Journal of Pediatric Gastroenterology and Nutrition最新文献

{"title":"Portal vein peak systolic velocity is a useful noninvasive predictor of high-risk varices in biliary atresia.","authors":"Tomoya Fukuoka, Hiroyo Ishii, Emi Ito, Yuki Matsuoka, Yoshikazu Miura, Takeshi Kimura, Kazuhiko Bessho, Takehisa Ueno, Yasuji Kitabatake","doi":"10.1002/jpn3.70566","DOIUrl":"https://doi.org/10.1002/jpn3.70566","url":null,"abstract":"<p><strong>Objectives: </strong>Portal vein (PV) flow velocity is considered an indicator of portal hypertension. However, few studies have evaluated the predictive performance of PV flow velocity for high-risk varices (HRV) in children with biliary atresia (BA). In this study, we evaluated the predictive performance of PV peak systolic velocity (PSV) for HRV in children with BA.</p><p><strong>Methods: </strong>We retrospectively reviewed consecutive children with BA, aged 18 years or younger, who underwent initial upper endoscopy and abdominal ultrasonography within 30 days of endoscopy at Osaka University Hospital between 2010 and 2024. HRV was defined as Grade 3 esophagogastric varices (EGV), or Grade 2 EGV with red color signs and/or gastric varices along the cardia. Clinical data, including PV-PSV and previously reported prediction indices for varices, were compared between children with and without HRV.</p><p><strong>Results: </strong>Seventy children were included, 23 of whom had HRV. Variables that differed significantly between children with and without HRV were albumin, total bilirubin, clinical prediction rule, King's variceal prediction score, risk score, and PV-PSV. On multivariate analysis, PV-PSV was the only independent predictor of HRV. PV-PSV yielded the highest area under the receiver operating characteristic curve for predicting HRV (0.871), with 82.6% sensitivity and 78.0% specificity at a cutoff of 16.7 cm/s.</p><p><strong>Conclusions: </strong>PV-PSV proved useful for predicting HRV, suggesting that it may serve as a noninvasive test in children with BA.</p>","PeriodicalId":16694,"journal":{"name":"Journal of Pediatric Gastroenterology and Nutrition","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148912679","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":"Association of attention-deficit/hyperactivity disorder and autism with inflammatory bowel disease activity.","authors":"Sabine Jansson, Mads Damsgaard Wewer, Johan Burisch, Matthew P Fox, Michael E Benros, Charlotte Ulrikka Rask, Vibeke Wewer, Mikkel Malham","doi":"10.1002/jpn3.70564","DOIUrl":"10.1002/jpn3.70564","url":null,"abstract":"<p><strong>Objectives: </strong>To estimate the effect of attention deficit hyperactivity disorder (ADHD) and autism on the disease activity of inflammatory bowel disease (IBD) in pediatric and young patients.</p><p><strong>Methods: </strong>Patients diagnosed with IBD between the ages of 6 and 24 years were identified in Danish nationwide registries 1996-2022. Cumulative incidences for severe disease activity (defined as advanced therapies, oral corticosteroids, IBD-related surgery and hospitalization) were estimated and compared between patients with IBD with and without ADHD/autism. Cox regression analysis was used to calculate adjusted hazard ratios (aHRs) with 95% confidence intervals (CIs) for each of the severe events.</p><p><strong>Results: </strong>A total of 785 patients with IBD and ADHD/autism and 6729 patients with IBD only were included. ADHD and autism were associated with a higher cumulative incidence of severe disease activity (10-year cumulative incidence: 36.2% vs. 33.7%). When investigating each severe event, ADHD and autism were associated with a higher risk of receiving advanced IBD therapies (aHR: 1.2, 95% CI: 1.0-1.3). Patients with ulcerative colitis and ADHD/autism had a higher risk for colectomy (aHR: 1.4, 95% CI: 1.0-1.8), especially those diagnosed with IBD before 18 years of age (aHR: 1.7, 95% CI: 1.1-2.6).</p><p><strong>Conclusions: </strong>ADHD and autism were associated with more severe IBD disease activity in pediatric and young patients. Although mainly smaller effects were observed, the findings may inform targeted efforts for patients with ADHD/autism and IBD to reduce the likelihood of severe disease activity.</p>","PeriodicalId":16694,"journal":{"name":"Journal of Pediatric Gastroenterology and Nutrition","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148912694","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":"Prevalence of cytomegalovirus in infants with cholestasis and response to oral antiviral therapy: A prospective cohort study.","authors":"Subhiksha Muralidhar, Aditi Kumar, Bhagirathi Dwibedi, Somanath Padhi, Susama Patra, Baijayantimala Mishra","doi":"10.1002/jpn3.70572","DOIUrl":"10.1002/jpn3.70572","url":null,"abstract":"<p><strong>Objectives: </strong>Cholestasis of infancy is characterized by abnormal production or obstruction to bile flow. The link between cytomegalovirus infection and the effectiveness of oral antiviral therapy in cytomegalovirus-related cholestasis remains unclear. This study assessed cytomegalovirus prevalence and antiviral response in infants with cholestasis.</p><p><strong>Methods: </strong>This single-center prospective study enrolled 147 consecutive cases of infantile cholestasis between May 2023 and December 2024. Participants were subcategorized into those with surgical or medical causes of cholestasis. Cytomegalovirus infection was identified using one of three methods: qualitative urine cytomegalovirus DNA polymerase chain reaction, cytomegalovirus immunoglobulin M, or liver biopsy for inclusion bodies. All cytomegalovirus-positive cases received oral antiviral therapy for 3 months. The outcomes evaluated included viral and biochemical clearance and survival at 18-month follow-up.</p><p><strong>Results: </strong>Cytomegalovirus infection was detected in 50% (74/147) of the cholestatic cohort, with 65% (40/62) prevalence in the surgical subgroup. Viral clearance and improvement in biochemical profile were observed in 51% (38/74) of cytomegalovirus-positive antiviral-treated cases without serious adverse effects. Eighteen months' native liver survival was 66% (56/85) in the medical subgroup and 30% (19/62) in the surgical subgroup, irrespective of cytomegalovirus infection status. Survival rates in the cytomegalovirus-positive treated surgical subgroup matched those of the cytomegalovirus-negative counterparts (hazard ratio [HR] 0.91, 95% confidence interval [CI] 0.51-1.61; p = 0.73). In contrast, the cytomegalovirus-positive medical subgroup demonstrated lower survival than their cytomegalovirus-negative counterparts despite antiviral therapy (HR 2.86, 95% CI 1.34-6.12; p < 0.01).</p><p><strong>Conclusions: </strong>The prevalence of cytomegalovirus infection in infantile cholestasis varies regionally. Native liver survival was not worse in cytomegalovirus-positive antiviral-treated surgical cases than in cytomegalovirus-negative infants, however a multicentre randomized control trial is needed to confirm these findings.</p>","PeriodicalId":16694,"journal":{"name":"Journal of Pediatric Gastroenterology and Nutrition","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148906048","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":"Best practices for prior authorization in pediatric inflammatory bowel disease: A practical multidisciplinary roadmap.","authors":"Brad D Constant, Megan McNicol, Jeron Speaks, Shannon Dodge, Hilary K Michel","doi":"10.1002/jpn3.70563","DOIUrl":"https://doi.org/10.1002/jpn3.70563","url":null,"abstract":"","PeriodicalId":16694,"journal":{"name":"Journal of Pediatric Gastroenterology and Nutrition","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148900873","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":"Transition of children with chronic gastrointestinal and liver disease to adult care: A multicentre Asian survey of paediatric gastroenterologists.","authors":"Shu Ching Ee, Sunitha Vimalesvaran, Way Seah Lee, Suporn Treepongkaruna, Nuthapong Ukarapol, Felizardo Gatcheco, Takashi Ishige, Hong Koh, Shaman Rajindrajith, Nikhil Thapar, Marion M Aw","doi":"10.1002/jpn3.70561","DOIUrl":"https://doi.org/10.1002/jpn3.70561","url":null,"abstract":"<p><strong>Objectives: </strong>The rising incidence of chronic gastrointestinal conditions and better survival of children with life-limiting diseases have resulted in the need for continuity of care into adulthood. This study aimed to detail transition practices in paediatric gastroenterology and hepatology within Asia.</p><p><strong>Methods: </strong>Paediatric gastroenterologists were invited to complete a web-based survey administered through a regional paediatric gastroenterology society to its members. The questionnaire was designed based on the 'Transition Policy Survey' and 'Barriers to Transition Care in Inflammatory Bowel Disease (IBD) Questionnaire'.</p><p><strong>Results: </strong>One hundred and nine paediatric gastroenterologists from 10 countries participated. Key factors influencing timing of transfer included patients demonstrating responsibility for their own care (mean 3.5 ± standard deviation [SD] 0.6, scale of 1-4, 1 = not important, 4 = very important), knowledge of disease and its prognosis (mean 3.40 ± SD 0.7), and emergence of adult-specific health issues (mean 3.38 ± SD 0.8). The 'ideal' age for transition was felt to be 18 (59%). Most clinicians would begin pre-transition preparation 2 years prior. Whilst all felt transition services were important, only 59% provided such care. Services were unavailable (28%) or ad-hoc (11%) in many centres. The top barriers to successful transition were patient-related (36%), parent-related (27%) and lack of engagement with adult subspecialty counterparts (21%).</p><p><strong>Conclusion: </strong>This study provides real-world data regarding transition practices in Asia. Beyond patient-related barriers, parent-related factors (possibly cultural influence) were significant. Transition care programs in the region and those including patients from Asia would need to be cognisant of these issues when planning transition of these patients to adult services.</p>","PeriodicalId":16694,"journal":{"name":"Journal of Pediatric Gastroenterology and Nutrition","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148900859","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":"Identification of human leukocyte antigen class I risk alleles and enriched T cell receptor groups in activated T cell pediatric acute liver failure.","authors":"Catherine A Chapin, Tamir Diamond, Joshua B Wechsler, Samantha L Gadd, Michelle Lau, Wenzhao Meng, Eline T Luning Prak, Jamie L Duke, Daria V Babushok, Kathleen M Loomes, Anat R Tambur, Estella M Alonso, Edward M Behrens","doi":"10.1002/jpn3.70573","DOIUrl":"10.1002/jpn3.70573","url":null,"abstract":"<p><strong>Objective: </strong>Activated T cell pediatric acute liver failure (TC-PALF) is characterized by CD8+T cells in liver and peripheral blood. TC-PALF patients are at increased risk of developing aplastic anemia (AA), an immune-mediated disorder in which CD8+ T cells target hematopoietic stem and progenitor cells. Clonal expansion of T cell receptors (TCRs) and specific human leukocyte antigen (HLA) class I risk alleles have been reported in AA. We hypothesized TC-PALF shares similar HLA associations and exhibits increased TCR clonality.</p><p><strong>Methods: </strong>Thirty-one TC-PALF and 15 other PALF diagnosis (other-PALF) patients enrolled in the Pediatric Acute Liver Failure Study Group (PALFSG) were included. Liver tissue DNA underwent TCR β-chain (TCRβ) complementarity-determining region 3 sequencing and HLA genotyping. HLA allele frequencies were compared with ethnicity-matched controls. TCR clonality was assessed and Grouping of Lymphocyte Interactions by Paratope Hotspots 2 (GLIPH2) was used to identify antigen-convergent, disease-associated TCR groups.</p><p><strong>Results: </strong>HLA class I alleles HLA-A*23:01, HLA-B*35:03, HLA-B*52:01, and HLA-B*39:05 were significantly overrepresented among TC-PALF patients compared to ethnicity-matched controls. Hepatic TCRβ clonality was increased in the TC-PALF group. GLIPH2 identified 158 statistically significant TCR convergence groups enriched in TC-PALF with significant HLA associations, representing putative antigen-specific TCR clusters.</p><p><strong>Conclusions: </strong>Enrichment of specific HLA class I alleles, increased hepatic TCR clonality, and HLA-associated TCR convergence groups support an HLA-restricted, antigen-driven CD8+ T cell response as a central mechanism of TC-PALF. These findings provide a mechanistic framework for antigen discovery and future development of immunogenetic biomarkers to improve disease classification, risk stratification, and targeted immunomodulatory therapy.</p>","PeriodicalId":16694,"journal":{"name":"Journal of Pediatric Gastroenterology and Nutrition","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148900865","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":"Race and neighborhood factors influence clinical outcomes in children hospitalized with acute pancreatitis.","authors":"Amy Fan, Elizabeth Baker, Chinenye R Dike","doi":"10.1002/jpn3.70569","DOIUrl":"10.1002/jpn3.70569","url":null,"abstract":"<p><strong>Objectives: </strong>Disparities impacting acute pancreatitis (AP) outcomes have been reported. Although racial/ethnic disparities are known in AP, geospatial disparities have been unexplored in pediatric AP. We aimed to investigate area level social determinant of health (SDOH) factors on pediatric AP outcomes.</p><p><strong>Methods: </strong>This is a retrospective study of children hospitalized with AP over 5 years. Data including home addresses and zip codes were geocoded to determine area level factors for SDOH. Descriptive statistics were used to summarize overall sample and stratified by length of stay (LOS), AP severity, and complications. Significance tests were performed using high-dimensional fixed effects regression with multiway cluster-robust standard errors.</p><p><strong>Results: </strong>A total of 242 encounters for 182 participants living in 160 different census tracts were included. Non-Hispanic Black (NHB) children were more likely to live in urban and more minority neighborhoods. Children living in more urban and minority neighborhoods had increased mean LOS, and AP severity. Increased mean LOS persisted in NHB children after adjusting for co-variates (p = 0.009). Abstract charges were higher in children with AP who live in poorer neighborhoods even after adjusting for co-variates (p = 0.048).</p><p><strong>Conclusions: </strong>Children hospitalized with AP living in minority and urban neighborhoods experience an increased LOS and complications. NHB children are more likely to live in urban and minority neighborhoods and have an increased mean LOS. Abstract charges are higher for children with AP who live in poorer neighborhoods.</p>","PeriodicalId":16694,"journal":{"name":"Journal of Pediatric Gastroenterology and Nutrition","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148906203","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":"Longitudinal changes in polyunsaturated fatty acids and their metabolites in preterm human milk during early lactation.","authors":"Andrea Martinez Pederzini, Hiroki Suganuma, Naho Ikeda, Natsuki Ohkawa, Naoko Kaga, Hikari Taka, Yoshiki Miura, Irena Santosa, Hiromichi Shoji","doi":"10.1002/jpn3.70567","DOIUrl":"10.1002/jpn3.70567","url":null,"abstract":"<p><strong>Objectives: </strong>Long-chain polyunsaturated fatty acids (LC-PUFAs) are integral components of cell membranes and serve as precursors of bioactive lipid mediators known as oxylipins. Although oxylipins have been identified in human milk (HM), their temporal dynamics and relationships with precursor LC-PUFAs during early lactation, particularly in preterm milk, remain under-examined. This study characterized longitudinal changes in LC-PUFAs and oxylipins in HM from Japanese mothers of moderately preterm infants during the first 3 weeks of lactation.</p><p><strong>Methods: </strong>HM samples were collected weekly for 3 consecutive weeks from breastfeeding women who delivered infants born moderately preterm (30-34 weeks of gestation). Analyses were performed on 50 HM samples from 21 participants. Selected precursor fatty acids and their derived oxylipins were quantified using liquid chromatography-tandem mass spectrometry.</p><p><strong>Results: </strong>Despite significant declines in milk arachidonic acid (AA) and docosahexaenoic acid (DHA) concentrations over the first 3 weeks of lactation, many corresponding oxylipins remained stable or increased. All measured linoleic acid (LA)-derived oxylipins increased significantly (p < 0.01) despite constant LA concentrations. Several n-3-derived oxylipins, including α-linolenic acid (ALA)-derived 13-hydroxy-9,11,15-octadecatrienoic acid (13-HOTrE), eicosapentaenoic acid (EPA)-derived 15-hydroxyeicosapentaenoic acid (15-HEPE) and DHA-derived protectin DX also increased by Week 3. Although some selected oxylipins were positively associated with their precursor fatty acids, the temporal oxylipin trajectories were not consistently aligned with changes in precursor concentrations.</p><p><strong>Conclusion: </strong>These findings highlight the dynamic, pathway-specific regulation of bioactive lipid mediators in preterm HM and provide a biochemical basis for future studies investigating the potential relationship between these mediators and prematurity-related morbidity.</p>","PeriodicalId":16694,"journal":{"name":"Journal of Pediatric Gastroenterology and Nutrition","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148906080","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":"Reflux symptom burden and duration of physical therapy in infants with congenital muscular torticollis: Prospective cohort analysis.","authors":"Laura K Bess, Jessica Costa, Jamie L Fierstein, Ernest Amankwah, Michael J Wilsey","doi":"10.1002/jpn3.70560","DOIUrl":"10.1002/jpn3.70560","url":null,"abstract":"<p><strong>Objectives: </strong>To determine the prevalence of provider-diagnosed gastroesophageal reflux disease (GERD) and clinically significant reflux symptoms in infants evaluated for congenital muscular torticollis (CMT) and their association with physical therapy duration.</p><p><strong>Methods: </strong>In this prospective cohort, 323 infants <12 months of age were enrolled and evaluated by physical therapists for CMT management. GERD status was established by medical record documentation and/or an infant gastroesophageal reflux questionnaire revised (I-GERQ-R) score >16. Demographic, clinical, and musculoskeletal characteristics were compared between infants with CMT alone and those with CMT plus reflux. Outcomes included time to achieve midline head posture, time to treatment discharge, and changes in I-GERQ-R scores over time.</p><p><strong>Results: </strong>GERD was identified in 93 infants (28.8%). Baseline demographic and musculoskeletal characteristics were similar between groups. The I-GERQ-R identified an additional subset of infants (5.6%) with clinically significant reflux symptom burden beyond those with a prior provider diagnosis. Head posture and muscle function improved gradually in both groups. Median time to discharge did not differ significantly; however, infants with CMT and reflux had a longer median duration of physical therapy (144 vs. 119 days, p = 0.08). I-GERQ-R scores decreased significantly over time in infants with (15-5; p < 0.0001) and without (8-4; p < 0.0001) reflux.</p><p><strong>Conclusions: </strong>Reflux symptoms were common among infants with CMT and were associated with a modestly longer duration of physical therapy. Although this association should not be interpreted as causal, awareness of reflux symptoms during CMT evaluation may inform counseling regarding the anticipated course of therapy.</p>","PeriodicalId":16694,"journal":{"name":"Journal of Pediatric Gastroenterology and Nutrition","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148900862","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":"Therapeutic response to ferric hydroxide versus ferrous glycine sulfate in pediatric autoimmune gastritis-related iron deficiency anemia.","authors":"Joana Carvalho Queirós, Inês Aires Martins, Ana Lachado, Francisco Ribeiro-Mourão, Helena Moreira-Silva, Isabel Couto Guerra, Marta Tavares, Emília Costa, Rosa Lima","doi":"10.1002/jpn3.70574","DOIUrl":"10.1002/jpn3.70574","url":null,"abstract":"<p><strong>Objectives: </strong>Autoimmune gastritis (AIG) is characterized by immune-mediated destruction of gastric parietal cells and impaired iron absorption. Refractory iron deficiency anemia (IDA) is often the main clinical presentation in pediatric patients. Because oral ferrous glycine sulfate (FGS) is absorbed independently of gastric pH, it may represent an effective alternative to ferric hydroxide (FH) in this setting.</p><p><strong>Aim: </strong>To compare the therapeutic response to FH and FGS in children and adolescents with AIG-associated IDA.</p><p><strong>Methods: </strong>We conducted a retrospective observational cohort study including pediatric patients diagnosed with AIG-associated IDA and followed at a tertiary Pediatric Gastroenterology Unit between 2007 and 2023. Treatment non-response was defined as a hemoglobin (Hb) increase <1 g/dL after 4 weeks of therapy and/or failure to normalize ferritin after 3 months.</p><p><strong>Results: </strong>Thirty-two patients were included (71% female; median age 12 years). IDA was the presenting feature in 94% of cases. Median baseline Hb was 9.8 g/dL and ferritin was 5 ng/mL. Thirty patients had previously received FH, of whom only four achieved an adequate response. The remaining 26 patients showed minimal improvement in Hb and ferritin and were subsequently switched to FGS. After switching, a significant increase in Hb and ferritin was observed (both p < 0.001), with normalization of Hb and ferritin achieved in 86% and 81% of patients, respectively. Two patients treated initially with FGS also demonstrated favorable hematologic responses.</p><p><strong>Conclusions: </strong>In this retrospective cohort, FGS was associated with substantial hematologic improvement in pediatric patients with AIG-associated IDA, particularly in those who had failed previous FH therapy.</p>","PeriodicalId":16694,"journal":{"name":"Journal of Pediatric Gastroenterology and Nutrition","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148906156","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}