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Original Article
Prednisolone impairs trabecular bone score changes in adolescents with 21-hydroxylase deficiency
Pattara Wiromrat, Yutapong Raruenrom, Phanpaphorn Namphaisan, Nantaporn Wongsurawat, Ouyporn Panamonta, Chatlert Pongchaiyakul
Background: Individuals with 21-hydroxylase deficiency (21OHD) require lifelong glucocorticoid (GC) therapy, which increases their risk of fragility fractures. However, fractures in GC-treated individuals can occur at normal bone mineral density (BMD) levels, suggesting an alteration in the bone microarchitecture.
Purpose: To evaluate trabecular bone microarchitecture and its changes in adolescents with 21OHD. Methods: We enrolled 38 adolescents with 21OHD for whom...
Review Article
Hematology
Iron deficiency in children with a focus on inflammatory conditions
Na Hee Lee
Clin Exp Pediatr. 2024;67(6):283-293.   Published online May 21, 2024
· Iron deficiency has important effects on neurodevelopment and the immune system in children.
· Hepcidine plays an important role in iron homeostasis.
· Diagnosis and treatment of iron deficiency in chronic inflammatory disease are important for patients' quality of life and disease course.
Immunology
Modern diagnostic capabilities of neonatal screening for primary immunodeficiencies in newborns
Evgenia Olegovna Khalturina, Natalia Dmitrievna Degtyareva, Anastasiia Vasi’evna Bairashevskaia, Alena Valerievna Mulenkova, Anna Vladimirovna Degtyareva
Clin Exp Pediatr. 2021;64(10):504-510.   Published online March 25, 2021
· Neonatal screening for primary immunodeficiency diseases (PIDs) enables early diagnosis and subsequent initiation of therapy.
· Excision of T-cell receptors and kappa-recombination excision circles are cheaper alternative PID screening methods.
· Sanger DNA sequencing remains the reference method for detecting PID; however, next-generation sequencing technology is increasingly used to diagnose it.
· Here we developed a graphical algorithm for diagnosing primary immunodeficiency syndrome based on modern methods of screening for primary immunodeficiencies in newborns.
Review article
Immunology
Systematic review of literature and analysis of big data from the National Health Insurance System on primary immunodeficiencies in Korea
Sohee Son, Ji-Man Kang, Younsoo Hahn, Kangmo Ahn, Yae-Jean Kim
Clin Exp Pediatr. 2021;64(4):141-148.   Published online July 13, 2020
In this article, a systematic review of reported primary immunodeficiency disease (PID) cases in Korea was performed and we attempted to estimate the number of PID patients and healthcare costs for the first time in Korea. Our review revealed that Korean PID cases are greatly underreported in the literature based on health insurance. Physicians in the field and health care policymakers should be aware of the disease burden of PID.
Review Article
Hematology
Genetic classification and confirmation of inherited platelet disorders: current status in Korea
Ye Jee Shim
Clin Exp Pediatr. 2020;63(3):79-87.   Published online February 6, 2020
Inherited platelet disorders (IPDs), which manifest as primary hemostasis defects, often underlie abnormal bleeding and a family history of thrombocytopenia, bone marrow failure, hematologic malignancies, undefined mucocutaneous bleeding disorder, or congenital bony defects. Wide heterogeneity in IPD types with regard to the presence or absence of thrombocytopenia, platelet dysfunction, bone marrow failure, and dysmegakaryopoiesis is observed in patients. The individual...
Original Article
Cardiology
Iron deficiency anemia as a predictor of coronary artery abnormalities in Kawasaki disease
Sohyun Kim, Lucy Youngmin Eun
Clin Exp Pediatr. 2019;62(8):301-306.   Published online February 8, 2019

Purpose: Coronary artery abnormalities (CAA) are the most important complications of Kawasaki disease (KD). Iron deficiency anemia (IDA) is a prevalent micronutrient deficiency and its association with KD remains unknown. We hypothesized that presence of IDA could be a predictor of CAA. Methods: This retrospective study included 173 KD patients, divided into 2 groups according to absence (group 1) and presence...
Gastroenterology
The role of Lactobacillus reuteri DSM 17938 for the absorption of iron preparations in children with iron deficiency anemia
Jeanette Manoppo, Hilda Tasiringan, Audrey Wahani, Adrian Umboh, Max Mantik
Clin Exp Pediatr. 2019;62(5):173-178.   Published online January 25, 2019

Purpose: To determine whether Lactobacillus reuteri DSM 17938 plays a role in absorption of iron preparations given to children with iron deficiency anemia (IDA). Methods: We performed a quasi-experimental study involving pre- and postintervention tests using a control group in North Sulawesi province, Indonesia, between July and September 2017. We conducted a single-blind controlled trial that included primary school children who...
Neonatology (Perinatology)
Association between vitamin D level at birth and respiratory morbidities in very-low-birth-weight infants
Ian Kim, Sung Shin Kim, Jee In Song, Seock Hwa Yoon, Ga Young Park, Yong-Wha Lee
Clin Exp Pediatr. 2019;62(5):166-172.   Published online October 24, 2018

Purpose: This study aimed to evaluate vitamin D status at birth in very-low-birth-weight infants (VLBWIs: <1,500 g) and to determine the association between vitamin D level and respiratory morbidity. Methods: A retrospective study was conducted at Soonchunhyang University Bucheon Hospital between November 2013 and November 2017. We collected blood samples and data on respiratory morbidity from 230 VLBWIs on the first...
Genetics and Metabolism
Neonatal indirect hyperbilirubinemia and glucose-6-phosphate dehydrogenase deficiency
Hasan M. Isa, Masooma S. Mohamed, Afaf M. Mohamed, Adel Abdulla, Fuad Abdulla
Clin Exp Pediatr. 2017;60(4):106-111.   Published online April 25, 2017
Purpose

This study aimed to determine the prevalence of glucose-6-phosphate dehydrogenase (G6PD) deficiency among infants with neonatal indirect hyperbilirubinemia (NIH); compare G6PD-deficient and G6PD-normal patients regarding hyperbilirubinemia and need for exchange transfusions (ET); and assess risk factors for ET and kernicterus.

Methods

This is a case-control retrospective study. Medical records of NIH patients admitted to the Pediatric Department, Salmaniya Medical Complex, Bahrain, between...

Endocrinology
The serum level of 25-hydroxyvitamin D for maximal suppression of parathyroid hormone in children: the relationship between 25-hydroxyvitamin D and parathyroid hormone
Jung In Kang, Yoon Suk Lee, Ye Jin Han, Kyoung Ae Kong, Hae Soon Kim
Clin Exp Pediatr. 2017;60(2):45-49.   Published online February 27, 2017
Purpose

Serum level of 25-hydroxyvitamin D (25-OHD) is considered as the most appropriate marker of vitamin D status. However, only a few studies have investigated the relationship between 25-OHD and parathyroid hormone (PTH) in children. To this end, this study was aimed at evaluating the lowest 25-OHD level that suppresses the production of parathyroid hormone in children.

Methods

A retrospective record review was...

Review Article
Endocrinology
Management issues of congenital adrenal hyperplasia during the transition from pediatric to adult care
Jin-Ho Choi, Han-Wook Yoo
Clin Exp Pediatr. 2017;60(2):31-37.   Published online February 27, 2017

Steroid 21-hydroxylase deficiency is the most prevalent form of congenital adrenal hyperplasia (CAH), accounting for approximately 95% of cases. With the advent of newborn screening and hormone replacement therapy, most children with CAH survive into adulthood. Adolescents and adults with CAH experience a number of complications, including short stature, obesity, infertility, tumor, osteoporosis, and reduced quality of life. Transition from...

Case Report
Endocrinology
Concomitant occurrence of Turner syndrome and growth hormone deficiency
Jung Yu, Ha Young Shin, Chong Guk Lee, Jae Hyun Kim
Clin Exp Pediatr. 2016;59(Suppl 1):S121-S124.   Published online November 30, 2016

Turner syndrome (TS) is a genetic disorder in phenotypic females that has characteristic physical features and presents as partial or complete absence of the second sex chromosome. Growth hormone deficiency (GHD) is a condition caused by insufficient release of growth hormone from the pituitary gland. The concomitant occurrence of TS and GHD is rare and has not yet been reported...

Immunology
A novel BTK gene mutation, c.82delC (p.Arg28 Alafs*5), in a Korean family with X-linked agammaglobulinemia
Jeongeun Lee, Minhee Rhee, Taek Ki Min, Hae In Bang, Mi-Ae Jang, Eun-Suk Kang, Hee-Jin Kim, Hyeon-Jong Yang, Bok Yang Pyun
Clin Exp Pediatr. 2016;59(Suppl 1):S49-S52.   Published online November 30, 2016

X-linked agammaglobulinemia (XLA) is a hereditary humoral immunodeficiency that results from Bruton’s tyrosine kinase (BTK) gene mutations. These mutations cause defects in B-cell development, resulting in the virtual absence of these lymphocytes from the peripheral circulation. Consequently, this absence leads to a profound deficiency of lg all isotypes, and an increased susceptibility to encapsulated bacterial infections. A 15-month-old Korean boy...

Genetics and Metabolism
Maternal 3-methylcrotonyl-coenzyme A carboxylase deficiency with elevated 3-hydroxyisovalerylcarnitine in breast milk
Kyung Lae Cho, Yeo Jin Kim, Song Hyun Yang, Gu-Hwan Kim, Jun Hwa Lee
Clin Exp Pediatr. 2016;59(Suppl 1):S41-S44.   Published online November 30, 2016

We report here a case of maternal 3-methylcrotonyl-coenzyme A carboxylase (3-MCC) deficiency in a Korean woman. Her 2 infants had elevated 3-hydroxyisovalerylcarnitine (C5-OH) on a neonatal screening test by liquid chromatography-tandem mass spectrometry (LC-MS/MS), but normal results were found on urine organic acid analysis. The patient was subjected to serial testing and we confirmed a maternal 3-MCC deficiency by blood...

Neurology
Glucose transport 1 deficiency presenting as infantile spasms with a mutation identified in exon 9 of SLC2A1
Hyun Hee Lee, Yun Jung Hur
Clin Exp Pediatr. 2016;59(Suppl 1):S29-S31.   Published online November 30, 2016

Glucose transport 1 (GLUT-1) deficiency is a rare syndrome caused by mutations in the glucose transporter 1 gene (SLC2A1) and is characterized by early-onset intractable epilepsy, delayed development, and movement disorder. De novo mutations and several hot spots in N34, G91, R126, R153, and R333 of exons 2, 3, 4, and 8 of SLC2A1 are associated with this condition. Seizures,...

Original Article
Nutrition
Increment in vitamin D level and bone mineral accrual in children with vitamin D deficiency
Yashwant Kumar Rao, Tanu Midha, Satyajeet Singh, Anurag Bajpai, Amita Tilak
Clin Exp Pediatr. 2016;59(7):292-297.   Published online July 31, 2016
Purpose

To compare different regimens of vitamin D with respect to its serum increment levels and bone mineral accrual in vitamin D-deficient children.

Methods

Children identified as being vitamin D deficient (serum levels<20 ng/mL) were divided into 3 treatment groups by stratified block randomization (group 1, 4,000 IU/day of vitamin D3 plus 50 mg/kg/day calcium for 12 weeks; group 2, 30,000 IU/wk of...

Iron and vitamin D status in breastfed infants and their mothers
Yu Sun Kang, Joon Hwan Kim, Eun Hee Ahn, Eun-Gyong Yoo, Moon Kyu Kim
Clin Exp Pediatr. 2015;58(8):283-287.   Published online August 21, 2015
Purpose

We assessed the relationships between iron and vitamin D statuses in breastfed infants and their mothers and evaluated the determinants of iron and vitamin D deficiencies in breastfed infants.

Methods

Seventy breastfed infants aged 4-24 months and their mothers participated in this study from February 2012 to May 2013. Complete blood counts, total iron binding capacity, and levels of C-reactive protein, iron,...

The usefulness of soluble transferrin receptor in the diagnosis and treatment of iron deficiency anemia in children
Se Hoon Yoon, Dong Sup Kim, Seung Taek Yu, Sae Ron Shin, Du Young Choi
Clin Exp Pediatr. 2015;58(1):15-19.   Published online January 31, 2015
Purpose

Soluble transferrin receptor (sTfR) is a truncated extracellular form of the membrane transferrin receptor produced by proteolysis. Concentrations of serum sTfR are related to iron status and erythropoiesis in the body. We investigated whether serum sTfR levels can aid in diagnosis and treatment of iron deficiency anemia (IDA) in children.

Methods

Ninety-eight patients with IDA were enrolled and were classified according to...

Case Report
Wernicke's encephalopathy in a child with high dose thiamine therapy
So Won Park, Yoon Young Yi, Jung Woo Han, Heung Dong Kim, Joon Soo Lee, Hoon-Chul Kang
Clin Exp Pediatr. 2014;57(11):496-499.   Published online November 30, 2014

Wernicke's encephalopathy is an acute neurological disorder characterized by mental confusion, oculomotor dysfunction, and ataxia. It has been reported in individuals with alcohol dependence, hyperemesis gravidarum, and prolonged parenteral nutrition without vitamin supplementation. Here we present the case of a 13-year-old male patient with neuroblastoma and a history of poor oral intake and nausea for 3 months. After admission, he...

Review Article
Iron deficiency increases blood concentrations of neurotoxic metals in children
Yangho Kim, Sangkyu Park
Clin Exp Pediatr. 2014;57(8):345-350.   Published online August 25, 2014

Iron deficiency affects approximately one-third of the world's population, occurring most frequently in children aged 6 months to 3 years. Mechanisms of iron absorption are similar to those of other divalent metals, particularly manganese, lead, and cadmium, and a diet deficient in iron can lead to excess absorption of manganese, lead, and cadmium. Iron deficiency may lead to cognitive impairments...

Vitamin D status and childhood health
Youn Ho Shin, Hye Jung Shin, Yong-Jae Lee
Clin Exp Pediatr. 2013;56(10):417-423.   Published online October 31, 2013

Vitamin D is an essential component of bone and mineral metabolism; its deficiency causes growth retardation and skeletal deformities in children and osteomalacia and osteoporosis in adults. Hypovitaminosis D (vitamin D insufficiency or deficiency) is observed not only in adults but also in infants, children, and adolescents. Previous studies suggest that sufficient serum vitamin D levels should be maintained in...

Original Article
Antibody response to pneumococcal vaccination in children with chronic or recurrent rhinosinusitis
Ji Hyeon Baek, Hyun Kyong Seo, Hye Mi Jee, Youn Ho Shin, Man Yong Han, Eun Sang Oh, Hyun Ju Lee, Kyung Hyo Kim
Clin Exp Pediatr. 2013;56(7):286-290.   Published online July 19, 2013
Purpose

Although chronic and recurrent rhinosinusitis is prevalent in children, little is known about its causes. Here, we investigated the humoral immunity in children with chronic or recurrent rhinosinusitis.

Methods

We examined 16 children attending the outpatient clinic at the CHA Bundang Medical Center including 11 boys and 5 girls, aged 3.11 years (mean age, 5.6 years), who had rhinosinusitis for >3 months...

Review Article
Endocrine problems in children with Prader-Willi syndrome: special review on associated genetic aspects and early growth hormone treatment
Dong-Kyu Jin
Clin Exp Pediatr. 2012;55(7):224-231.   Published online July 17, 2012

Prader-Willi syndrome (PWS) is a complex multisystem genetic disorder characterized by hypothalamic-pituitary dysfunction. The main clinical features include neonatal hypotonia, distinctive facial features, overall developmental delay, and poor growth in infancy, followed by overeating with severe obesity, short stature, and hypogonadism later in development. This paper reviews recent updates regarding the genetic aspects of this disorder. Three mechanisms (paternal deletion,...

Original Article
Prevalence and risk factors for vitamin D deficiency in children with iron deficiency anemia
Jung Won Yoon, Sung Woo Kim, Eun Gyong Yoo, Moon Kyu Kim
Clin Exp Pediatr. 2012;55(6):206-211.   Published online June 21, 2012
Purpose

The increasing prevalence of breast feeding has led to concerns about vitamin D deficiency (VDD) and iron deficiency anemia (IDA) in children. We evaluated the prevalence of VDD in a population of Korean children with IDA and assessed the risk factors for VDD in these children.

Methods

A total of 79 children who were diagnosed with IDA were prospectively surveyed from April...

Case Report
Acute treatment of hyperammonemia by continuous renal replacement therapy in a newborn patient with ornithine transcarbamylase deficiency
Hyo Jeong Kim, Se Jin Park, Kook In Park, Jin Sung Lee, Ho Sun Eun, Ji Hong Kim, Jae Il Shin
Clin Exp Pediatr. 2011;54(10):425-428.   Published online October 31, 2011

Ornithine transcarbamylase (OTC) deficiency is well known as the most common inherited disorder of the urea cycle, and 1 of the most common causes of hyperammonemia in newborns. We experienced a case of a 3-day-old boy with OTC deficiency who appeared healthy in the first 2 days of life but developed lethargy and seizure soon afterwards. His serum ammonia level...

Original Article
Clinical characteristics and prevalence of vitamin D insufficiency in children less than two years of age
Ji Hyun Yoon, Cheong Soo Park, Ji Young Seo, Yun Sun Choi, Young Min Ahn
Clin Exp Pediatr. 2011;54(7):298-303.   Published online July 31, 2011
Purpose

To evaluate the clinical characteristics of vitamin D deficiency and its association with iron deficiency anemia (IDA).

Methods

A total of 171 children aged less than two years underwent 25-hydroxyvitamin D3 tests between January 2007 and July 2009. The study was classified into two groups: normal and vitamin D insufficiency, by their vitamin 25-hydroxyvitamin D3 levels.

Results

In total, 120 children were in the...

Review Article
Nutritional management of breastfeeding infants for the prevention of common nutrient deficiencies and excesses
Jin Soo Moon
Clin Exp Pediatr. 2011;54(7):282-286.   Published online July 31, 2011

Breastfeeding is the best source of nutrition for every infant, and exclusive breastfeeding for 6 months is usually optimal in the common clinical situation. However, inappropriate complementary feeding could lead to a nutrient-deficient status, such as iron deficiency anemia, vitamin D deficiency, and growth faltering. The recent epidemic outbreak of obesity in Korean children emphasizes the need for us to...

Case Report
A case of intracranial hemorrhage in a neonate with congenital factor VII deficiency
Won Seok Lee, Young Sil Park
Clin Exp Pediatr. 2010;53(10):913-916.   Published online October 31, 2010

Congenital factor VII deficiency is a rare autosomal-recessive bleeding disorder. Bleeding manifestations and clinical findings vary widely, ranging from asymptomatic subjects to patients with hemorrhages that may cause significant handicaps. Treatment has traditionally involved factor VII(FVII) replacement therapy using fresh frozen plasma, prothrombin complex concentrates or plasma-derived FVII concentrates. Recombinant activated FVII (NovoSeven®) is currently considered the first-line treatment for...

Original Article
Prevalence and risk factors of the metabolic syndrome in young adults with childhood-onset hypopituitary growth hormone deficiency
Han Hyuk Lim, Min Jae Kang, In Suk Yun, Young Ah Lee, Choong Ho Shin, Sei Won Yang
Clin Exp Pediatr. 2010;53(10):892-897.   Published online October 31, 2010
Purpose

This study evaluated the prevalence of the metabolic syndrome (MetS) and risk factors for metabolic derangement in young adults with childhood-onset hypopituitary growth hormone deficiency (ACOHGHD).

Methods

Thirty patients with ACOHGHD who were treated with hormone-replacement therapy, aged 18 to 29 years, who visited the Seoul National University Children's Hospital between September 2009 and February 2010 were enrolled. Height, weight, waist circumference,...

Case Report
A case of anemia caused by combined vitamin B12 and iron deficiency manifesting as short stature and delayed puberty
Seung Min Song, Keun Wook Bae, Hoi-Soo Yoon, Ho Joon Im, Jong-Jin Seo
Clin Exp Pediatr. 2010;53(5):661-665.   Published online May 31, 2010

Anemia caused by vitamin B12 deficiency resulting from inadequate dietary intake is rare in children in the modern era because of improvements in nutritional status. However, such anemia can be caused by decreased ingestion or impaired absorption and/or utilization of vitamin B12. We report the case of an 18-year-old man with short stature, prepubertal sexual maturation, exertional dyspnea, and severe...