in males still poses a challenge for pediatric endocrinologists. The existing literature is limited, and it is not yet possible to make definitive recommendations. We described the various treatment for this condition and tried to analyze the unresolved questions to address the question posed in the title of our manuscript.

DOI: https://doi.org/10.3345/cep.2025.02355

Cited By 55	Prevalence of anxiety, depression, and stress among parents of neonates admitted to neonatal intensive care unit: a systematic review and meta-analysis
Cited By 36	Community-acquired pneumonia in children: updated perspectives on its etiology, diagnosis, and treatment
Cited By 34	Metabolic complications of obesity in children and adolescents
Cited By 33	Microplastic and human health with focus on pediatric well-being: a comprehensive review and call for future studies
Cited By 30	Global burden of asthma among children and adolescents with projections to 2050: a comprehensive review and forecasted modeling study

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