- Correspondence and reply
- Nephrology (Genitourinary)
- Authors’ reply: a commentary on “Assessing kidney outcomes in childhood-onset lupus nephritis: role of National Institutes of Health-modified histological indices”
- Pornpimol Rianthavorn
- Clin Exp Pediatr. 2026;69(4):364-365. Published online March 6, 2026
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- Correspondence
- Nephrology (Genitourinary)
- A commentary on “Assessing kidney outcomes in childhood-onset lupus nephritis: role of National Institutes of Health-modified histological indices”
- Yanlan Ma, Yunyun Zhu
- Clin Exp Pediatr. 2026;69(4):362-363. Published online March 6, 2026
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- Original Article
- 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
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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.
- Hematology
- Outcomes of hematopoietic stem cell transplantation for pediatric patients with transfusion-dependent thalassemia in Thailand
- 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
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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.
- 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
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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.
- 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
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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.
- 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
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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.
- 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
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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.
- Editorial
- General Pediatrics
- Adiposity rebound in early childhood: understanding body mass index percentiles and monitoring on growth charts to be healthy
- Sochung Chung
- Clin Exp Pediatr. 2026;69(4):301-303. Published online April 1, 2026
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Height, weight, and body mass index percentiles should be tracked in routine childhood health checkups to address the age of adiposity rebound in early childhood. Comprehensive interventional lifestyle counselling in primary practice after growth and nutritional status assessments might be an early, effective strategy for preventing obesity and decreasing the double burden of disease in later life. Therefore, there is an urgent need for a cooperative and supportive health care system.
- Review Article
- Neonatology (Perinatology)
- Optimal postnatal corticosteroid regimens to prevent bronchopulmonary dysplasia with minimal adverse effects
- Ga Won Jeon
- Clin Exp Pediatr. 2026;69(4):293-300. Published online March 27, 2026
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Postnatal corticosteroids facilitate ventilator weaning and reduce the risk of bronchopulmonary dysplasia (BPD). Despite being commonly used in high-risk infants, administration guidelines have not been established. Early dexamethasone may cause neurodevelopmental harm, and the optimal dosing remains uncertain. Inhaled corticosteroids show inconclusive benefits, whereas intratracheal administration with surfactant appears promising. Thus, corticosteroids should be used cautiously in high-risk, ventilator-dependent infants with severe BPD, and further high-quality trials are needed.
- Moving toward meaningful shared decision-making in neonatal care: clinical practice and policy implications in Korea
- In Gyu Song, Trisha M. Prentice, Lynn Gillam
- Clin Exp Pediatr. 2026;69(4):282-292. Published online March 13, 2026
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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.
- Original Article
- Neonatology (Perinatology)
- Validation of a new Japanese classification for predicting severe bronchopulmonary dysplasia in preterm infants
- Masato Ito, Shinya Hirano, Fumihiko Namba
- Clin Exp Pediatr. 2026;69(3):274-281. Published online January 20, 2026
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Question: Can the revised Japanese classification predict severe bronchopulmonary dysplasia (BPD) early in preterm infants?
Finding: Small for gestational age and bubbly/cystic chest radiographic patterns were independently associated with severe BPD, and subtypes I and III showed particularly strong associations.
Meaning: This classification may facilitate early risk stratification and guide timely supportive strategies to prevent progression to severe BPD.
- Thrombocytopenia in preterm infants born to mothers with systemic lupus erythematosus: a retrospective cohort study
- Ru Xue, Guoqing Zhang, Xiafang Chen, Jun Bu, Lanlan Mi, Fei Bei
- Clin Exp Pediatr. 2026;69(3):266-273. Published online December 22, 2025
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Question: What are the characteristics and clinical implications of thrombocytopenia in preterm neonates born to mothers with systemic lupus erythematosus?
Finding: Nearly one-third of preterm infants developed thrombocytopenia. Key modulators of this risk included gestational age, maternal hypertensive disorders of pregnancy, and hydroxychloroquine use. Thrombocytopenia may be associated with neonatal morbidity.
Meaning: Platelet count should be monitored during the first week of life, and infants should be assessed for potential complications.
- 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
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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.
- Other
- Improvements in obesity-related measures among Asian patients with severe obesity following a structured lifestyle intervention
- Pei-Shan Chen, Shu-Mei Tsai, Chih-Hsuan Chang, Hui-Ru Yang, Yen-Ju Huang, Hsiang-Yin Liu, Kai-Chi Chang, Huey-Ling Chen
- Clin Exp Pediatr. 2026;69(3):247-256. Published online December 22, 2025
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Question: How does obesity severity affect baseline fitness and improvements in key obesity-related measures following participation in a structured lifestyle modification program?
Finding: Severely obese youth showed poorer baseline physical fitness but greater improvements in key obesity-related measures following lifestyle interventions.
Meaning: Early targeted intervention may help prevent progression to more severe obesity and declines in physical fitness in patients with obesity.
- 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
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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.
- 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
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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.
- Gastroenterology
- Longitudinal analysis of gut microbiota dysbiosis and bacterial signatures predictive of postoperative enterocolitis in children with Hirschsprung disease
- 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
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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.
- Editorial
- Neonatology (Perinatology)
- Early prediction of bronchopulmonary dysplasia using new classification in high-risk preterm infants
- Ga Won Jeon
- Clin Exp Pediatr. 2026;69(3):211-213. Published online February 25, 2026
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The definition of bronchopulmonary dysplasia (BPD) has continued to evolve. Recently, newer definitions based on respiratory support at 36 weeks’ postmenstrual age better predict long-term outcomes but diagnose BPD relatively late. To address this limitation, the New Japanese Classification uses early postnatal factors, including small for gestational age and bubbly or cystic chest radiographic findings, to predict severe BPD and enable early targeted interventions.
- Review Article
- Immunology
- Multiomics approaches in Kawasaki disease: insights into pathogenesis and emerging directions for diagnosis and treatment
- Jong Gyun Ahn, Insoo Kang
- Clin Exp Pediatr. 2026;69(3):197-210. Published online February 25, 2026
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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....
- 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
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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.
- Clinical Note
- Genetics and Metabolism
- Happle-Tinschert syndrome in an infant: clinical, radiologic and genetic correlation
- Belén Rodríguez-Sanchez, Francisco Javier Narbona-Cárceles, Jorge Martín-Nieto-González, Marina de la Puente-Alonso, Luis Zamarro-Díaz, Luis Jiménez-Briones, Julia Suárez-González, Francisco Arias-Lotto, Minia Campos-Domínguez
- Clin Exp Pediatr. 2026;69(2):182-185. Published online January 20, 2026
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- Original Article
- General Pediatrics
- Global and regional burden of neonatal disorders (preterm birth, encephalopathy, jaundice, and sepsis), 1990–2021 and projections to 2050
- Yuseon Kang, Jeongseon Oh, Dongjin Yeo, Jaeyu Park, Sooji Lee, Na Yun Kim, Jungmin Park, Seung Ha Hwang, Tae Hyeong Kim, Dong Keon Yon
- Clin Exp Pediatr. 2026;69(2):171-181. Published online October 30, 2025
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This study provides the first comprehensive estimated global burden of neonatal disorders attributable to risk factors in 1990–2021 stratified by sex, cause, sociodemographic index (SDI), and region. We identified persistent disparities across SDI levels, with low birthweight and short gestation contributing most to the age-standardized disability-adjusted life year rate of neonatal disorders. These findings highlight the urgent need for targeted context-specific interventions to reduce infant mortality and improve neonatal health equity.
- Associations of routine breakfast and napping habits with early adiposity rebound by age 3 years: a population-based cohort study in Japan
- Toshifumi Yodoshi
- Clin Exp Pediatr. 2026;69(2):163-170. Published online October 22, 2025
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In a population‑based cohort of 74,466 children, 25% experienced early adiposity rebound (AR) by age 3. Daily breakfast and routine napping at 1.5 years were independently associated with lower odds of AR, while obesity at 1.5 years was a strong predictor. These modifiable routines could help delay AR and enable early identification during routine child health checks.
- Bifidobacterium animalis subsp. lactis BLa80 for preventing allergic, respiratory, and gastrointestinal diseases in young children in China: a randomized double-blind placebo-controlled trial
- Ke Chen, Xi Zhang, Kaihong Zeng, Jiayi Zhong, Shanshan Jin, Yang Nie, Ping Yang, Nianyang He, Haixia Chen, Yanmei Cao, Yunrong Fu, Ziji Fang, Wei Jiang, Changqi Lium
- Clin Exp Pediatr. 2026;69(2):150-162. Published online October 30, 2025
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Question: Can probiotic BLa80 bring long-term benefits to the health of young children?
Finding: This trial demonstrated that the daily administration of s BLa80 at 5×109 colony-forming units for 3 months in children can reduce the risk of eczema, upper respiratory tract infections, and acute tracheitis/bronchitis as well as beneficially improve the gut microbiome without any adverse effect.
Meaning: Bla80 can bring definite health benefits to young children.
- Critical Care Medicine
- Telemedicine outcome of mechanically ventilated children in Brazilian pediatric intensive care units
- Aristóteles de Almeida Pires, Luciano Remião Guerra, João Ronaldo Mafalda Krauzer, Luciane Gomes da Cunha, Mariana Motta Dias da Silva, Vanessa Cristina Jacovas, Hilda Maria Rodrigues Moleda Constant, Taís de Campos Moreira, Paulo Márcio Pitrez, Felipe Cezar Cabral
- Clin Exp Pediatr. 2026;69(2):140-149. Published online October 23, 2025
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Question: Telemedicine interventions in Brazilian public pediatric intensive care units effectively address the challenges related to specialized care provision in resource-limited settings.
Finding: The implementation of telemedicine significantly reduced overall mortality rates among mechanically ventilated children (from 20.7% to 10.4%) and increased ventilator-free days from 3 (interquartile range, 0–7) to 4 (interquartile range, 2–8) days.
Meaning: These findings support telemedicine as a viable strategy for enhancing pediatric critical care in public health systems, particularly by improving patient outcomes.
- Nephrology (Genitourinary)
- Assessing kidney outcomes in childhood-onset lupus nephritis: role of National Institutes of Health-modified histological indices
- Nuanpan Penboon, Pornpimol Rianthavorn
- Clin Exp Pediatr. 2026;69(2):130-139. Published online October 23, 2025
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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.
- 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
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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.
- Editorial
- Neurology
- Tocilizumab as a key therapeutic option in high-risk pediatric acute necrotizing encephalopathy
- Jon Soo Kim
- Clin Exp Pediatr. 2026;69(2):114-116. Published online January 26, 2026
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· Acute necrotizing encephalopathy (ANE) is a severe, infection- triggered encephalitis driven primarily by cytokine- mediated immune dysregulation rather than direct viral cytotoxicity.
· Tocilizumab, through targeted inhibition of interleukin-6 signaling, is an important therapeutic option for ANE that may improve survival and neurological outcomes of high-risk pediatric patients.
- 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
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· 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.
