{"title":"Liver function trends in children with suspected drug-induced hepatocellular injury: A survey using an electronic medical records database.","authors":"Masayoshi Nakakuni, Kosuke Nakano, Ayano Inui, Shinji Kobayashi, Naoko Deguchi, Seiji Mitsui, Takeshi Kuriyama, Seiko Miyazaki","doi":"10.1111/ped.15847","DOIUrl":"10.1111/ped.15847","url":null,"abstract":"<p><strong>Background: </strong>Drug-induced liver injury (DILI) is a common adverse drug event with limited pediatric data in the literature. This study aimed to use pediatric electronic medical records to assess hepatocellular DILI in pediatric patients who were prescribed liver-injury-inducing drugs.</p><p><strong>Methods: </strong>The Pediatric Medical Information Collection System (P-MICS) is a centralized database integrating electronic medical records from over 40 medical pediatric centers. Pediatric patients in the P-MICS with serum alanine aminotransferase (ALT) levels five or more times the upper limit of normal and who were below 15 years of age were selected. Those with liver diseases unrelated to drug-induced causes were excluded. We identified drugs prescribed 2 to 90 days before the first elevated ALT reading. High-risk liver-injury-causing drugs were determined based on the LiverTox score. We analyzed post-event ALT and total bilirubin levels (TB) and DILI management.</p><p><strong>Results: </strong>Of the 817 patients with suspected DILI, 251 were prescribed four drugs identified as high-risk drugs for hepatocellular DILI: methotrexate (n = 129), aspirin (n = 82), vancomycin (n = 58), and cyclophosphamide (n = 51). The median ALT level at the first event was 245 U/L. Approximately 35% of methotrexate users and cyclophosphamide users experienced recurrent ALT elevation. Some methotrexate users also showed TB elevation. Discontinuation of high-risk drugs resulted in fewer relapses and TB elevations than pharmacotherapy.</p><p><strong>Conclusions: </strong>The P-MICS effectively identifies pediatric patients with potential liver injury and tracks liver function in those prescribed liver-injury-causing drugs. This study underscores liver injury risks in pediatric anticancer drug users, highlighting the utility of the P-MICS in monitoring off-label drug safety in children.</p>","PeriodicalId":20039,"journal":{"name":"Pediatrics International","volume":"67 1","pages":"e15847"},"PeriodicalIF":1.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143449615","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":"Febrile infant with bacteremia caused by group B Streptococcus and coronavirus disease 2019 during the pandemic.","authors":"Miho Ikeda, Shinsuke Mizuno, Yukari Aida, Masaaki Kugo, Yasuo Nakagishi, Masashi Kasai","doi":"10.1111/ped.70033","DOIUrl":"https://doi.org/10.1111/ped.70033","url":null,"abstract":"","PeriodicalId":20039,"journal":{"name":"Pediatrics International","volume":"67 1","pages":"e70033"},"PeriodicalIF":1.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144036593","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":"Retrospective evaluation of mild encephalitis/encephalopathy with a reversible splenial lesion in children.","authors":"Xin Li, Suzhen Sun, Huifeng Zhang","doi":"10.1111/ped.15869","DOIUrl":"10.1111/ped.15869","url":null,"abstract":"<p><strong>Background: </strong>Comprehensive documentation on consecutive years of mild encephalitis/encephalopathy with a reversible splenial lesion (MERS) in children is lacking. This study aims to provide an in-depth analysis of the clinical profiles of MERS in children across different age groups, focusing on pathogens and recovery time.</p><p><strong>Methods: </strong>In this retrospective study, 43 patients diagnosed with MERS were enrolled between December 2017 and November 2021. Due to different clinical manifestations at different ages, we categorized them into two age groups: the 6-year-old or younger group and the over 6-year-old group. Clinical data were described and compared for these age cohorts.</p><p><strong>Results: </strong>Sixty percent of the cases occurred during winter, with two distinct peaks in onset age, at 1-3 years of age and 7-8 years of age. Intestinal infections were prevalent among children aged below 6 years, mainly caused by rotavirus; convulsion was the most common symptom (92.6% vs. 50%, p = 0.005). Conversely, respiratory tract infections were often observed in children older than 6 years of age, which were mainly attributed to mycoplasma pneumonia; headache and dizziness were characteristic symptoms (62.5% vs. 18.5%, p = 0.003). No significant differences were found in treatment outcomes between the two age groups. Nonetheless, MERS type II exhibited a notably longer clinical recovery time than type I (4.8 ± 1.7 vs. 8.2 ± 5.5).</p><p><strong>Conclusion: </strong>Mild encephalitis/encephalopathy with a reversible splenial lesion exhibits a distinct seasonal pattern with varied clinical manifestations across different age groups. Although the prognosis was favorable, discernible differences in clinical symptoms and pathogens were observed between the two age cohorts. It was noted that the clinical recovery time for MERS type II was comparatively protracted in comparison with type I.</p>","PeriodicalId":20039,"journal":{"name":"Pediatrics International","volume":"67 1","pages":"e15869"},"PeriodicalIF":1.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143606093","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":"Evaluation of the effect of inhaled β<sub>2</sub> agonist on lung sounds of children with acute bronchiolitis.","authors":"Yu Kuramochi, Mami Ichinose, Takashi Matsushita, Takanori Kagawa, Takashi Sakama, Kota Hirai, Hiroyuki Furuya, Fumio Niimura, Hiroyuki Mochizuki","doi":"10.1111/ped.70053","DOIUrl":"https://doi.org/10.1111/ped.70053","url":null,"abstract":"<p><strong>Background: </strong>Discussions regarding the treatment of acute bronchiolitis are ongoing. In this study, we investigated the effects of bronchodilators in infants with viral bronchiolitis using a lung sound analysis.</p><p><strong>Methods: </strong>Subjects were hospitalized children diagnosed with viral acute bronchiolitis who received inhaled short-acting inhaled beta 2-agonist (SABA). Lung sounds were collected before and after SABA inhalation, and imaged and quantified using a dedicated analysis system to objectively evaluate the effects of SABA. Furthermore, we investigated the influence of the child's clinical symptoms (clinical score, SpO<sub>2</sub> value, hospitalization days, etc.), past history and family history of allergic diseases on the changes in lung sounds after SABA inhalation.</p><p><strong>Results: </strong>Twenty-six children (male: female = 16: 10, median age: 11 months) participated in the study, and wheezes on the lung sound spectrogram disappeared or decreased after inhalation of SABA in 57.7% (n = 15). However, no improvement in the low-pitched sounds of the lung spectrogram was evident, and no significant change was observed in the exhalation/inspiration power ratio. Although SpO<sub>2</sub> in the group whose wheezes improved due to SABA inhalation was significantly lower than that in the group without improvement (p = 0.008), there were no significant differences in other factors.</p><p><strong>Conclusion: </strong>The lung sound analysis confirmed that wheezes improved after SABA inhalation in half of the infants with acute viral bronchiolitis. However, since there was no improvement in clinical symptoms or low-pitched sounds, it was hypothesized that respiratory dysfunctions were caused by various mechanisms in infants with acute bronchiolitis.</p>","PeriodicalId":20039,"journal":{"name":"Pediatrics International","volume":"67 1","pages":"e70053"},"PeriodicalIF":1.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144032857","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":"A novel in-frame deletion flanking exon 54 of the FBN1 gene in a Japanese girl with Marfan syndrome.","authors":"Toshihiko Mori, Shigeto Fuse, Kazuna Hirai, Maki Katai, Hiroko Morisaki","doi":"10.1111/ped.15857","DOIUrl":"https://doi.org/10.1111/ped.15857","url":null,"abstract":"","PeriodicalId":20039,"journal":{"name":"Pediatrics International","volume":"67 1","pages":"e15857"},"PeriodicalIF":1.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142984474","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}