Clinical and Experimental Pediatrics

Review Article

Gastroenterology

Sarcopenia in pediatric gastroenterology and hepatology: an updated review

Toshifumi Yodoshi

Clin Exp Pediatr. 2026;69(5):366-383. Published online April 27, 2026

Pediatric sarcopenia is common in chronic gastrointestinal and liver diseases, often hidden by normal body mass index or obesity, and predicts worse outcomes. Because growth and puberty alter body composition, assessment should use age- and sex-specific measures of muscle mass and, when feasible, function. Early multidisciplinary intervention—protein-adequate nutrition, resistance-based activity, and disease control—may improve prognosis.

DOI: https://doi.org/10.3345/cep.2026.00234

Editorial

Neurology

Limited improvement in outcomes of infantile epileptic spasms syndrome despite therapeutic advances

Donghwa Yang

Clin Exp Pediatr. 2026;69(5):384-385. Published online April 28, 2026

· Despite advances in treatment, infantile epileptic spasms syndrome remains associated with poor long-term epilepsy and developmental outcomes.
· Improved seizure control alone may not be sufficient, underscoring the need for early diagnosis and etiology-driven management strategies.

DOI: https://doi.org/10.3345/cep.2026.00745

Original Articles

Neurology

Long-term outcome in children with infantile epileptic spasms syndrome: a multicenter retrospective study in Korea

Sun Ah Choi, Minhye Kim, Hye Jin Kim, Woo Joong Kim, Byung Chan Lim, Ji Yeon Han, Hunmin Kim, Min-Jee Kim, Mi-Sun Yum, Jiwon Lee, Jeehun Lee, Hyewon Woo, Jon Soo Kim

Clin Exp Pediatr. 2026;69(5):386-393. Published online February 19, 2026

Crossref 1

Question: How have epilepsy and cognitive outcomes of children with infantile epileptic spasms syndrome (IESS) evolved over the past 20 years?
Finding: Approximately 78% of children developed chronic epilepsy, and one-third progressed to drug-resistant epilepsy, while 90% of them exhibited intellectual disabilities.
Meaning: Given the poor outcomes associated with IESS, consensus guidelines tailored to Korean clinical practice are required to ensure timely treatment and improve outcomes.

DOI: https://doi.org/10.3345/cep.2025.02089

Neonatology (Perinatology)

Context-dependent features of transcriptomic landscapes in pregnant mother-neonate dyads of preeclampsia

Yu-Chun Cheng, Yun-Ju Lai, Wei-Shiung Lian, Ching-Chang Tsai, Hsin-Hsin Cheng, Hong-Ren Yu, Mao-Meng Tiao, Jiunn-Ming Sheen, Ying-Lun Hsu, Feng-Sheng Wang, I-Chun Lin

Clin Exp Pediatr. 2026;69(5):394-406. Published online February 19, 2026

Question: What genes are commonly altered in mother-neonate dyads immediately after shared exposure to preeclampsia?
Finding: Perinatal/peripartum gene expression in preeclampsia is context-dependent, involves diverse signaling pathways, and is associated with some perinatal features.
Meaning: Our results may help build the fundamentals for managing future cardiometabolic risks in these populations. Further investigation of the long-term influence of these candidate genes on cardiometabolic phenotypes is required.

DOI: https://doi.org/10.3345/cep.2025.02565

Hematology

Effects of induction-phase acute kidney injury and age at diagnosis on chronic kidney disease in pediatric acute lymphoblastic leukemia: a time-to-event cohort study

Pongpak Phongphiew, Nuanpan Penboon, Kanhatai Chiengthong, Pornpimol Rianthavorn

Clin Exp Pediatr. 2026;69(5):407-416. Published online March 5, 2026

Question: In pediatric acute lymphoblastic leukemia (ALL), what are the incidence and causes of induction-phase acute kidney injury (AKI), and which factors predict chronic kidney disease (CKD)?
Finding: Induction AKI occurred in 43% of patients, while CKD developed in 1 of 8 patients. The 5-year CKD-free survival rate was 94%. Older age at diagnosis was a continuous independent determinant of CKD risk.
Meaning: Induction AKI is common and clinically relevant. Older children warrant closer kidney monitoring during and after therapy.

DOI: https://doi.org/10.3345/cep.2025.02327

Neurology

Clinical application of whole exome and genome sequencing in pediatric neurodevelopmental disorders

Keun Soo Lee, Seung Hwan Oh, Ja Young Lee, Go Hun Seo, Da Eun Roh, Ji Kyoung Park, Bo Lyun Lee

Clin Exp Pediatr. 2026;69(5):417-427. Published online April 22, 2026

Question: What is the diagnostic utility of whole exome sequencing (WES) and whole genome sequencing (WGS) in unexplained neurodevelopmental disorders (NDDs)?
Finding: WES and WGS achieved a combined diagnostic yield of 39.1% in children with NDDs. Novel variants accounted for over half the pathogenic findings, and trio-based or phenotype-driven testing improved the diagnostic rate.
Meaning: Comprehensive genomic sequencing integrated with clinical phenotyping enhances diagnostic yield among children with NDDs.

DOI: https://doi.org/10.3345/cep.2025.02775

Nutrition

Human milk macronutrient composition and intake in relation to preterm infant growth: a cohort study

Eakkarin Mekangkul, Chonnikant Visuthranukul, Anongnart Sirisabya, Thaninee Chitsinchayakul, Santi Punnahitananda, Sirinuch Chomtho

Clin Exp Pediatr. 2026;69(5):428-436. Published online April 22, 2026

Question: Is macronutrient intake, particularly that from human milk, distinctly associated with the growth of preterm infants?
Finding: Total protein and fat intake derived from human milk and fortifiers showed distinct positive associations with weight gain velocity.
Meaning: Particular attention to protein and fat composition during individualized human milk fortification can optimize weight gain in preterm infants.

DOI: https://doi.org/10.3345/cep.2025.02509

Neonatology (Perinatology)

Association between impaired renal function based on decline in serum creatinine level and brain injury in neonates with hypoxic-ischemic encephalopathy

Mélaine Boget, William Rozalen, Jeanne Fayard, Mohamed Boucekine, Diane Gillot, Isabelle Grandvuillemin, Farid Boubred

Clin Exp Pediatr. 2026;69(5):437-442. Published online April 27, 2026

Question: The clinical relevance of impaired renal function (IRF), based on the rate of serum creatinine level decline during the week after birth, in neonates treated with therapeutic hypothermia for hypoxic-ischemic encephalopathy need further investigation.
Finding: In this study, neonates with IRF had 2-fold higher risk of early death or severe brain injury.
Meaning: IRF can be used as a marker of adverse neonatal outcomes.

DOI: https://doi.org/10.3345/cep.2025.02670

Neurology

Classification of neurocognitive impairment in pediatric drug-resistant focal epilepsy by quantifying seizure-affected brain network abnormalities in clinical diffusion-weighted imaging connectome

Jeong-Won Jeong, Min-Hee Lee, Yoon Ho Hwang, Michael Behen, Aimee Luat, Csaba Juhász, Eishi Asano

Clin Exp Pediatr. 2026;69(5):443-454. Published online March 13, 2026

Question: Does epilepsy affect neurocognitive functions in pediatric drug-resistant focal epilepsy?
Finding: Diffusion magnetic resonance imaging (MRI) connectome could identify new imaging markers for seizure-associated structural abnormalities. New markers reflect deviations of local efficiency in neurocognitive networks and provide outstanding discretionary capacity for neurocognitive impairments, achieving an accuracy range of 90%–98% in the independent test patients.
Meaning: Supplementary MRI-driven decisions could be performed for personalized interventions to mitigate long-term neurocognitive effects.

DOI: https://doi.org/10.3345/cep.2025.02936

Erratum: Authour correciton

Author correction: 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(5):455-455. Published online April 28, 2026

DOI: https://doi.org/10.3345/cep.2026.err01

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