Journal of Pediatric Gastroenterology and Nutrition最新文献

{"title":"Inflammatory cloacogenic polyp in a pediatric patient: Importance of retroflexion in anorectal evaluation.","authors":"David Simon, Jessenia Guerrero, Nisha Mangalat","doi":"10.1002/jpn3.70206","DOIUrl":"https://doi.org/10.1002/jpn3.70206","url":null,"abstract":"","PeriodicalId":16694,"journal":{"name":"Journal of Pediatric Gastroenterology and Nutrition","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144958112","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Growth impairment in Japanese children with inflammatory bowel disease: A multicenter prospective cohort study.","authors":"Hirotaka Shimizu, Ryusuke Nambu, Nao Tachibana, Reiko Kunisaki, Takahiro Kudo, Sawako Kato, Tatsuki Mizuochi, Hideki Kumagai, Mikihiro Inoue, Naomi Iwata, Takeshi Saito, Takashi Ishige, Toshifumi Yodoshi, Atsuko Noguchi, Shigeo Nishimata, Takahiro Mochizuki, Shin-Ichiro Hagiwara, Mika Sasaki, Hitoshi Tajiri, Fumihiko Kakuta, Eitaro Hiejima, Itaru Iwama, Yuri Hirano, Toshiaki Shimizu, Katsuhiro Arai","doi":"10.1002/jpn3.70202","DOIUrl":"https://doi.org/10.1002/jpn3.70202","url":null,"abstract":"<p><strong>Objectives: </strong>To investigate the prevalence and characteristics of growth impairment (GI) in children with inflammatory bowel disease (IBD).</p><p><strong>Methods: </strong>In this prospective observational study, 402 children with ulcerative colitis (UC, n = 257) and Crohn's disease (CD, n = 145) were enrolled from the Japanese Pediatric IBD Registry (2012-2020). GI was defined by Paris classification criteria. Longitudinal outcomes were assessed in children with ≥2 years of follow-up (n = 307).</p><p><strong>Results: </strong>At diagnosis, the GI prevalence was comparable between children with UC and CD (6.2% vs. 8.3%, p = 0.54). However, children with UC diagnosed at 0-4 years demonstrated significantly higher GI rates (35.3%) than older children (p < 0.001). All children with CD experiencing GI had small intestinal lesions. Among those with GI at diagnosis, fewer children with UC (9%) recovered growth at a 2-year follow-up than those with CD (50%). Among children with normal growth at baseline, new-onset GI occurred in 23% of UC and 16% of CD cases. Of these, 31% recovered within 2 years, while persistent GI was observed in 16% of UC and 11% of CD cases. Prolonged corticosteroid use at 1 year was more frequent in UC (31% vs. 19%, p = 0.02) and was significantly associated with persistent GI.</p><p><strong>Conclusions: </strong>Distinct growth patterns exist in Japanese children with IBD. Children with UC diagnosed at 0-4 years are particularly vulnerable and may benefit from early, steroid-sparing treatment. The association between small intestinal lesions and GI in CD emphasizes the importance of small bowel evaluation. Age-specific, patient-centered growth monitoring is crucial to optimize long-term outcomes.</p>","PeriodicalId":16694,"journal":{"name":"Journal of Pediatric Gastroenterology and Nutrition","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144958099","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A significant number of pediatric inflammatory bowel disease patients are exposed to a medication not approved by the Food and Drug Administration for pediatric use.","authors":"Courtney Rusch, Anthony J Perkins, Steven J Steiner","doi":"10.1002/jpn3.70200","DOIUrl":"https://doi.org/10.1002/jpn3.70200","url":null,"abstract":"<p><strong>Objectives: </strong>Inflammatory bowel disease (IBD) presents before age 20 years in ~25% of patients. Regulatory approvals of IBD medications for pediatric use are often delayed. Nevertheless, many pediatric patients receive medication not approved for pediatric use. The aim of this study was to summarize the exposure of pediatric patients to IBD medication without regulatory approval for pediatrics.</p><p><strong>Methods: </strong>A retrospective study of exposure to nonapproved biologic/small molecule medications in patients listed in the ImproveCareNow registry with IBD diagnosed before September 2023 was conducted. Chi-square tests were used to see whether exposure differed by demographics, the cohort of IBD diagnosis (Crohn's disease [CD], ulcerative colitis [UC]), or exposure timeframe (i.e., age at exposure and time from diagnosis to exposure).</p><p><strong>Results: </strong>16,085 eligible patients with year of diagnosis from 1993 to 2023 were identified. 2836 patients (17.6%) were exposed to a medication not approved by the Food and Drug Administration (FDA) for pediatric use. The mean age of exposure was 12.5 years and the mean time from diagnosis to exposure was 2.9 years. Patients with UC (23.8%) were significantly more likely to have exposure than CD (15.3%). Female patients (19.1%) were more likely to have exposure than male patients (16.5%). Patients diagnosed with IBD between ages 0-5 years had the highest rate of exposure and shortest time from diagnosis to exposure.</p><p><strong>Conclusions: </strong>A significant number of pediatric IBD patients were exposed to medication not approved by the FDA for pediatrics. There is an urgent need for more rapid approval of medications for IBD in pediatrics.</p>","PeriodicalId":16694,"journal":{"name":"Journal of Pediatric Gastroenterology and Nutrition","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144958175","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bowel habits in preterm infants: Observations from the first 2 weeks of life.","authors":"Ulrikke Lyng Beauchamp, Susanne Soendergaard Kappel, Ilan Jasper Nader Koppen, Marc Alexander Benninga, Lise Aunsholt","doi":"10.1002/jpn3.70199","DOIUrl":"https://doi.org/10.1002/jpn3.70199","url":null,"abstract":"<p><strong>Objectives: </strong>Uniform descriptions of normal preterm infant bowel habits are lacking, causing ambiguity in identifying abnormal bowel habits in this population. This study examines preterm infants' bowel habits and their association with maternal and infant factors in the first 2 weeks of life.</p><p><strong>Methods: </strong>An observational study included infants with a gestational age (GA) < 31 weeks from January to September 2021. From infant and maternal medical records, information on prenatal events, 2 weeks of bowel habit observations, enteral feeding, and laxative treatment was obtained. Extremely preterm infants (EPI) and very preterm infants (VPIs) were defined as GA < 28 weeks and GA ≥ 28 weeks, respectively.</p><p><strong>Results: </strong>Of the 93 infants, 53 (57%) were included, and 37 (70%) were EPI. EPI received first enteral feeds at a median of 5 h after birth versus 2 h after birth in VPI (p < 0.01). EPI passed their first meconium at a median of 30 h (interquartile range [IQR] 12-49 h) after birth versus 26 h in VPI (IQR: 10-40, p = 0.2). In 21% of all infants, saline enemas were used to induce the passage of meconium. In 41% of EPIs (n = 15) laxatives were initiated before 2 weeks of age. Stool frequency varied from 0 to 9 stools daily, and prenatal events did not affect bowel habits.</p><p><strong>Conclusion: </strong>This study provides a day-by-day description of bowel habits, enteral feeds, and laxative treatment but shows no associations with prenatal events in preterm infants. For future research, we recommend implementing homogeneous observation tools to enable comparison between studies.</p>","PeriodicalId":16694,"journal":{"name":"Journal of Pediatric Gastroenterology and Nutrition","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144958172","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ability of triglyceride-glucose indices to predict metabolic dysfunction associated with steatotic liver disease in pediatric obesity.","authors":"Procolo Di Bonito, Anna Di Sessa, Maria Rosaria Licenziati, Domenico Corica, Małgorzata Gabriela Wasniewska, Anita Morandi, Claudio Maffeis, Maria Felicia Faienza, Enza Mozzillo, Valeria Calcaterra, Francesca Franco, Giulio Maltoni, Emanuele Miraglia Del Giudice, Giuseppina Rosaria Umano, Giuliana Valerio","doi":"10.1002/jpn3.70201","DOIUrl":"https://doi.org/10.1002/jpn3.70201","url":null,"abstract":"<p><strong>Objectives: </strong>We aimed to evaluate the best cut-off of alanine aminotransferase (ALT) to predict the metabolic dysfunction-associated steatotic liver disease (MASLD) in youths with overweight/obesity (OW/OB) and analyze the performance of the triglyceride-glucose index (TyG) or its association with anthropometric variables compared to ALT.</p><p><strong>Methods: </strong>This multicenter, cross-sectional study analyzed data of 2813 youths (1463 boys and 1350 girls) aged 6-17 years recruited in 10 Italian centers for the management of pediatric OB. Exclusion criteria were: body mass index (BMI) Z-score >5, diabetes, secondary obesity, triglycerides (TG) ≥ 400 mg/dL. MASLD was defined on the presence of hepatic steatosis at abdominal ultrasound, in combination with at least one cardiometabolic risk factor. The performance of ALT and TyG-derived indices for MASLD diagnosis was assessed using the receiver operation curve and the area under the curve (AUC) with the 95% confidence intervals were obtained.</p><p><strong>Results: </strong>MASLD was observed in 1278 youths (45.1%). The global AUC of ALT was 0.661 (0.641-0.682), p < 0.0001. Using Youden's index the best cut-off of ALT was ≥26 IU/L in boys and ≥22 IU/L in girls. The AUCs of TyG-BMI, TyG-WC, and TyG-ALT were 0.678 (0.659-0.698), 0.659 (0.639-0.679), and 0.666 (0.645-0.686), respectively. Using Delong's test none TyG-derived index showed a better performance than ALT alone.</p><p><strong>Conclusions: </strong>This study demonstrates that the values of ALT ≥ 26 IU/L in boys and ≥22 IU/L in girls can be used for the screening of MASLD in youths with OW/OB, while the combination of TyG-derived indices is not superior to ALT alone.</p>","PeriodicalId":16694,"journal":{"name":"Journal of Pediatric Gastroenterology and Nutrition","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144958156","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition 2025 guidelines on the diagnosis of cyclic vomiting syndrome in children.","authors":"Katja Karrento, John M Rosen, Amy A Gelfand, Sumit Parikh, Sally E Tarbell, Robert M Issenman, Heidi Gamboa, Kathleen Adams, Wojtek Wiercioch, B U K Li","doi":"10.1002/jpn3.70193","DOIUrl":"https://doi.org/10.1002/jpn3.70193","url":null,"abstract":"<p><strong>Objectives: </strong>Cyclic vomiting syndrome (CVS) is characterized by distinct clinical features and symptom overlap with migraine disorders. Cannabinoid hyperemesis syndrome (CHS) is a related condition with similar symptom expression. Due to a lack of diagnostic biomarkers, there is a need for optimal symptom-based diagnostic criteria. These evidence-based guidelines from the North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition (NASPGHAN) were formulated to assist clinicians in the diagnosis of pediatric CVS.</p><p><strong>Methods: </strong>The NASPGHAN council approved a multidisciplinary content expert panel. The panel prioritized a set of clinical questions and outcomes. The recommendations were developed based on a systematic review that applied the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach. To formulate the recommendations and suggested diagnostic algorithm, the panel linked decisions to current evidence and utilized the Delphi Method for expert consensus when available literature was insufficient. A systematic review of available research evidence informed the summary on pediatric CHS. A separate document provides GRADE-based treatment guidelines for pediatric CVS.</p><p><strong>Results: </strong>The panel voted and agreed on one prioritized recommendation on the utility of diagnostic screening tests for pediatric CVS and updated the past consensus-based diagnostic algorithm. A consensus-based clinical approach to the diagnosis of pediatric CHS as a related but separate entity is also provided.</p><p><strong>Conclusions: </strong>The panel recommends screening serum and urine laboratory testing and an upper gastrointestinal radiographic series for all patients with symptoms suggestive of CVS. The panel concluded that there is low yield and cost-effectiveness of other diagnostic screening tests. A set of recommended diagnostic criteria for CVS was formulated based on the characteristics of vomiting attack frequency, duration, and associated symptoms.</p>","PeriodicalId":16694,"journal":{"name":"Journal of Pediatric Gastroenterology and Nutrition","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144958259","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Real-world efficacy of ustekinumab and vedolizumab in pediatric and young adult patients with inflammatory bowel disease.","authors":"Diane Hsu, Justin Lee, Alison Kotzen, Rachel Bensen, Alka Goyal","doi":"10.1002/jpn3.70198","DOIUrl":"https://doi.org/10.1002/jpn3.70198","url":null,"abstract":"<p><strong>Objectives: </strong>Ustekinumab and vedolizumab are used off-label for pediatric inflammatory bowel disease (PIBD). Real-world data are needed to determine their positioning and safety. To assess the (1) 6-month and 1-year clinical outcome on ustekinumab and vedolizumab in PIBD based on Pediatric Ulcerative Colitis Activity Index, short Pediatric Crohn's Disease Activity Index, and calprotectin, and (2) secondary measures including safety and endoscopy.</p><p><strong>Methods: </strong>Retrospective chart review of children and young adults with inflammatory bowel disease (IBD) treated at a pediatric academic hospital and two outpatient practices. Patients <21 years old with IBD were included if they received ustekinumab or vedolizumab between January 2015 and June 2022.</p><p><strong>Results: </strong>One hundred eight patients were included. Patients with ulcerative colitis or IBD-unclassified had significantly higher 1-year steroid-free clinical remission with vedolizumab compared to ustekinumab (61% vs. 32%, p = 0.04) with a similar but nonsignificant trend at 6 months (59% vs. 38%, p = 0.12). Most patients with Crohn's disease receiving vedolizumab and ustekinumab achieved 6-month clinical remission (63% vs. 68%, p = 0.70) and 1-year steroid-free remission (64% vs. 67%, p > 0.90). Most patients receiving vedolizumab or ustekinumab achieved calprotectin <250 μg/g at 6 months (73% vs. 61%, p = 0.20) and 1 year (60% vs. 63%, p = 0.90), respectively. A greater proportion of biologic-naïve patients received vedolizumab, whereas most patients on ustekinumab were biologic-exposed. Adverse events occurred in 6.6% and 10% of patients on vedolizumab and ustekinumab, respectively.</p><p><strong>Conclusions: </strong>Ustekinumab and vedolizumab are safe and effective in achieving clinical remission at 6 months and 1 year in PIBD. Comparative efficacy clinical trials are needed.</p>","PeriodicalId":16694,"journal":{"name":"Journal of Pediatric Gastroenterology and Nutrition","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144958271","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cystatin C: A new marker of early kidney damage in paediatric patients on parenteral nutrition for intestinal failure.","authors":"Alessia Salatto, Maurizio Giordano, Marilena Cipullo, Maria Immacolata Spagnuolo","doi":"10.1002/jpn3.70188","DOIUrl":"https://doi.org/10.1002/jpn3.70188","url":null,"abstract":"","PeriodicalId":16694,"journal":{"name":"Journal of Pediatric Gastroenterology and Nutrition","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144958146","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Vegan diet and nutritional status in infants, children and adolescents: A position paper based on a systematic search by the ESPGHAN Nutrition Committee.","authors":"Elvira Verduci, Jutta Kӧglmeier, Nadja Haiden, Laura Kivelä, Barbara de Koning, Susan Hill, Veronica Luque, Sissel J Moltu, Lorenzo Norsa, Miguel Saenz De Pipaon, Francesco Savino, Jiri Bronsky","doi":"10.1002/jpn3.70182","DOIUrl":"https://doi.org/10.1002/jpn3.70182","url":null,"abstract":"<p><p>Vegan and other plant-based diets are becoming increasingly popular in the paediatric age group. There is limited evidence in the current medical literature to determine whether a vegan diet is adequate for children, since the currently available society position papers are based on narrative reviews and expert opinion. Updated evidence-based recommendations are needed to guide clinical practice. This position paper presents findings from a literature review performed using a systematic search strategy, following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. We analyzed the current evidence on the effect of vegan diet compared to omnivorous diet on body growth, nutritional adequacy and laboratory biomarkers in infants, children and adolescents. Observational studies, cohort studies and clinical trials published over the last 15 years in MEDLINE/PubMed, EMBASE and Cochrane Library were retrieved. Our position paper aims to update the evidence for or against the adequacy of a vegan diet in infants, children and adolescents and to provide evidence-based recommendations. A total of 10 articles were accepted and included in the final review, providing information on approximately 1500 children following a vegan diet. Several articles assessed more than one outcome: seven addressed body growth, five evaluated nutritional adequacy and five examined laboratory biomarkers. To complement the primary data, three systematic reviews and meta-analyses were also included. Current evidence is inconclusive to determine whether a strictly vegan diet supports normal childhood growth, although no significant differences in height or body mass index z-scores were observed compared to omnivorous peers. We recommend that dietary intake, growth and nutritional status should be regularly monitored in vegan children. Focusing on dietary intakes (e.g., protein, omega-3, calcium and iron) and ensuring supplementation with specific micronutrients, including vitamin B12, is essential during paediatric age when following a strict vegan diet. Clinical research, well-designed prospective studies and high-quality trials are required to address current research gaps.</p>","PeriodicalId":16694,"journal":{"name":"Journal of Pediatric Gastroenterology and Nutrition","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144862301","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Coexistence of hepatitis B e antigen and antibody during antiviral treatment predicts better clinical outcomes in children.","authors":"Yingping Gu, Wenxian Ouyang, Shuangjie Li, Zhenzhen Yao, Ling Ye, Meng Yang, Sisi Li, Songxu Peng","doi":"10.1002/jpn3.70196","DOIUrl":"https://doi.org/10.1002/jpn3.70196","url":null,"abstract":"<p><strong>Objectives: </strong>The coexistence of hepatitis B e antigen (HBeAg) and hepatitis B e antibody (HBeAb) during antiviral therapy is considered atypical in patients with chronic hepatitis B (CHB), and its clinical implications remain inadequately understood, particularly in pediatric patients. This study aimed to investigate the clinical characteristics of this coexistence pattern and its impact on the outcomes of combined antiviral therapy in children with CHB.</p><p><strong>Methods: </strong>A total of 254 treatment-naïve children diagnosed with HBeAg-positive CHB were retrospectively enrolled. All patients received combination therapy with entecavir and interferon-alpha/pegylated-interferon-alpha. Participants were categorized into a coexistence group and a control group based on whether HBeAg and HBeAb coexisted during treatment period. Clinical characteristics and treatment outcomes were compared, and Cox regression analysis was used to evaluate factors influencing the coexistence pattern and its association with antiviral responses.</p><p><strong>Results: </strong>The incidence of HBeAg and HBeAb coexistence during antiviral therapy was 35.43% (90/254). This pattern was associated with the higher HBV DNA levels (hazard ratio [HR] = 1.25, p = 0.009) at baseline. Notably, children in the coexistence group demonstrated a greater likelihood of achieving HBsAg loss (HR = 2.58, p < 0.001), HBeAg loss (HR = 2.23, p < 0.001) and HBV-DNA undetectability (HR = 1.42, p = 0.034).</p><p><strong>Conclusions: </strong>The HBeAg/HBeAb coexistence pattern is relatively common during antiviral therapy in children and is associated with significantly improved treatment outcomes. These findings highlight the importance of monitoring HBeAg/HBeAb dynamics and continuing treatment during this critical phase.</p>","PeriodicalId":16694,"journal":{"name":"Journal of Pediatric Gastroenterology and Nutrition","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144862298","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}