Jornal de pediatria最新文献

{"title":"Parents' perception of their children's neurodevelopment during the COVID-19 pandemic and associated factors.","authors":"Sabrina Ribeiro Ibiapina, Taís Michele Werle, Milena Monticelli Giongo, Magda Lahorgue Nunes","doi":"10.1016/j.jped.2025.06.002","DOIUrl":"10.1016/j.jped.2025.06.002","url":null,"abstract":"<p><strong>Objective: </strong>To verify parents'/caregivers' perceptions of changes in their children's development during the COVID-19 pandemic and factors associated with such perceptions.</p><p><strong>Methods: </strong>Cross-sectional study using an online survey made available to parents/caregivers of children between 0-7 years old, from September 2021 to March 2023 in two Brazilian states. Respondents answered questions about their perceptions regarding their children's neurodevelopment, and worsening of neurodevelopment during the COVID-19 pandemic. Validated questionnaires such as M-CHAT, \"Swanson, Nolan and Pellham,\" and \"Strengths and Difficulties \"were applied according to age. Comparisons were made using the chi-square test or Fisher's exact test, and Poisson regression was used in the univariate analysis and in the multivariate analysis.</p><p><strong>Results: </strong>Data from 589 children were obtained, 49.7% aged 0-3 years and 50.3% 4-7 years. Of the 0-3 age group, 50 (17.1%) were perceived as having abnormal neurodevelopment, and 79 (27.0%) as having worsened neurodevelopment during the pandemic. Of the 4-7 year group, 76 (25.7%) were perceived as having abnormal neurodevelopment, and 104 (35.1%) as having worsened their neurodevelopment. Significant risk factors associated with the perception of abnormal neurodevelopment were maternal schooling, the child's sex and age; for the perception of worsening neurodevelopment were the child's sex and age, low socioeconomic status, degree of social isolation, and death in the family due to COVID-19.</p><p><strong>Conclusion: </strong>Data from the present study showed that parents/ caregivers' perception of normal neurodevelopment was significantly higher than their recognition of abnormalities. In addition, a significant percentage perceived a worsening during the COVID-19 pandemic.</p>","PeriodicalId":14867,"journal":{"name":"Jornal de pediatria","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144637071","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exclusive breastfeeding modifies the association between maternal education and child development: a cross-sectional study nested in a cohort","authors":"Luiza Alves Ford ,&nbsp;Gabriela Buccini ,&nbsp;Amanda Castelo Saragosa ,&nbsp;Isadora de Araújo Martins ,&nbsp;Janaína Matos Moreira ,&nbsp;Stela Maris Aguiar Lemos ,&nbsp;Claudia Regina Lindgren Alves ,&nbsp;Vivian Mara Gonçalves de Oliveira Azevedo","doi":"10.1016/j.jped.2025.02.004","DOIUrl":"10.1016/j.jped.2025.02.004","url":null,"abstract":"<div><h3>Objective</h3><div>Low maternal education is a risk factor for early childhood development (ECD), while exclusive breastfeeding (EBF) is a protective factor. This study examined the association between maternal education and ECD outcomes such as cognitive, language, and motor domains and whether EBF modifies this association in Brazil.</div></div><div><h3>Methods</h3><div>This cross-sectional study analyzed data from a non-probabilistic sample of 12-month-old infants born during the COVID-19. Moderation analyses using the Mann-Whitney test examined the effect of EBF at 6 months (effect modifier) on the relationship between Bayley-III cognitive, language, and motor scores as well as Bayley Global Score (BGS) (outcomes) and maternal education (independent variable). The effect size (r) from the sensitivity analysis of the effect modifier was estimated.</div></div><div><h3>Results</h3><div>A total of 269 full-term infants were evaluated. Higher maternal education was associated with better cognitive, language, and BGS (<em>p</em> &lt; 0.00). EBF was associated with higher cognitive (<em>p</em> &lt; 0.01), language (<em>p</em> &lt; 0.02), and BGS (<em>p</em> &lt; 0.00). EBF modified the effect of low maternal education (&lt;10 years; and 10–12 years) on cognitive score and BGS. Among mothers with &gt;10 years of education, a large effect size of EBF was observed on the BGS (<em>r</em> = 0.51), and a medium effect size was noted in the cognitive domain (<em>r</em> = 0.38).</div></div><div><h3>Conclusion</h3><div>Higher maternal education is associated with better scores on Bayley-III domains, and EBF can modify the effect of lower maternal education on ECD in Brazil. This is the first study to identify EBF as a mechanism to protect ECD in adverse conditions such as low maternal education.</div></div>","PeriodicalId":14867,"journal":{"name":"Jornal de pediatria","volume":"101 4","pages":"Pages 511-519"},"PeriodicalIF":2.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143753036","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors associated with developmental delay in late preterm infants: the BRISA cohort","authors":"Paulo Ricardo Higassiaraguti Rocha ,&nbsp;Gabriela Pap da Silva ,&nbsp;Otávio Augusto Gratão ,&nbsp;Marco Antonio Barbieri ,&nbsp;Viviane Cunha Cardoso ,&nbsp;Maria da Conceição Pereira Saraiva ,&nbsp;Heloisa Bettiol","doi":"10.1016/j.jped.2025.04.002","DOIUrl":"10.1016/j.jped.2025.04.002","url":null,"abstract":"<div><h3>Objective</h3><div>To investigate the association of sociodemographic characteristics, gestational factors, and birth outcomes with developmental delay from the second year of life in late preterm (LPT) infants.</div></div><div><h3>Method</h3><div>This study included 327 LPT infants from a cohort started in 2010. Developmental performance was assessed using the Bayley-III screening test. The covariates were obtained with questionnaires and from the maternity records. Hierarchical multiple logistic regression was used for analysis.</div></div><div><h3>Results</h3><div>Smoking during pregnancy was associated with fine motor and cognitive delays (OR = 2.27, 95 %CI 1.05–4.93 and OR = 2.22, 95 %CI 1.05–4.68, respectively). Living without a partner (OR = 2.98, 95 %CI 1.36–6.52) and intrauterine growth restriction of the child (OR = 2.63, 95 %CI 1.32–5.24) were associated with fine motor delay and neonatal intensive care unit admission with cognitive delay (OR = 2.11, 95 %CI 1.01–4.44).</div></div><div><h3>Conclusions</h3><div>These factors must be considered when implementing strategies for the diagnosis of possible developmental delays and when designing interventions for LPT children.</div></div>","PeriodicalId":14867,"journal":{"name":"Jornal de pediatria","volume":"101 4","pages":"Pages 657-664"},"PeriodicalIF":2.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144013671","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mental health issues in adolescent mothers and young adult mothers: the Brazilian context","authors":"Amanda Ferreira de Carvalho ,&nbsp;Daniela Dal Forno Kinalski Guaranha ,&nbsp;Bruna Marmett ,&nbsp;Júlia Mathias Reis ,&nbsp;Carmem Lisiane Escouto de Souza ,&nbsp;Bruna Silveira da Rosa ,&nbsp;Tiago Chagas Dalcin ,&nbsp;Sérgio Luis Amantea","doi":"10.1016/j.jped.2025.03.011","DOIUrl":"10.1016/j.jped.2025.03.011","url":null,"abstract":"<div><h3>Objective</h3><div>To analyze anxiety and depression levels in adolescent and young adult mothers.</div></div><div><h3>Methods</h3><div>This multicenter cross-sectional study was conducted across Brazil’s five regions. A non-probabilistic sample of 1177 adolescent (10–19 years) and young adult (20–29 years) mothers was selected proportionally based on regional live birth rates. Data collection (August 2022–May 2023) involved a structured questionnaire assessing mental health (DASS-21), family support, and quality of life. Statistical analyses were performed using RStudio©, with p-values &lt; 0.05 considered significant. The study was approved by the Research Ethics Committee (CAAE: 55465822.0.2003.5086).</div></div><div><h3>Results</h3><div>Depression or anxiety was reported by 22.7 % of both adolescent and young adult mothers, with 7.55 % and 7.07 % diagnosed during pregnancy, respectively. Among affected adolescents, 66.67 % did not seek follow-up care, primarily due to limited healthcare access (29.55 %). Adolescent mothers showed a higher prevalence of depression (<em>p</em> &lt; 0.001), anxiety (<em>p</em> &lt; 0.001), and stress (<em>p</em> = 0.027) postpartum. Depression was associated with a lack of emotional support from the child’s father (<em>p</em> = 0.096), insufficient family caregiving support (<em>p</em> = 0.014), and low perceived quality of life.</div></div><div><h3>Conclusion</h3><div>Adolescent mothers exhibit greater vulnerability to mental disorders, emphasizing the need for targeted psychological and social support during the perinatal period.</div></div>","PeriodicalId":14867,"journal":{"name":"Jornal de pediatria","volume":"101 4","pages":"Pages 608-615"},"PeriodicalIF":2.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144015554","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Parental predictors of childhood vaccination adherence in border areas of Southern Vietnam: a first look at minority communities","authors":"An Dai Tran ,&nbsp;Charuai Suwanbamrung ,&nbsp;Muhammad Haroon Stanikzai ,&nbsp;Nirachon Chutipattana ,&nbsp;Shamarina Shohaimin ,&nbsp;Patthanasak Khammaneechan ,&nbsp;Le Minh Luan ,&nbsp;Tran Phu Dien ,&nbsp;Truong Thanh Nam ,&nbsp;Phan Thanh Tung ,&nbsp;Cua Ngoc Le","doi":"10.1016/j.jped.2025.04.005","DOIUrl":"10.1016/j.jped.2025.04.005","url":null,"abstract":"<div><h3>Objectives</h3><div>Suboptimal timeliness and coverage of childhood vaccination programs undermined their effectiveness in achieving population-level immunity. This issue is particularly concerning among minority populations, where disparities in vaccination adherence persist. To address this gap, the study assessed the extent of parental adherence to age-appropriate childhood vaccination and its predictors among the minority children under five years of age.</div></div><div><h3>Methods</h3><div>This cross-sectional study was conducted in three districts of Dong Thap Province, Vietnam, and neighboring Cambodia. A total of 449 ethnic minority parents with children under five years old participated. Data were gathered through face-to-face household interviews using a structured questionnaire, complemented by direct observation of the children’s vaccination cards to verify adherence. Binary logistic regression was used to identify predictors of vaccination adherence.</div></div><div><h3>Results</h3><div>The adherence rate to childhood vaccination among children in the minority population was 18.9 %. Parental adherence was significantly higher for children under one year of age (aOR = 2.54, 95 % CI: 1.29–5.03) and for firstborn children (aOR = 3.48, 95 % CI: 1.36–9.92). Within the Health Belief Model framework, greater perceived barriers were associated with lower adherence (aOR = 0.32, 95 % CI: 0.21–0.49), while higher parental self-efficacy was linked to increased adherence (aOR = 1.84, 95 % CI: 1.11–3.11).</div></div><div><h3>Conclusion</h3><div>This study revealed a low parental adherence rate (18.9 %) to childhood vaccination. A child’s age, birth order, perceived barriers, and parental self-efficacy influenced adherence. These findings emphasize the need to incorporate these factors into targeted policies and interventions for improving immunization rates in minority populations and comparable settings.</div></div>","PeriodicalId":14867,"journal":{"name":"Jornal de pediatria","volume":"101 4","pages":"Pages 642-650"},"PeriodicalIF":2.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144093719","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cutoff levels for newborn screening of 21-OH deficiency in a Brazilian metropolitan area","authors":"Kallianna Paula Duarte Gameleira ,&nbsp;Juliana de Vasconcellos Thomas ,&nbsp;Vitor Guilherme Brito de Araújo ,&nbsp;Cláudia Vicari Bolognani ,&nbsp;Sérgio Eduardo Soares Fernandes ,&nbsp;Fábio Ferreira Amorim","doi":"10.1016/j.jped.2025.03.003","DOIUrl":"10.1016/j.jped.2025.03.003","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate the accuracy of neonatal 17-hydroxyprogesterone (N17OHP) levels adjusted for birth weight (BW) and time of the sample collection (TC) and propose optimized cutoff values to improve the effectiveness of newborn screening tests for congenital adrenal hyperplasia (CAH<img>NBS) programs, utilizing a comprehensive dataset encompassing all newborn screening tests for 21-hydroxylase deficiency (21OHD) conducted over a decade in a Brazilian metropolitan region.</div></div><div><h3>Methods</h3><div>A cross-sectional study analyzed all CAH<img>NBS tests from newborns aged 2 to 7 days in the Federal District, Brazil, from January 2012 to September 2022. The accuracy of cutoff values based on the 99.5th percentile (99.5P) for BW and TC was compared to the CAH<img>NBS program of São Paulo and a threshold of ≥20 mg/dL. New cutoff values were proposed to enhance screening effectiveness.</div></div><div><h3>Results</h3><div>Among the 340,291 newborns screened, CAH-21OHD was confirmed in 11 cases. The N17OHP cutoff in this sample reduced false positives for neonates ≤ 2500 g but increased them for those &gt; 2500 g The proposed cutoff values based on 99.5P from the sample for neonates ≤ 2500 g, combined with a fixed cutoff ≥ 20 mg/dL for those &gt; 2500 g, showed superior specificity (99.83 %, 95 % CI: 99.81–99.84 %), LR+ (579.16, 95 % CI: 524.23–627.87), PPV (1.84, 95 %CI: 1.70–1.99), and accuracy (99.83 %, 95 %CI: 99.81–99.84 %) than prior criteria.</div></div><div><h3>Conclusion</h3><div>The proposed 17OHP cutoff strategy effectively reduced false positives, improving specificity, LR+, PPV, and accuracy Thus, it optimized CAH<img>NBS programs while minimizing unnecessary costs and parental distress.</div></div>","PeriodicalId":14867,"journal":{"name":"Jornal de pediatria","volume":"101 4","pages":"Pages 561-568"},"PeriodicalIF":2.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143780157","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Combining procalcitonin, c-reactive protein, and white blood cell count in predicting infections in pediatric open cardiac surgery with cardiopulmonary bypass","authors":"Tuan Manh Ha ,&nbsp;Man Minh Tran ,&nbsp;Tung Viet Le ,&nbsp;Nguyen The Nguyen Phung","doi":"10.1016/j.jped.2025.04.006","DOIUrl":"10.1016/j.jped.2025.04.006","url":null,"abstract":"<div><h3>Objective</h3><div>This study aimed to evaluate the validity of models using Procalcitonin (PCT) alone and PCT combined with other biomarkers to predict early infection after pediatric open-heart surgery with cardiopulmonary bypass (CPB).</div></div><div><h3>Methods</h3><div>A prospective observational study was conducted on children undergoing open-heart surgery with CPB, without preoperative infection. Procalcitonin, C-reactive protein (CRP), and white blood cell (WBC) count were measured preoperatively and on postoperative days 1 and 3. Postoperative infection was defined according to the Centers for Disease Control and Prevention 2008 criteria.</div></div><div><h3>Results</h3><div>Fifty eligible cases were included, comprising 46 % males with a median age of 7 months (4–17). The AUC (area under the curve) for PCT on postoperative day 3 was 0.67 (0.51–0.82) (<em>p</em> = 0.085). The AUCs for the models combining PCT + CRP and PCT + WBC were 0.71 (0.57–0.86) (<em>p</em> = 0.014) and 0.72 (0.55–0.86) (<em>p</em> = 0.014), respectively. The AUC for the model combining PCT + CRP + WBC was 0.81 (0.69–0.93) (<em>p</em> = 0.002). The combination of PCT &gt; 4.15 ng/ml, CRP &gt; 22.03 mg/l, and WBC &gt; 15.3 × 10³/µl predicted infection with a hazard ratio 9.66 times (2.94–31.72) higher than PCT &gt; 4.15 ng/ml alone (<em>p</em> &lt; 0.05).</div></div><div><h3>Conclusions</h3><div>PCT measurement on the third postoperative day alone cannot predict infection in pediatric open-heart surgery with CPB. The combination of PCT with CRP and WBC may enhance early infection prediction, although further validation in larger, multicenter cohorts is warranted.</div></div>","PeriodicalId":14867,"journal":{"name":"Jornal de pediatria","volume":"101 4","pages":"Pages 634-641"},"PeriodicalIF":2.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144078091","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical and nutritional profile of children and adolescents with autism spectrum disorder in Brazil: a nationwide online survey","authors":"Gabriele Gonçalves de Souza Corrêa,&nbsp;Fernanda Valente Mendes Soares,&nbsp;Zilton Farias Meira de Vasconcelos,&nbsp;Ana Carolina Carioca Costa,&nbsp;Adriana Duarte Rocha","doi":"10.1016/j.jped.2024.12.008","DOIUrl":"10.1016/j.jped.2024.12.008","url":null,"abstract":"<div><h3>Objective</h3><div>To characterize the clinical and nutritional profile of children and adolescents with ASD in Brazil and their eating problems.</div></div><div><h3>Method</h3><div>This is a cross-sectional study using a national online survey, with a sample of 613 children and adolescents with ASD aged between 2 and 17 years. Data analysis consisted of descriptive analysis, followed by Pearson's chi-square test with a statistical significance of 0.05 and a 95% confidence interval.</div></div><div><h3>Results</h3><div>Food allergy was reported by 33.8% of the participants, the most frequent being cow's milk (70.2%), among those who reported gastrointestinal problems, constipation was the most frequent (54.1%). The presence of pica was reported by 25% and food selectivity was present in 77.2%, with greater refusal of fruit, vegetables and pasty textures. Most of the participants do not have follow-ups with a nutritionist and 44.5% are on some special diet, excluding gluten/wheat (75.4%) and without casein/animal milk (76.1%). More than half of the participants did not eat fruit (50.6%), vegetables (68.1%), or leafy greens (83.6%) frequently. A positive correlation was found between food selectivity and gastrointestinal symptoms (p-value &lt; 0.050); food allergy and gastrointestinal symptoms (p-value &lt; 0.001) and pica and gastrointestinal symptoms (p-value &lt; 0.001).</div></div><div><h3>Conclusions</h3><div>The results of this study show changes in food consumption and increased risk of nutritional deficiencies for children and adolescents with ASD in Brazil.</div></div>","PeriodicalId":14867,"journal":{"name":"Jornal de pediatria","volume":"101 4","pages":"Pages 529-535"},"PeriodicalIF":2.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143990775","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is the capacity to consent different from the capacity to refuse treatments and procedures in adolescence?","authors":"Guilherme Henrique Martins ,&nbsp;Kalline Eler ,&nbsp;Aline Albuquerque ,&nbsp;Rui Nunes","doi":"10.1016/j.jped.2025.04.004","DOIUrl":"10.1016/j.jped.2025.04.004","url":null,"abstract":"<div><h3>Objective</h3><div>The objective of this article is to broaden the discussion on the factors that constitute adolescent healthcare decisional capacity, ensuring that adolescents are recognized as capable of refusing treatments or procedures.</div></div><div><h3>Sources</h3><div>Materials from different sources were analyzed, including articles from reputable databases and documents from government agencies, forming a purposefully selected sample. The research was conducted in two phases: document selection and reflective analysis, followed by a report. The discussion was approached from a phenomenological perspective, with reflections grounded in human rights principles.</div></div><div><h3>Summary of the findings</h3><div>Healthcare decisional capacity must be sufficiently robust to allow adolescents to refuse treatments or procedures. It is essential to respect the right of capable adolescents to refuse treatments and procedures. Protecting the vulnerability of adolescent patients involves honoring their growing autonomy. Data from field research regarding the refusal of treatments and procedures in adolescence are scarce, which limits the scope of the proposed discussion.</div></div><div><h3>Conclusions</h3><div>It cannot be argued that adolescents should have different abilities to refuse a treatment or procedure compared to those required to give consent. The importance of these skills seems to vary between these situations. This difference is justified by the need to consider potential harm to health, even though it could be argued that damage to health should be part of the bioethical deliberation surrounding the decision, rather than a factor in the assessment of decisional capacity.</div></div>","PeriodicalId":14867,"journal":{"name":"Jornal de pediatria","volume":"101 4","pages":"Pages 501-510"},"PeriodicalIF":2.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144086304","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Understanding the natural history of selective IgA deficiency","authors":"Nayara Maria Furquim Nasser,&nbsp;Antonio Carlos Pastorino,&nbsp;Thais Costa Lima de Moura,&nbsp;Beni Morgenstern,&nbsp;Mayra de Barros Dorna,&nbsp;Ana Paula Beltran Moschione Castro","doi":"10.1016/j.jped.2025.03.002","DOIUrl":"10.1016/j.jped.2025.03.002","url":null,"abstract":"<div><h3>Objective</h3><div>Patients with selective IgA deficiency (SIgAD) present elevated morbidity associated with infections, allergic conditions, autoimmune disorders, and neoplasms. This study aims to characterize clinical manifestations, disease progression, and laboratory findings in a cohort of pediatric patients with SIgAD.</div></div><div><h3>Methods</h3><div>The study included patients with confirmed SIgAD and a clinical history of at least 5 years. Data encompassed clinical manifestations of the disease, patient outcomes, and laboratory findings, including IgA, IgG, IgM, IgE levels and complete blood count.</div></div><div><h3>Results</h3><div>A total of 51 patients (1.2:1 female-to-male ratio) were included, with a median age at diagnosis of 6 years. Infections were the most common clinical manifestations of SIgAD (98 %), with pneumonia being the most frequent (94 %), followed by sinusitis (70 %). Additionally, 47 patients (92.1 %) exhibited allergic manifestations, including rhinitis or asthma. Autoimmune conditions were identified in 10 patients, predominantly thyroiditis (60 %), while neoplasms were observed in 3 patients. The sequence of disease onset revealed a natural progression, beginning with infectious diseases, followed significantly by allergic and autoimmune conditions. Elevated immunoglobulin levels (IgM or IgG) were observed in 25 patients, with hypergammaglobulinemia significantly associated with autoimmune conditions or the presence of autoantibodies (<em>p</em> &lt; 0.05).</div></div><div><h3>Conclusions</h3><div>SIgAD is a clinically significant condition. Understanding its natural history deepens our knowledge of the disease and helps early detection and diagnosis of comorbidities that may arise at various stages of a patient's life. Monitoring other immunoglobulin levels may offer potential biomarkers for predicting autoimmune conditions; however, larger studies are needed to validate these biomarkers.</div></div>","PeriodicalId":14867,"journal":{"name":"Jornal de pediatria","volume":"101 4","pages":"Pages 569-575"},"PeriodicalIF":2.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143764056","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}