Clinical and Experimental Pediatrics

Review Articles

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

Allergy

Update on pediatric allergic rhinitis: narrative review based on guideline updates

Jung Yeon Shim

Clin Exp Pediatr. 2026;69(6):473-483. Published online May 28, 2026

Intranasal corticosteroids remain the cornerstone treatment for moderate to severe allergic rhinitis. The 2024–2025 Allergic Rhinitis and its Impact on Asthma guideline update suggests that fixed intranasal antihistamine–intranasal corticosteroid combinations may provide greater symptom control in allergic rhinitis than either agent alone. A control-based patient-centered approach that incorporates real-world evidence is essential for optimizing treatment outcomes in children.

DOI: https://doi.org/10.3345/cep.2026.00444

Editorial

Cardiology

Beyond morphometry: the atrial septal defect pressure gradient as a dynamic predictor of mitral valve growth in borderline left hearts

Han Ki Park

Clin Exp Pediatr. 2026;69(6):484-485. Published online May 27, 2026

Traditional morphometric scores often fail to predict the success of biventricular repair of borderline left hearts. Wang et al. demonstrated that a low atrial septal defect (ASD) pressure gradient is a critical functional predictor of mitral valve growth. By integrating ASD hemodynamics with anatomical data, clinicians can better identify candidates for biventricular repair, proving that the "grey zone" is narrower than previously thought and improving outcomes for vulnerable neonates.

DOI: https://doi.org/10.3345/cep.2026.01081

Original Articles

Endocrinology

Thyroid peroxidase gene variants and susceptibility to congenital hypothyroidism and autoimmune thyroid disease among Egyptian pediatric cohort

Hala M. Sakhr, Mohammed H. Hassan, Esraa Abbass Abdallah, Amira Mahmoud Ewis, Mohamed Hesham Mohamed, Shymaa Gaber Rizk

Clin Exp Pediatr. 2026;69(6):486-496. Published online March 26, 2026

Question: Which factors influence pediatric thyroid disorder susceptibility and severity?
Finding: Anemia, selenium deficiency, excess copper, and the thyroid peroxidase (TPO) Arg³⁸⁶His polymorphism, especially with the histidine/histidine genotype, are strongly associated with pediatric thyroid disease and high thyroid-stimulating hormone levels.
Meaning: Pediatric thyroid disorders are multifactorial. The TPO Arg³⁸⁶His variant may help identify children at higher risk of severe thyroid dysfunction, enabling earlier diagnosis, improved risk stratification, and more personalized clinical management.

DOI: https://doi.org/10.3345/cep.2025.02957

Pulmonology

High-Risk CCL14 lineage drives severe Mycoplasma pneumoniae pneumonia in children: a study in central China

Chunbo Hao, Zijie Li, Yanjuan Yu, Song Wang, Genhao Wang, Gaijing Jia, Tiantian Sun, Shouhang Chen, Yang Wu, Yu Tang, Fang Wang, Guangcai Duan, Yuefei Jin

Clin Exp Pediatr. 2026;69(6):497-507. Published online April 10, 2026

Crossref 1

Question: Are the predominant circulating strains of Mycoplasma pneumoniae associated with disease severity and clinical indicators?
Finding: The common cluster label 14 (CCL14) lineage was a high-risk clone circulating in central China that demonstrated a strong association between severe pediatric pneumonia and a distinct hyperinflammatory profile.
Meaning: Targeted molecular surveillance of the CCL14 lineage may facilitate early risk stratification and guide clinical management to reduce the burden of severe disease.

DOI: https://doi.org/10.3345/cep.2025.02796

Endocrinology

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

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

Clinical Notes

Gastroenterology

Ultrasonographic features of 5-aminosalicylic acid intolerance in pediatric ulcerative colitis

Hirotoki Murashige, Yasufumi Sakata, Yoshihiro Azuma, Shunji Hasegawa

Clin Exp Pediatr. 2026;69(6):524-526. Published online May 28, 2026

DOI: https://doi.org/10.3345/cep.2025.02446

Esophagopleural fistula following coin impaction in a female toddler: successful management using through-the-scope clips

Sarthak Chakrabarti, Nikhil Sonthalia, Kaustabh Chaudhuri, Tamashis Mukherjee, Uday Chand Ghoshal, Mahesh Kumar Goenka

Clin Exp Pediatr. 2026;69(6):527-530. Published online May 14, 2026

DOI: https://doi.org/10.3345/cep.2026.00654

Cited By 50	Prevalence of anxiety, depression, and stress among parents of neonates admitted to neonatal intensive care unit: a systematic review and meta-analysis
Cited By 33	Microplastic and human health with focus on pediatric well-being: a comprehensive review and call for future studies
Cited By 33	Community-acquired pneumonia in children: updated perspectives on its etiology, diagnosis, and treatment
Cited By 30	Metabolic complications of obesity in children and adolescents
Cited By 25	Neonatal family-centered care: evidence and practice models

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