Clinical and Experimental Pediatrics

Clinical note

Immunology

Salivary and lacrimal gland enlargement with serum immunoglobulin G4 elevation

Jinseok Lee, Da-Eun Kim, Jeong-Hwan Yang, Misun Lim, Hye Yung Yum, JoongGon Kim

Clin Exp Pediatr. 2021;64(2):93-95. Published online December 8, 2020

Question: What diseases should be considered in a 15-year-old girl presenting enlarged lacrimal and salivary glands?
Finding: Laboratory tests revealed elevated IgG4 levels. A submandibular gland biopsy showed lymphoplasmacytic infiltration and more than 40 immunoglobulin G4 (IgG4)-positive cells per high-power field. The patient was diagnosed with IgG4-related disease.
Meaning: Although rare in children, IgG4-related disease should be considered a differential diagnosis in children with enlarged salivary and lacrimal glands.

DOI: https://doi.org/10.3345/cep.2020.01319

Original Article

Hematology

Changes in the prevalence of anemia in Korean adolescents, 1998–2018

Jun Young An, Yoo Rha Hong, Seom Gim Kong

Clin Exp Pediatr. 2021;64(2):86-92. Published online November 16, 2020

Web of Science 2 Crossref 2

Question: Over the past 21 years, has the prevalence of anemia decreased among Korean adolescents?
Finding: The prevalence of anemia in boys aged 10–18 years decreased from 3.0% to 0.5% over the study period, whereas that in girls did not change significantly over time (increased from 7.9% to 8.5%).
Meaning: The prevalence of anemia in female adolescents remains high, requiring attention and efforts to improve it.

DOI: https://doi.org/10.3345/cep.2020.01508

Gastroenterology

Value of the International Classification of Diseases code for identifying children with biliary atresia

Pornthep Tanpowpong, Chatmanee Lertudomphonwanit, Pornpimon Phuapradit, Suporn Treepongkaruna

Clin Exp Pediatr. 2021;64(2):80-85. Published online August 24, 2020

Web of Science 1 Crossref 1

Question: What is the value of the diagnostic code in identifying cases of biliary atresia in a large administrative database?
Finding: The diagnostic code’s accuracy and sensitivity are acceptable for identifying algorithm-defined cases. A history of pale stool and a presumed diagnosis of biliary atresia prior to referral added value.
Meaning: The addition of clinical data to the diagnostic code significantly increased the diagnostic yield.

DOI: https://doi.org/10.3345/cep.2020.00423

Editorial

Hematology

Time to pay attention to anemia in female adolescents

Jae Min Lee

Clin Exp Pediatr. 2021;64(2):78-79. Published online February 1, 2021

Web of Science 1 Crossref 1

DOI: https://doi.org/10.3345/cep.2020.02117

Cardiology

Where should we start to improve pediatric heart transplantation outcomes?

Jinyoung Song

Clin Exp Pediatr. 2021;64(2):76-77. Published online November 25, 2020

· Pediatric heart transplantation is achieving better outcomes.
· The waitlist mortality is still high, especially in Korea, and should be reduced.
· The use of ventricular assist device is promising and might offer improved waitlist mortality rates.

DOI: https://doi.org/10.3345/cep.2020.00584

Review Article

General Pediatrics

Clinical features, diagnosis, and outcomes of multisystem inflammatory syndrome in children associated with coronavirus disease 2019

Ji Hee Kwak, Soo-Young Lee, Jong-Woon Choi; the Korean Society of Kawasaki Disease

Clin Exp Pediatr. 2021;64(2):68-75. Published online December 30, 2020

Web of Science 57 Crossref 61

Hundreds of cases of children and adolescents with hyperinflammatory responses such as Kawasaki disease have been reported amid the coronavirus disease 2019 (COVID-19) pandemic, leading to coining of the new term COVID-19–associated multisystem inflammatory syndrome in children. In this review article, we introduce the illness and describe its case definitions, epidemiology, pathogenesis, clinical features, treatments, and outcomes.

DOI: https://doi.org/10.3345/cep.2020.01900

Allergy

Eosinophils and childhood asthma

Bong Seok Choi

Clin Exp Pediatr. 2021;64(2):60-67. Published online January 6, 2021

Web of Science 9 Crossref 10

•In allergic eosinophilic asthma, eosinophils act as important effector cells and antigen-presenting cells, while in nonallergic eosinophilic asthma, type 2 innate lymphoid cells play an important role in eosinophil activation.
•Sputum eosinophil counts can be helpful for evaluating allergic airway inflammation in asthma.
• Anti-interleukin-5 has broadened the scope of asthma treatment.

DOI: https://doi.org/10.3345/cep.2020.00717

Cardiology

Pediatric heart transplantation: how to manage problems affecting long-term outcomes?

Young Hwue Kim

Clin Exp Pediatr. 2021;64(2):49-59. Published online April 8, 2020

Crossref 5

Since the initial International Society of Heart Lung Transplantation registry was published in 1982, the number of pediatric heart transplantations has increased markedly, reaching a steady state of 500–550 transplantation annually and occupying up to 10% of total heart transplantations. Heart transplantation is considered an established therapeutic option for patients with end-stage heart disease. The long-term outcomes of pediatric heart...

DOI: https://doi.org/10.3345/cep.2019.01417

Perspective

Infection

Addressing children’s health amid the coronavirus disease 2019 pandemic

Young June Choe, Bilal Aurang Zeb Durrani, Stefan Swartling Peterson

Clin Exp Pediatr. 2021;64(2):46-48. Published online December 15, 2020

Web of Science 1 Crossref 1

In the coronavirus disease 2019 (COVID-19) pandemic, children experience heightened barriers to health and protective services. Children may also be disproportionately affected due to their reliance on the education system for daily tasks and lack of access to remote learning options. Republic of Korea findings on how vaccination coverage could be sustained in children and schools could be reopened without aggravating COVID-19 underlie the need for coordinated efforts across sectors.

DOI: https://doi.org/10.3345/cep.2020.01473

Letter to the Editor

Neonatology (Perinatology)

Role of neutrophil CD11b expression in diagnosis of earlyonset neonatal sepsis in full-term infant

Safaa ELMeneza, Walaa Mohamed, Iman Elbagoury, Karima Bahagat

Clin Exp Pediatr. 2021;64(1):44-45. Published online April 14, 2020

Web of Science 6 Crossref 6

Question: Can CD11b detect sepsis in full-term infants with suspected sepsis?
Finding: The percentage of neutrophils expressing CD11b was significantly upregulated in the sepsis and suspected sepsis groups versus the control group.
Meaning: CD11b is a sensitive marker for sepsis and suspected sepsis in full-term neonates and it may be added to sepsis markers. This information would allow the neonatologist to confidently discontinue antibiotic use as long as the neonate is clinically stable.

DOI: https://doi.org/10.3345/cep.2019.01319

Original Article

Neonatology (Perinatology)

The protective effect of CXC chemokine receptor 2 antagonist on experimental bronchopulmonary dysplasia induced by postnatal systemic inflammation

Seung Hyun Lee, Chang Won Choi

Clin Exp Pediatr. 2021;64(1):37-43. Published online July 15, 2020

Web of Science 3 Crossref 3

Question: Can CXC chemokine receptor 2 (CXCR2) antagonist preserve alveolarization by attenuating the inflammation induced by systemic lipopolysaccharide (LPS) administration in a rat model of bronchopulmonary dysplasia (BPD)?
Finding: CXCR2 antagonist significantly decreased neutrophil counts in bronchoalveolar lavage fluid and peripheral blood induced by systemic LPS administration and restored alveolarization in newborn rats.
Meaning: CXCR2 antagonist protected the lungs from the inflammation in a rat model of BPD.

DOI: https://doi.org/10.3345/cep.2020.00381

Gastroenterology

Noninvasive markers for esophageal varices in children with cirrhosis

Parisa Rahmani, Fatemeh Farahmand, Ghobad Heidari, Azadeh Sayarifard

Clin Exp Pediatr. 2021;64(1):31-36. Published online July 21, 2020

Web of Science 8 Crossref 9

Question: Can noninvasive biomarkers identify esophageal varices among children with esophageal cirrhosis?
Finding: The spleen size, platelet count, international normalized ratio, aspartate aminotransferase to platelet ratio index, platelet count to spleen size ratio, and risk score differed significantly between the patients with and those without esophageal varices.
Meaning: These biological parameters can predict esophageal varices among pediatric patients and indicate the need for esophagogastroduodenoscopy.

DOI: https://doi.org/10.3345/cep.2019.01599

Editorial

Neonatology (Perinatology)

Neutrophil CD11b as a promising marker for early detection of neonatal sepsis

Ju Sun Heo

Clin Exp Pediatr. 2021;64(1):28-30. Published online September 1, 2020

Web of Science 3 Crossref 3

· Neonatal sepsis is a global problem and significant cause of neonatal mortality and adverse short- and long-term outcomes.
· Due to severe limitations diagnosing neonatal sepsis, there is a critical need to identify reliable specific biomarkers for early detection.
· nCD11b might be an accurate and rapid biomarker for the early detection of neonatal sepsis.

DOI: https://doi.org/10.3345/cep.2020.00626

General Pediatrics

Why should we be concerned about early menarche?

Hae Sang Lee

Clin Exp Pediatr. 2021;64(1):26-27. Published online July 13, 2020

Crossref 25

· Early menarche is associated with several health problems in later life.
· Early menarche can be caused by environmental factors such as increased subcutaneous fat, a high body mass index, and sugar-sweetened beverages as well as genetic factors.
· Health education can prevent early menarche by aiming to reduce the consumption of fructose, high concentrations of which are present in sugar-sweetened beverages.

DOI: https://doi.org/10.3345/cep.2020.00521

Review Article

Gastroenterology

Changing prevalence of Helicobacter pylori infection in children and adolescents

Ji Sook Park, Jin Su Jun, Ji-Hyun Seo, Hee-Shang Youn, Kwang-Ho Rhee

Clin Exp Pediatr. 2021;64(1):21-25. Published online July 15, 2020

Web of Science 32 Crossref 35

Although Helicobacter pylori infection rate in children is unclear due to diversity and limitation of diagnostic tests unlike in adults, investigation the childhood prevalence is important for predicting H. pylori-related diseases in the future.
H. pylori infection occurred in early childhood, and declined during 30 years in our study.
Change in risk factors of H. pylori transmission and consensus for eradication therapy in children might further reduce the infection rate.

DOI: https://doi.org/10.3345/cep.2019.01543

Endocrinology

Early menarche and its consequence in Korean female: reducing fructose intake could be one solution

Ji Hyun Kim, Jung Sub Lim

Clin Exp Pediatr. 2021;64(1):12-20. Published online May 14, 2020

Web of Science 12 Crossref 10

In Korea, the average age of menarche has declined sharply. Early menarche is associated with psychosocial and behavioral problems and cardiometabolic disease. Excess fructose intake has been suggested as one cause of early menarche in recent studies, so reducing fructose intake may be one solution.

DOI: https://doi.org/10.3345/cep.2019.00353

Other

Review of epidemiological studies on air pollution and health effects in children

Jong-Tae Lee

Clin Exp Pediatr. 2021;64(1):3-11. Published online June 10, 2020

Web of Science 22 Crossref 22

This review summarized the accumulated epidemiologic evidence with emphasis on studies conducted in Korea and heterogeneity in the literature. Based on systematic reviews and meta-analyses, there is consistent evidence on the association between exposure to ambient air pollution and children’s health, especially respiratory health and adverse birth outcomes, and growing evidence on neurodevelopmental outcomes.

DOI: https://doi.org/10.3345/cep.2019.00843

Perspective

Neurology

How can pediatricians treat neurodevelopmental disorders

Young-Hoon Kim

Clin Exp Pediatr. 2021;64(1):1-2. Published online July 27, 2020

Web of Science 1 Crossref 2

∙ Recently neurodevelopmental therapy for preschool-aged children with neurodevelopmental disorders is paid for by health insurance in Korea.
∙ There are good evidences that parenting programs and neurodevelopmental therapy can work in attention deficit hyperactivity disorder and autism spectrum disorder.
∙ Pediatricians must be able to pass away important information to parents.

DOI: https://doi.org/10.3345/cep.2020.00507

Clinical note

Infection

Coronavirus disease 2019 in a 2-month-old male infant: a case report from Iran

Hosein Heydari, Seyed Kamal Eshagh Hossaini, Ahmad Hormati, Mahboubeh Afifian, Sajjad Ahmadpour

Clin Exp Pediatr. 2020;63(12):499-502. Published online September 21, 2020

Crossref 1

DOI: https://doi.org/10.3345/cep.2020.00941 Retraction in: Clin Exp Pediatr 2022;65(8):417

Original Article

Nephrology (Genitourinary)

Sonographic renal length and volume of normal Thai children versus their Chinese and Western counterparts

Chantima Rongviriyapanich, Thanarat Sakunchit, Chirawat Sudla, Supamas Mungkung, Napapong Pongnapang, Chai Hong Yeong

Clin Exp Pediatr. 2020;63(12):491-498. Published online July 13, 2020

Crossref 4

Question: What is the normal renal size of Thai children and is the renal nomogram comparable to those of Western and Chinese cohorts?
Finding: The renal length of Thai children was moderately correlated with that of Western children, while the age-specific renal volume was significantly smaller than that of Chinese children.
Meaning: Renal size in children can vary among regions and sociodemographic backgrounds; hence, a local reference standard is needed.

DOI: https://doi.org/10.3345/cep.2019.01676

Gastroenterology

Evaluating the effects of probiotics in pediatrics with recurrent abdominal pain

Parisa Rahmani, Azin Ghouran-orimi, Farzaneh Motamed, Alireza Moradzadeh

Clin Exp Pediatr. 2020;63(12):485-490. Published online July 21, 2020

Web of Science 16 Crossref 17

Question: ecurrent abdominal pain (RAP) is a chief complaint among pediatrics and is associated with reduced quality of life, for both parent and child, and economic burden. Does probiotics reduce the frequency of RAP among children?
Finding: This study reported the effects of Lactobacillus reuteri probiotics among children with RAP as a result of multiple etiologies.
Meaning: The administration of probiotic supplements is significantly associated with pain relief among RAP children presented with functional abdominal pain, irritable bowel syndrome, and functional dyspepsia.

DOI: https://doi.org/10.3345/cep.2019.01613

Editorial

Allergy

Insights into pediatric pollen food allergy syndrome

Jeong Hee Kim

Clin Exp Pediatr. 2020;63(12):483-484. Published online June 1, 2020

Web of Science 1 Crossref 2

DOI: https://doi.org/10.3345/cep.2019.01179

Review Article

Infection

The COVID-19 pandemic: an unprecedented tragedy in the battle against childhood obesity

Maximilian Andreas Storz

Clin Exp Pediatr. 2020;63(12):477-482. Published online November 5, 2020

Web of Science 56 Crossref 60

Large-scale quarantine and home confinement during the coronavirus disease 2019 (COVID-19) pandemic will impose new and unfamiliar stressors on children, thereby worsening the childhood obesity epidemic. Physical, nutritional, and psychosocial factors that promote obesity in children during this special situation complementarily contribute to an unprecedented obesogenic environment. Involved stakeholders, including governments, schools, and families, must make all efforts to minimize the impact of the COVID-19 epidemic on childhood obesity.

DOI: https://doi.org/10.3345/cep.2020.01081

Pulmonology

Current perspectives on atypical pneumonia in children

Jung Yeon Shim

Clin Exp Pediatr. 2020;63(12):469-476. Published online June 10, 2020

Web of Science 16 Crossref 22

Macrolides are the first line treatment in atypical pneumonia caused by M. pneumoniae, C. pneumoniae, and L. pneumophila. Macrolide-resistant mycoplasma pneumonia (MRMP) is emerging worldwide, especially in East Asia. Immune modulators such as corticosteroids or second line antibiotics are treatment options for MRMP. Pediatricians should be careful with empirical therapy of macrolides in children with mild to moderate community-acquired pneumonia not to increase the risk of MRMP.

DOI: https://doi.org/10.3345/cep.2019.00360

Allergy

Pollen-food allergy syndrome in children

You Hoon Jeon

Clin Exp Pediatr. 2020;63(12):463-468. Published online May 14, 2020

Web of Science 11 Crossref 16

The prevalence of pollen-food allergy syndrome (PFAS) in Korean children with pollen allergy was recently reported to be 42.7%. PFAS can cause a wide range of symptoms from mild allergy to severe anaphylaxis depending on the nature of food allergens that share the epitopes with pollen. Cases of anaphylaxis caused by PFAS have recently increased. Treatments for PFAS should be individualized for patients according to the severity of symptoms.

DOI: https://doi.org/10.3345/cep.2019.00780

Guideline

Endocrinology

2017 Clinical practice guidelines for dyslipidemia of Korean children and adolescents

Jung Sub Lim, Eun Young Kim, Jae Hyun Kim, Jae-Ho Yoo, Kyung Hee Yi, Hyun Wook Chae, Jin-Ho Choi, Ji Young Kim, Il Tae Hwang; the Committee of Dyslipidemia of Korean Children and Adolescents on behalf of Korean Society of Pediatric Endocrinology (KSPE)

Clin Exp Pediatr. 2020;63(12):454-462. Published online November 25, 2020

Web of Science 9 Crossref 9

Question: How are children and adolescents with dyslipidemia treated and managed in Korea?
Finding: 2017 guidelines recommend to measure nonfasting non-HDL-C as a screening test and introduce new diet methods: Cardiovascular Health Integrated Lifestyle Diet (CHILD)-1, CHILD-2-low-density lipoprotein cholesterol, and CHILD-2-triglyceride. Statin is the only drug approved in children older than 10 years.
Meaning: New clinical practice guidelines for treating and managing dyslipidemia of Korean children and adolescents are provided.

DOI: https://doi.org/10.3345/cep.2020.01340

Clinical Note

Allergy

Recurrent urticaria caused by specific cat serum albumin IgE cross-reacting with pork serum albumin

Cheon Kim, Sung Won Kim, Yoon Ha Hwang

Clin Exp Pediatr. 2020;63(11):451-453. Published online April 6, 2020

Web of Science 2 Crossref 1

Question: What should be considered in children who complain of pork allergies?
Finding: History of raising a cat, the onset of symptoms after the ingestion of pork and specific IgE tests to pork, cat, milk, and Alpha-gal are needed.
Meaning: Pork cat syndrome could be the cause of pork allergies.

DOI: https://doi.org/10.3345/cep.2019.01725

Original Article

Gastroenterology

Acquired noncaustic esophageal strictures in children

Elif Sag, Aysenur Bahadir, Mustafa Imamoglu, Sefa Sag, Gokce Pinar Reis, Erol Erduran, Murat Cakir

Clin Exp Pediatr. 2020;63(11):447-450. Published online October 15, 2020

Web of Science 2 Crossref 4

Question: Which clinical findings suggest esophageal structure in children with dysphagia?
Finding: The presence of solid dysphagia, malnutrition, and a comorbid condition is suggestive of esophageal stricture in children with dysphagia.
Meaning: Patients with findings suggestive of noncaustic esophageal stricture should receive early referral to pediatric gastroenterology units.

DOI: https://doi.org/10.3345/cep.2020.00199

Developmental and Behavioral Medicine

Development of the Korean Developmental Screening Test for Infants and Children (K-DST)

Hee Jung Chung, Donghwa Yang, Gun-Ha Kim, Sung Koo Kim, Seoung Woo Kim, Young Key Kim, Young Ah Kim, Joon Sik Kim, Jin Kyung Kim, Cheongtag Kim, In-Kyung Sung, Son Moon Shin, Kyung Ja Oh, Hee-Jeong Yoo, Hee Joon Yu, Seoung-Joon Lim, Jeehun Lee, Hae-Ik Jeong, Jieun Choi, Jeong-Yi Kwon, Baik-Lin Eun

Clin Exp Pediatr. 2020;63(11):438-446. Published online May 14, 2020

Web of Science 35 Crossref 37

Question: Can the Korean Developmental Screening Test for Infants and Children (K-DST) be a useful screening tool for infants and children in Korea?
Finding: The K-DST has high reliability (internal consistency of 0.73–0.93, test-retest reliability of 0.77–0.88) and a high discriminatory ability with a sensitivity of 0.833 and specificity of 0.979.
Meaning: The K-DST is an effective and reliable screening tool for infants and children with neurodevelopmental disorders in Korea.

DOI: https://doi.org/10.3345/cep.2020.00640

Neonatology (Perinatology)

Knowledge and perceptions of kangaroo mother care among health providers: a qualitative study

Hadi Pratomo, Tiara Amelia, Fatmawati Nurlin, Asri C. Adisasmita

Clin Exp Pediatr. 2020;63(11):433-437. Published online July 21, 2020

Web of Science 7 Crossref 7

Question: What are health providers’ knowledge and perceptions of Kangaroo mother care (KMC)?
Finding: Health providers’ knowledge of KMC was sufficient; however, some of their perceptions about it could create barriers to the successful implementation of hospital KMC programs.
Meaning: Health providers’ perceptions about KMC should be considered to ensure successful KMC implementation. Locally designed on-site training programs could overcome the challenges.

DOI: https://doi.org/10.3345/cep.2018.06506

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