Clinical and Experimental Pediatrics

Guideline

Oncology

Evidence-based clinical practice guidelines for pediatric hepatoblastoma: a systematic review and expert recommendations from Korea

Jin Kyung Suh, Jisun Hwang, Hee Mang Yoon, Kyong Ihn, Jung-Man Namgoong, Jeong A. Park, Jung-Sun Kim, Hyoung Soo Choi, Sung Hye Park, Dong Ah Park, Kyung-Nam Koh

Clin Exp Pediatr. 2026;69(11):912-924. Published online October 23, 2026

This is the first Korean evidence-based clinical practice guideline for pediatric hepatoblastoma. Key recommendations include computed tomography and magnetic resonance imaging for PRETEXT (PRE-Treatment EXTent of disease) staging, cisplatin monotherapy for standard-risk disease, upfront surgery for resectable tumors, metastasectomy for residual lung lesions, and sodium thiosulfate for otoprotection. Well-differentiated fetal histology carries a favorable prognosis, whereas the small cell undifferentiated pattern requires immunohistochemical and molecular testing to exclude malignant rhabdoid tumor.

DOI: https://doi.org/10.3345/cep.2026.02691

Original Article

Neonatology (Perinatology)

Maternal metformin protects developing auditory brainstem function after neonatal hypoxia-ischemia in a neonatal rat model

Sei Eun Kim, Joo Young Kweon, Yong Joo Ahn, Jun Hee Kim

Clin Exp Pediatr. 2026;69(10):806-816. Published online September 17, 2026

Web of Science 1 Crossref 1

Question: Does maternal metformin administration during pregnancy protect offspring auditory brainstem function after neonatal hypoxia-ischemia (HI)?
Finding: Maternal metformin prevented HI-induced hearing threshold elevation, preserved auditory brainstem response amplitudes, and partially rescued neuronal and oligodendrocyte lineage cells in the medial nucleus of the trapezoid body.
Meaning: Maternal metformin during gestation may serve as a prenatal neuroprotective strategy against neonatal hypoxic-ischemic brain injury.

DOI: https://doi.org/10.3345/cep.2026.01368

Review Article

Infection

Antibiotic pretreatment and culture yield in pediatric osteoarticular infection: a systematic review and meta-analysis

Mohamad Shieb, Caroline Decesare, Guyu Li, Elizabeth Ristagno

Clin Exp Pediatr. 2026;69(11):825-832. Published online September 14, 2026

In this systematic review and meta-analysis of 9 studies comprising 1,704 tissue culture specimens from children with osteoarticular infection, antibiotic pretreatment was not associated with reduced tissue culture yield (odds ratio, 1.60; 95% confidence interval, 1.23–2.08). Empiric antibiotic therapy should not be withheld to preserve culture yield in suspected osteoarticular infection; invasive cultures should be obtained at the earliest safe opportunity without delaying treatment.

DOI: https://doi.org/10.3345/cep.2026.01634

Original Article

Neurology

Prenatal stress via chronic immobilization amplifies N-methyl-D-aspartate-induced spasm-like seizure susceptibility and neuroinflammation in neonatal rats

Hyeok Hee Kwon, Seungyeon Bin, Seung Gyu Choi, Hyo Jung Shin, Joon Won Kang

Clin Exp Pediatr. 2026;69(11):858-867. Published online September 8, 2026

Question: Does chronic prenatal immobilization stress increase an offspring's susceptibility to spasms, and is this associated with altered glial activation and gamma-aminobutyric acid (GABA)ergic signaling in the developing brain?
Finding: Prolonged prenatal stress increases susceptibility to N-methyl-D-aspartate-induced spasms, enhanced glial activation, and impaired GABAergic signaling.
Meaning: Long-term prenatal stress may promote early life epileptogenesis associated with neuroinflammation as well as disrupted inhibitory neurotransmission, although a causal role remains to be established.

DOI: https://doi.org/10.3345/cep.2026.01403

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

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.

DOI: https://doi.org/10.3345/cep.2026.00241

Gastroenterology

Impact of bacterial infection on native liver survival in children with cirrhosis due to biliary atresia

Varissara Kaewchaivijit, Pornthep Tanpowpong, Songpon Getsuwan, Sophida Boonsathorn, Chatmanee Lertudomphonwanit, Suporn Treepongkaruna

Clin Exp Pediatr. 2026;69(10):788-796. Published online July 24, 2026

Question: Are bacterial infections associated with lower native liver survival in children with biliary atresia (BA)?
Finding: Children with BA and proven/suspected bacterial infections, including cholangitis, had significantly lower native liver survival and higher rates of liver transplantation or death.
Meaning: Early recognition, appropriate management, and prevention of bacterial infections may improve native liver survival in children with BA-related cirrhosis.

DOI: https://doi.org/10.3345/cep.2026.00388

Neurology

Patient-independent automated pediatric seizure monitoring based on expert-labeled electrographic ictal data as core reference knowledge

Yoon Gi Chung, Jaeso Cho, Anna Cho, Hunmin Kim, Byung Chan Lim

Clin Exp Pediatr. 2026;69(8):665-675. Published online July 14, 2026

Question: Can deep learning models trained on expert-verified electroencephalography segments reliably detect seizures and be applied to single-channel wearable monitoring?
Finding: This technique demonstrated 80.1%–100% sensitivity and low false-alarm rates. On 1,604 expert-labeled segments, the model outperformed previous studies in terms of latency and accuracy across unseen datasets.
Meaning: Expert-labeled data are essential for achieving universal seizure detection. This channel-specific approach enabled efficient and continuous monitoring using wearable devices.

DOI: https://doi.org/10.3345/cep.2026.01011

Gastroenterology

Prognosis of pediatric hepatic Wilson disease with ATP7B loss of function variants

Amresh Kumar Mishra, Moinak Sen Sarma, Anchal Dubey, Pratik Gadekar, Amita Moirangthem, Anshu Srivastava, Amrita Mathias

Clin Exp Pediatr. 2026;69(8):646-654. Published online July 13, 2026

Question: Do the loss of function (LOF) of ATP7B mutated variants affect the severity or outcomes of hepatic Wilson disease (WD)?
Finding: LOF is associated with advanced liver disease, portal hypertension, and extrahepatic involvement. LOF did not determine hepatic or overall outcomes. ATP7B: c.813C>A (truncation variant) has an aggressive course with higher predisposition to acute liver failure. Lower serum exchangeable copper levels and higher disappearance of Kayser-Fleischer ring were observed in ATP7B: c.3809A>G (nontruncation variant) suggesting a better effect of chelation and lesser systemic copper.
Meaning: Truncation of the ATP7B protein determines the severity of the phenotype in WD.

DOI: https://doi.org/10.3345/cep.2026.00689

Other

Association between sodium content of intravenous immunoglobulin and electrolyte changes and clinical course of Kawasaki disease

Yoshitaka Watanabe, Naomi Yagi, Toya Hattori, Chisato Oyake, Shota Endo, Maria Yoshimi, Takayoshi Kyoda, Hirokazu Ikeda

Clin Exp Pediatr. 2026;69(8):639-645. Published online July 1, 2026

Web of Science 1

Question: Hyponatremia in Kawasaki disease is associated with inflammation and disease severity. Intravenous immunoglobulin (IVIG) formulations feature various sodium contents. What is the clinical impact of such variations?
Finding: IVIG sodium content was associated with sodium, potassium, and protein level changes.
Meaning: Coronary outcomes were similar but electrolyte changes differed: high-sodium IVIG caused hypokalemia, whereas low-sodium IVIG caused hyponatremia. IVIG preparation requires consideration when interpreting laboratory values.

DOI: https://doi.org/10.3345/cep.2026.00619

Review Article

Endocrinology

Testosterone therapy in boys with constitutional delay of growth and puberty: a PubMed-based systematic review and exploratory meta-analysis

Ashraf T. Soliman, Fawzia Alyafei, Nada Alaaraj, Noor Hamed, Shayma Ahmed, Khaled A. Siddiq, Mohammed Qusad, Mohamed AlKhalaf

Clin Exp Pediatr. 2026;69(7):531-541. Published online June 18, 2026

Web of Science 3 Crossref 3

In boys with constitutional delay of growth and puberty, a short course of low-dose testosterone consistently accelerates linear growth and advances pubertal maturation. Long-term follow-up studies do not show a clinically meaningful effect of conservative regimens on near-adult height. As the pooled quantitative evidence represents only 46 boys in 2 controlled studies, treatment should remain individualized, while larger randomized trials using standardized patient-reported outcomes are needed.

DOI: https://doi.org/10.3345/cep.2026.00675

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

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

Original Article

Gastroenterology

Distinct age-dependent phenotypes of abnormal liver function tests derived from national Emergency Department data

Dong-Uk Kim, Shinjie Choi, Yeji Kim, Lia Kim, Jung Ok Shim, Jin Soo Moon, Jong Woo Hahn, Hye Ran Yang, Ju Young Chang, Jae Sung Ko

Clin Exp Pediatr. 2026;69(7):563-571. Published online May 14, 2026

Question: What are the clinical phenotypes and pathogen associations of pediatric and adult Emergency Department visits for abnormal liver function tests?
Finding: Pediatric visits showed fever-predominant profiles with temporal correlations with respiratory viruses, whereas adult visits revealed population-level temporal associations between enteric pathogens and infectious gastroenteritis, upper gastrointestinal disorders, and metabolic comorbidity clustering.
Meaning: These findings provide novel population-level evidence of age-specific pathogen associations and support distinct age-stratified clinical diagnostics.

DOI: https://doi.org/10.3345/cep.2026.00038

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

Web of Science 2 Crossref 2

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

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

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

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

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.

DOI: https://doi.org/10.3345/cep.2025.02999

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

Web of Science 1 Crossref 1

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.

DOI: https://doi.org/10.3345/cep.2025.02936

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

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.

DOI: https://doi.org/10.3345/cep.2025.02327

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

Web of Science 1 Crossref 1

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.

DOI: https://doi.org/10.3345/cep.2025.02397

Review Article

Gastroenterology

Balancing therapeutic benefits and hidden risks of proton pump inhibitors in pediatric practice: a narrative review and update

Maria Rogalidou, Alexandra Papadopoulou

Clin Exp Pediatr. 2026;69(3):186-196. Published online February 25, 2026

Web of Science 1 Crossref 1

Proton pump inhibitors (PPIs) effectively treat acid-related disorders, including gastroesophageal reflux disease, eosinophilic esophagitis, peptic ulcers, and Zollinger-Ellison syndrome. Long-term use, particularly in children, may lead to microbiome alterations, nutrient deficiencies, infections, renal injury, osteoporosis, fractures, and other gastrointestinal changes. PPI therapy should be guided by clear clinical indications, prescribed at the lowest effective dose for the shortest necessary duration, and regularly reassessed to minimize risks in young children.

DOI: https://doi.org/10.3345/cep.2025.02761

Original Article

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

Web of Science 2 Crossref 2

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.

DOI: https://doi.org/10.3345/cep.2025.02089

Allergy

Can a basophil activation test of cord blood predict a cow's milk allergy?

Dilara Fatma Kocacik Uygun, Durmuş Burgucu, Vedat Uygun, Gül Alkan Bulbul, Fulden Duyar, Cem Yasar Sahnal, Aysen Bingöl

Clin Exp Pediatr. 2026;69(3):257-265. Published online January 20, 2026

Question: Can a basophil activation test (BAT) of cord blood predict a cow's milk allergy?
Finding: Infants with a high casein-BAT value were more likely to develop food allergy symptoms in the first year, whereas cow’s milk BAT showed no predictive association.
Meaning: Cord blood casein BAT may help identify newborns at increased risk for early-life food allergies, enabling closer monitoring and preventive strategies, although larger studies are needed for validation.

DOI: https://doi.org/10.3345/cep.2025.01697

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

Crossref 1

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.

DOI: https://doi.org/10.3345/cep.2025.02572

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

Web of Science 1 Crossref 1

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.

DOI: https://doi.org/10.3345/cep.2025.02110

Hematology

Granulocyte transfusion improves survival in pediatric febrile neutropenia: a 15-year cohort study

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

Crossref 1

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

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

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

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

Web of Science 2 Crossref 2

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.

DOI: https://doi.org/10.3345/cep.2025.02117

Review Article

Gastroenterology

Ingestion of foreign bodies and caustic substances in children: a narrative review on clinical evaluation and management update

Maria Rogalidou

Clin Exp Pediatr. 2026;69(1):11-21. Published online December 10, 2025

Web of Science 4 Crossref 5

Foreign body and caustic substance ingestion in children aged 1–5 years can feature to severe and, sometimes life-threatening complications. High-risk items include batteries, magnets, and corrosive chemicals. Severity depends on object type, location, and ingestion timing. Prompt diagnosis and early endoscopic intervention are crucial. Individualized management, high clinical suspicion, and parental education are essential to improving outcomes and preventing immediate and long-term complications affecting a child’s quality of life.

DOI: https://doi.org/10.3345/cep.2025.01823

Original Article

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

Web of Science 2 Crossref 2

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

Nephrology (Genitourinary)

Discordance between antibiotic therapy and recurrent urinary tract infections in young children with third-generation cephalosporin-resistant infections

Yusin Kim, Hyun A Lee, Gil Lee, Kyungseok Park, Ye Kyung Kim, Peong Gang Park

Clin Exp Pediatr. 2026;69(3):228-235. Published online November 26, 2025

Question: Does completing a third-generation cephalosporin course, despite in vitro resistance, increase the early urinary tract infection recurrence rate in children?
Finding: Among 989 Korean children, discordant therapy increased the 2-month recurrence risk by 40% compared with concordant or susceptible therapy.
Meaning: Checking isolate susceptibility and switching to an active oral drug may curb recurrence and limit the use of broad-spectrum antibiotics.

DOI: https://doi.org/10.3345/cep.2025.01417

Review Article

Neurology

Sacral dimple: clinical perspectives of lesions hidden beneath the skin

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

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