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Review Article
Nutrition
The Korea Infant Physical Growth Examination Survey (KIPGroS): a study protocol
Jong Woo Hahn, MinSoo Shin, Jin Gyu Lim, Yoon-Joo Kim, Ki Soo Kang, Narae Lee, Seong Hee Jeong, Mun Hui Jeong, Yeoun Joo Lee, Eui Kyung Choi, Jung Ok Shim, Jee Yoon Park, Chan-Wook Park, Joo Young Kim, Su Jin Jeong, Young Hwa Jung, Jaehyun Kim, Chang Won Choi, Ju Whi Kim, Seung Han Shin, Yun Jeong Lee, Young Ah Lee, Choong-Ho Shin, Seung-sik Hwang, Young Eun Kim, Youn Ha Kang, Kyungwon Oh, Sungha Yun, Jae Sung Ko, Jin Soo Moon
Clin Exp Pediatr. 2025;68(5):352-358.   Published online February 13, 2025
The suitability of World Health Organization (WHO) growth charts for assessing the growth of children under 3 years of age in all countries remains controversial, and their applicability must be evaluated based on country-specific growth data. The Korea Infant Physical Growth Examination Survey evaluated the suitability of WHO growth charts to contribute to the next revision of growth charts in Korea.
Original Article
Nutrition
Differential effects of dietary and physical activity interventions on adiposity of children with obesity
Anekchoke Tangtongsoong, Chonnikant Visuthranukul, Yuda Chongpison, Sirinuch Chomtho
Clin Exp Pediatr. 2025;68(5):370-378.   Published online February 3, 2025
Question: How do dietary intake and physical activity affect body mass index (BMI) z scores and adiposity among children with obesity?
Finding: Higher dietary protein and fiber intakes were significantly associated with a decrease in BMI z scores and adiposity among children with obesity.
Meaning: Optimizing dietary interventions by focusing on protein and fiber intakes could be an effective strategy for managing childhood obesity.
Perspective
Other
Telemedicine in pediatrics: things to consider
Sandhya J. Kadam, Archana Reddy Bongurala
Clin Exp Pediatr. 2025;68(4):326-328.   Published online February 3, 2025
This article highlights the benefits, challenges, and current significance of telemedicine. Future research is needed, primarily to address the challenges of optimizing the implementation of telehealth. To use telemedicine effectively and efficiently for the timely diagnosis and management of patients, an evaluation of current telemedicine practice is needed. Analysis of shortcomings and advantages can help enhance healthcare delivery to pediatric patients, making it more accessible for future use.
Original Article
COVID-19 vaccine hesitancy among parents of children with systemic lupus erythematosus
Karnchanit Sausukpaiboon, Nuanpan Penboon, Pornpimol Rianthavorn
Background: Coronavirus disease 2019 (COVID-19) vaccination remains an essential strategy for reducing disease burden. Specific guidelines for vaccinating children with systemic lupus erythematosus (SLE) are currently unavailable, highlighting the gap in tailored recommendations for this population.
Purpose: This study aimed to estimate parental intention to vaccinate children with SLE against COVID-19 and identify factors associated with this intention. It also explored...
Review Article
Eosinophil-derived neurotoxin levels can predict allergic disease development and atopic march in children
Zak Callaway, Chang-Keun Kim
In some children, atopic manifestations begin with atopic dermatitis and progress to allergic asthma and allergic rhinitis; of them, a small subset experience food allergies as well. This progression shares genetic and environmental predisposing factors and immunological features, such as allergen-specific T helper type 2 responses, that manifest as specific immunoglobulin E production and eosinophil activation. Eosinophil-derived neurotoxin (EDN), which...
Original Article
Impact of Xmn1 polymorphism on hydroxyurea therapy in children with HbE-βnon-transfusion dependent thalassemia: a cohort study
Saheli Roy, Paramita Bhattacharya, Atanu Kumar Dutta, Mrinal Kanti Das
Background: Fetal hemoglobin (HbF) inducers, among which hydroxyurea is the most extensively used, have shifted the paradigm toward the treatment of non-transfusion-dependent thalassemia (NTDT). Xmn1 polymorphism (rs7482144) is characterized by substitution (C>T) at -158 position of the γ-globin gene, which leads to CC, CT, or TT genotype. Recently, the role of the Xmn1 polymorphism as a modifier of hydroxyurea therapy...
General Pediatrics
The role of serum zinc and selenium levels in etiology of febrile seizures
Yavuz Ataş, Hatice Gamze Poyrazoğlu
Clin Exp Pediatr. 2025;68(5):388-394.   Published online January 13, 2025
Zinc may play a key role in preventing febrile seizures by increasing the seizure threshold and reducing oxidative stress. Incorporating zinc supplements into treatment could help protect children from the adverse effects of febrile seizures and improve their overall outcomes.
Immunology
Serum bactericidal activity against meningococcus in patients with systemic lupus erythematosus
Soyoung Lee, Kyung-Hyo Kim, Ji Hyen Lee, Han Wool Kim
Clin Exp Pediatr. 2025;68(5):362-369.   Published online January 13, 2025
Question: What is the level of immunity against meningococcal infections in patients with systemic lupus erythematosus (SLE) under the age of 19, and is vaccination against meningococcus necessary for these patients, given their susceptibility to infections due to immunosuppressive treatments and disease characteristics?
Finding: Although some of our study patients exhibited serum bactericidal activity against meningococci, most remained seronegative.
Meaning: These findings suggest that patients with SLE who are at risk of meningococcal infection receive appropriate vaccinations.
Review Article
Gastroenterology
Anxiety disorders presenting as gastrointestinal symptoms in children – a scoping review
Anjali Kumar, Pramodh Vallabhaneni
Clin Exp Pediatr. 2025;68(5):344-351.   Published online January 13, 2025
A positive bidirectional relationship between gastrointestinal disorders and anxiety, but with no clear aetiology, was identified. Factors such as somatisation and pain catastrophising resulted in poorer pain-related outcomes in children. Further studies are required to understand this relationship in order to have targeted treatments and ensure better long term outcomes.
Clinical Note
Gastroenterology
Congenital antral web: rare cause of gastric outlet obstruction successfully managed with endoscopic balloon dilatation
Upasana Ghosh, Ujjal Poddar, Srinivas Srinidhi Vadlapudi, Moinak Sen Sarma, Anshu Srivastava
Clin Exp Pediatr. 2025;68(3):266-268.   Published online January 13, 2025
Review Article
Peripheral nerve sheath tumors in the head and neck in patients with APC gene deletion mutations: a case report and scoping review of the literature
Koral Blunt, Monirah Albathi, Miriam Conces, Tendy Chiang
Adenomatous Polyposis Coli (APC) is a tumor suppressor gene expressed throughout the body. APC mutations increase the risk of malignancy and are often characterized by syndromes that encompass a spectrum of neoplastic manifestations, such as familial adenomatous polyposis (FAP). We present a rare case of palatal peripheral nerve sheath tumor in the context of APC gene mutation. A 17-year-old male...
Editorial
Screen time and neurodevelopment in preschoolers: addressing a growing concern in pediatric practice
Soongang Park, Hyewon Woo
Original Article
Prognostic role of midregional proadrenomedullin in predicting infection in pediatric cancer with febrile neutropenia
Seham Ragab, Sara El-Deeb, Ahmed Saeed, Asmaa Mahmoud
Background: Febrile neutropenia (FN) remains an important complication of cytotoxic chemotherapy for which an urgent and appropriate evaluation is imperative.
Purpose: To assess the diagnostic and prognostic roles of mid-regional pro-adrenomedullin (MR-ProADM) levels in predicting infection in patients with FN. Methods: This comparative cross-sectional study included 137 patients with chemotherapy-induced FN. Complete blood count, C-reactive protein (CRP), procalcitonin, and MR-ProADM were...
Gastroenterology
Differences in immune cells and gene expression in human milk by parity on integrated scRNA sequencing
Dae Yong Yi, Hong-Jai Park, Min Sun Shin, Hyoungsu Kim, Sang Jin Lee, Insoo Kang
Clin Exp Pediatr. 2025;68(2):141-152.   Published online January 10, 2025
Question: Is there a difference in immune cells in human breast milk by parity?
Finding: There were higher proportions of monocytes and T/B cells in the primiparous and multiparous group, respectively. The expression of genes with a direct role in the infant immune system and immune response-related genes were highest in the primiparous group
Meaning: There were parity-dependent differences in the expression of genes between innate and adaptive immune cells.
Infection
Enteric pathogens implicated in acute infectious diarrhea among young children in resource-limited region with rapidly growing population: a hospital-based cross-sectional study
Aseel Mahmood Ibrahim Al-Mashahedah, Randa Mohammed Dhahi
Clin Exp Pediatr. 2025;68(5):379-387.   Published online December 23, 2024
Question: What are the most common enteric pathogens in acute diarrhea among children younger than 5 years of age, and which age group is most susceptible?
Finding: Bacteria were the most common causative microorganisms of diarrhea, followed by viruses, parasites, and fungi. The 1–2-year age group was the most commonly affected.
Meaning: There is a need to formulate preventive strategies targeting children exposed to enteric pathogens to limit diarrhea.
Review Article
Neonatology (Perinatology)
Recent advances in understanding pathophysiology of non-nutritional stunting in very preterm infants
Eduardo Cuestas, Alina Rizzotti
Clin Exp Pediatr. 2025;68(4):287-297.   Published online December 23, 2024
· Previous reviews of extrauterine growth restriction focused mainly on weight growth restriction caused by nutritional factors or pathological conditions.
· This review summarizes recent developments in the pathophysiology of nonnutritional length growth restriction in very preterm infants with focus on the impact of sustained neonatal inflammation on their short- and long-term outcomes.
· Further research is needed to investigate optimal strategies to improve length growth restriction in very preterm infants.
Original Article
Differential roles of IL-6 and adrenomedullin in early diagnosis and mortality predictions in late-onset neonatal sepsis
Emilly Henrique dos Santos, Gabriel Acca Barreira, Mariana Okay Saippa, Maria Carolina Pires Cruz, Karen Alessandra Rodrigues, Ronaldo Arkader, Thelma Suely Okay
Background: Diagnosing and predicting neonatal sepsis is challenging because of its nonspecific symptoms, lack of diagnostic criteria consensus, and absence of early, sensitive, and specific diagnostic laboratory tests.
Purpose: To evaluate the diagnostic and prognostic potential of adrenomedullin (ADM), interleukin-6 (IL-6), and C-reactive protein (CRP) in late-onset neonatal sepsis (LOS). Methods: We studied 53 neonates with culture-proven LOS by sampling...
Nephrology (Genitourinary)
C3 glomerulopathy in children: experience at a resource-limited center
Soumya Reddy, Abhishek Ghante, Mahesha Vankalakunti, Anil Vasudevan
Clin Exp Pediatr. 2025;68(4):311-318.   Published online November 28, 2024
Question: What are the clinicopathological features and outcomes of pediatric C3 glomerulopathy (C3G) in resource-limited settings?
Finding: Children with C3G in resource-limited settings have significant morbidities, and most experience kidney sequelae despite treatment. Electron microscopy was performed in only 50% of our patients, while none received complement assays or genetic testing.
Meaning: Pediatric C3G presentation, management, and kidney outcomes vary. Its thorough evaluation and management are challenging in resource-limited settings.
Editorial
Neonatology (Perinatology)
Advancements and challenges in neonatal resuscitation: embracing laryngeal mask airways for improved outcomes
Jang Hoon Lee
Clin Exp Pediatr. 2025;68(4):298-299.   Published online November 28, 2024
Positive pressure ventilation (PPV) is the most critical intervention provided during delivery room resuscitation. In the new guidelines, this recommendation has been expanded to suggest the use of laryngeal mask airyway (LMA) versus face masks for PPV. Evidence-based information and hands-on training related to this practice will help more healthcare providers become familiar with and appropriately use LMA during delivery room resuscitations.
Review Article
Cardiology
Lifelong impact of elevated blood pressure from childhood to adulthood
Junhyun Kwon, Eunji Kim
Clin Exp Pediatr. 2025;68(4):278-286.   Published online November 28, 2024
· Childhood blood pressure (BP) is significantly associated with adult hypertension and cardiovascular disease.
· Despite ongoing debate regarding the need for regular BP screening and early pharmacotherapy in children, the benefits of optimizing BP throughout childhood are clear.
· Childhood presents a critical window for normalizing BP through lifestyle modifications such as reducing sodium intake and increasing physical activity to promote lifelong cardiovascular health and prevent longterm complications.
Neurology
Cerebral organoid research for pediatric patients with neurological disorders
Jin Eun, Jung Eun Lee, Seung Ho Yang
Clin Exp Pediatr. 2025;68(4):269-277.   Published online November 28, 2024
Cerebral organoids obtained from human induced pluripotent stem cells are transforming the study of pediatric neurological diseases by providing more accurate models of human brain development and pathology. These advancements have improved pathology modeling and the potential for novel therapeutic approaches despite existing challenges such as reproducibility and vascularization.
Original Article
Genetics and Metabolism
Long-term follow-up of neurocognitive function in patients with citrin deficiency and cholestasis
Meng-Ju Melody Tsai, Jung-Chi Chang, Heng-Yu Lu, Susan Shur-Fen Gau, Yin-Hsiu Chien, Wuh-Liang Hwu, Yen-Hsuan Ni, Huey-Ling Chen, Ni-Chung Lee
Clin Exp Pediatr. 2025;68(3):257-265.   Published online November 28, 2024
Question: Do transient metabolic disturbances in early childhood due to citrin deficiency have lasting effects on neurocognitive function?
Finding: Children with citrin deficiency have a higher prevalence of ADHD compared to the general population, with elevated ammonia levels in infancy associated with increased hyperactivity-impulsivity risk.
Meaning: Metabolic disturbances in early childhood due to citrin deficiency may contribute to long-term neurocognitive impacts, particularly ADHD, while IQ and life outcomes generally remain normal.
Review Article
Endocrinology
Hidden link between endocrine-disrupting chemicals and pediatric obesity
Min Won Shin, Shin-Hye Kim
Clin Exp Pediatr. 2025;68(3):199-222.   Published online November 28, 2024
Studies indicate potential connections between exposure to endocrine-disrupting chemicals (EDCs) and childhood obesity. Variations in the impact of EDCs in epidemiological studies may result from differences in exposure concentrations and timing, measurement methods, and interactive effects of multiple EDCs. Longitudinal studies on exposure to multiple EDCs are crucial to elucidating their contribution to pediatric obesity and minimize the adverse health consequences of EDC exposure.
Letter to the Editor
Other
Adolescent hypertension and carotid intima-media thickness: significance of submillimetric differences
Christian Saleh
Clin Exp Pediatr. 2025;68(1):104-105.   Published online November 28, 2024
Original Article
Infection
Clinical, biochemical, and genetic study of TACE/TNF-α/ACE signaling pathway in pediatric COVID-19 infection
Ahmed El-Abd Ahmed, Sawsan M.A. Abuhamdah, Mohammed H. Hassan, Nagwan I. Rashwan, Eman A. Abd-Elmawgood, Haggagy Mansour, Hoda S. Sherkawy, Shymaa G. Rizk
Clin Exp Pediatr. 2024;67(12):704-717.   Published online November 27, 2024
Question: Is the tumor necrosis factor (TNF) signaling pathway (TNF-α-converting enzyme [TACE]/TNF-α/angiotensin converting enzyme [ACE]) involved in pediatric coronavirus disease 2019 (COVID-19) infection?
Finding: Significantly increased circulating TACE/TNF-α and decreased ACE2 levels were noted. TNF-α-308G/A plays a significant role in susceptibility to COVID-19 infection among children. The ACE (I/D) (rs4646994) and ACE2 (rs2285666) single nucleotide polymorphisms lack significant associations with pediatric COVID-19 infection.
Meaning: The TNF signaling pathway participates in pediatric COVID-19 infection.
Clinical Note
Oncology
Right ventricular mass in a 10-year-old girl with osteosarcoma: an unusual case of asymptomatic cardiac metastasis
Jun Ah Lee, Hyun-Ju Lim, Jong Woong Park, Sang-Hoon Shin, Mi Hyang Kwak
Clin Exp Pediatr. 2024;67(12):725-727.   Published online November 26, 2024
Editorial
Other
Further research on impact of microplastics on children's health is essential to protecting future generations
Jongin Lee, Dong-Wook Lee
Clin Exp Pediatr. 2025;68(5):359-361.   Published online November 13, 2024
· The ecological impacts of microplastics have been documented. It was recently recognized that they can directly or indirectly cause diseases in humans.
· There are few established methods for assessing human exposure to microplastics.
· Standardization of exposure assessments and large-scale epidemiological studies are required to explore the human effects of microplastics.
Original Article
Pulmonology
Impact of obesity on pulmonary function of preschool children: an impulse oscillometry study
Anuvat Klubdaeng, Kanokporn Udomittipong, Apinya Palamit, Pawinee Charoensittisup, Khunphon Mahoran
Clin Exp Pediatr. 2025;68(4):319-325.   Published online November 13, 2024
Question: Does obesity in preschool children affect lung function, and which obesity indices can predict such alterations?
Finding: Preschool children with obesity exhibit impaired lung function characterized by elevated total and peripheral airway resistance. Waist-to-height ratio was the strongest predictor of such changes.
Meaning: Early obesity prevention and treatment are needed. Monitoring waist-to-height ratio, body weight, and body mass index may help identify children at risk of altered lung function.
Neurology
Occurrence of stroke in children and young adults in Indonesia: a multicenter private hospital study
Jeanne Leman, Veli Sungono, Yosua Timotius Haryono, Muhammad Adam Mudzakir, Dewi Lestari Rahmawati, Callistus Bruce Henfry Sulay, Gilbert Sterling Octavius
Clin Exp Pediatr. 2025;68(4):303-310.   Published online November 13, 2024
Question: What is the occurrence of pediatric stroke in Indonesia?
Finding: This multicenter study identified 1,074 stroke cases, predominantly hemorrhagic (83.4%), with males and older children at higher risk. Accidents were the primary cause (73.2%).
Meaning: Pediatric stroke in Indonesia shows critical epidemiological trends, highlighting the need for targeted prevention efforts, particularly for high-risk groups like males and accident victims.
Editorial
General Pediatrics
Global breastfeeding efforts: a long way to go
Hye-Jung Shin
Clin Exp Pediatr. 2025;68(4):300-302.   Published online November 13, 2024
· Despite much effort, breastfeeding practices remain unsatisfactory worldwide.
· Effective breastfeeding-promoting interventions are needed that are appropriate for age, culture, and social environment.
· Interventions can promote breastfeeding, especially in younger populations such as adolescent mothers.
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