Clinical and Experimental Pediatrics最新文献

{"title":"Hepcidin and other obesity-related factors affecting BNT162b2 response in children and adolescents over a 6-month period.","authors":"Anthie Damianaki, Antonios Marmarinos, Margaritis Avgeris, Dimitrios Gourgiotis, Elpis-Athina Vlachopapadopoulou, Marietta Charakida, Maria Tsolia, Lydia Kossiva","doi":"10.3345/cep.2026.01298","DOIUrl":"https://doi.org/10.3345/cep.2026.01298","url":null,"abstract":"<p><strong>Background: </strong>Obesity causes chronic inflammation and metabolic dysregulation of the immune response and increases an individual's susceptibility to severe infection.</p><p><strong>Purpose: </strong>This study aimed to evaluate the effect of an increased body mass index (BMI), obesity-associated biomarkers, and habitual factors on immune responses following BNT162b2 vaccination in a pediatric population over a 6-month period.</p><p><strong>Methods: </strong>In this prospective, single-center cohort study, the participants received a 2-dose regimen of the BNT16 2b2 mRNA vaccine. Anti-severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) immunoglobulin G (IgG) and neutralizing antibody (Ab) levels were measured before vaccination (T0), 14 days after vaccination (T1), and 6 months after the second dose (T2). Baseline anthropometric and biochemical assessments including BMI measurements were performed at T0. Lifestyle characteristics were evaluated using a standardized questionnaire administered at baseline.</p><p><strong>Results: </strong>T2 SARS-CoV-2 neutralizing Ab levels were significantly lower in overweight or obese participants (P= 0.02). Among the other biochemical markers, hepcidin, and leptin levels were significantly correlated with BMI (P= 0.004 and P<0.001, respectively). The main biochemical parameters that were inversely correlated with T1 IgG and neutralizing titers were uric acid (P=0.007, P<0.001), fasting serum glucose-to-plasma insulin ratio (P=0.02 and P=0.02), and hepcidin (P=0.01 and P=0.01). Passive smoking was associated with lower T2 IgG titers (P=0.04). Higher uric acid levels and a lower KIDMED index were associated with reduced T2 SARS-CoV-2 neutralizingtiters (P=0.005 and P=0.02, respectively). Reactogenicity was significantly correlated with BMI and age (P=0.03 and P= 0.02, respectively), whereas higher hepcidin and uric acid levels were associated with the presence of local and systemic adverse effects, respectively (P=0.008 and P= 0.02, respectively).</p><p><strong>Conclusion: </strong>Our findings suggest that obesity-related environmental and behavioral factors may be associated with humoral immune responses during 6 months of follow-up.</p>","PeriodicalId":36018,"journal":{"name":"Clinical and Experimental Pediatrics","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149115871","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between surgical repair timing and mortality in neonates with congenital diaphragmatic hernia: a systematic review and meta-analysis.","authors":"Veerabhadra Radhakrishna, Bharathi Balachander, Sanjana Hansoge Somanath, Hejmady Aneesh Shenoy, Srinivas Balachander","doi":"10.3345/cep.2026.01837","DOIUrl":"https://doi.org/10.3345/cep.2026.01837","url":null,"abstract":"<p><p>Congenital diaphragmatic hernia (CDH) is a rare congenital anomaly whose management involves a complex interplay between medical and surgical treatments. Stabilization prior to surgery is vital. However, the optimal timing of surgical repair and its relationship with mortality remain unknown. Hence, this meta-analysis aimed to evaluate the association between repair timing and mortality in neonates with CDH. A systematic review and meta-analysis were conducted in accordance with PRISMA (Preferred Reporting Items for Systematic reviews and Meta-analyses) guidelines. The PubMed, NCBI, Cochrane CENTRAL, Google Scholar, CINHAL, Ovid, Scopus, Web of Science, and Epistemonikos databases were searched for articles published through April 2026. Forty studies, including 2 randomized controlled trials, 3 prospective observational studies, and 35 retrospective studies, were included in the meta-analysis. Newborns operated on within 24 hours of life had significantly higher mortality (relative risk [RR], 2.54; 95% confidence interval [CI], 1.76-3.66; P<0.001) than those operated on at or after 24 hours. This association persisted in a subgroup analysis restricted to contemporary studies published since 2000 (RR, 2.57; 95% CI, 1.00-6.62; P<0.001). Additional subgroup analyses demonstrated significantly higher mortality in neonates who underwent repair within 24 hours than in those who underwent repair at 24-48 hours (P<0.001), whereas mortality did not differ significantly between those who underwent repair at 24-48 hours and those who underwent repair after 48 hours (P=0.65). Surgical timing did not significantly alter mortality in a specific subset of newborns requiring ECMO support. In conclusion, a brief period of stabilization of at least 24 hours significantly improved survival among neonates with CDH, whereas delaying surgical repair beyond 48 hours conferred no additional survival benefits.</p>","PeriodicalId":36018,"journal":{"name":"Clinical and Experimental Pediatrics","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148991742","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Antibiotic pretreatment and culture yield in pediatric osteoarticular infection: a systematic review and meta-analysis.","authors":"Mohamad Shieb, Caroline Decesare, Guyu Li, Elizabeth Ristagno","doi":"10.3345/cep.2026.01634","DOIUrl":"10.3345/cep.2026.01634","url":null,"abstract":"<p><p>Whether early antibiotic administration compromises microbiological tissue culture yield in children with suspected osteoarticular infection remains a common clinical concern, yet the underlying evidence has never been pooled. We performed a systematic review and meta-analysis to quantify the association between antibiotic pretreatment and tissue culture yield in pediatric osteomyelitis and septic arthritis. MEDLINE (PubMed) and Embase (Ovid) were searched from inception to December 2025 under a protocol prospectively registered with PROSPERO (CRD420251126960); the review is reported in accordance with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses) 2020 statement. Eligible studies reported tissue culture yield in pediatric patients (0-18 years) with osteoarticular infection stratified by antibiotic exposure prior to culture; all included evidence was observational, and no randomized controlled trials were identified. Risk of bias was assessed using a modified Newcastle-Ottawa Scale, and a Der Simonian-Laird random-effects meta-analysis was performed for the primary outcome of tissue culture positivity from the infection site. Nine studies: 7 retrospective cohort studies and 2 case series, comprising 1,704 tissue culture specimens were included. Antibiotic pretreatment was not associated with reduced tissue culture yield (odds ratio, 1.60; 95% confidence interval, 1.23-2.08; P=0.0004; I²=8.9%), with culture positivity of 71.5% in pretreated versus 60.0% in not-pretreated specimens. Because an odds ratio greater than 1 could be misread as a benefit of antibiotics, we emphasize that this direction most plausibly reflects confounding by indication or disease severity rather than a true effect on yield. No evidence of publication bias was detected (Egger P=0.99). Pooled evidence does not support routinely withholding antibiotics solely to preserve tissue culture yield in pediatric osteoarticular infection. Because the included studies were observational and subject to confounding by indication, these findings should not be taken as a uniform recommendation on antibiotic timing; decisions should remain individualized, with appropriate specimens obtained before antibiotics whenever clinically feasible.</p>","PeriodicalId":36018,"journal":{"name":"Clinical and Experimental Pediatrics","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148991683","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of varicella vaccine introduction on chickenpox incidence in Kingdom of Bahrain.","authors":"Afaf Mohammed, Hasan Isa, Malak Hasan, Maram Hasan, Ali Moosa, Janan Radhi, Basma Al Saffar, Adel Al Sayyad","doi":"10.3345/cep.2026.01326","DOIUrl":"https://doi.org/10.3345/cep.2026.01326","url":null,"abstract":"<p><strong>Background: </strong>Chickenpox (varicella) is a highly contagious and self-limiting disease in children. However, complications and hospitalizations may occur. In Bahrain, the varicella vaccine was introduced into the routine childhood immunization schedule in May 2015. However, published data describing the epidemiological patterns of varicella postvaccine introduction are limited.</p><p><strong>Purpose: </strong>This study aimed to estimate varicella vaccine effectiveness (VE); investigate changes in varicella incidence and seasonal variation; compare age groups, healthcare utilization, and hospitalization; and identify predictors of vaccine uptake.</p><p><strong>Methods: </strong>This retrospective national study included all clinically diagnosed varicella cases reported to the Public Health Directorate in Bahrain in 2010-2024. Annual and age-specific incidence rates and seasonal variations were calculated. Demographic characteristics, healthcare settings, and hospitalizations were compared by vaccination status. Varicella VE was estimated using a screening method.</p><p><strong>Results: </strong>Of the 34,499 varicella surveillance records, 32,177 were confirmed as chickenpox cases (15,579 in 2010- 2013, 16,598 in 2014-2024). The annual incidence peaked at 251.8 per 100,000 in 2015 and declined to 28.5 per 100,000 by 2024 postvaccination (88.7% reduction). Seasonal peaks were more evident between 2014 and 2019 but became less pronounced thereafter. Most patients were male (57.4%), Bahraini nationals (69.1%), or unvaccinated (90.1%). The most affected age groups were children aged 5-9 years (36.1%) and 0-4 years (28.4%). More than 98% of the cases were managed in primary healthcare settings. Only 12 of the unvaccinated patients (0.1%) required hospitalization. The calculated VE ranged from 97.7% to 100%. Compared to children aged 0-4 years, all older age groups had significantly lower odds of vaccination (P<0.001). Similarly, non-Bahraini patients had a lower odd than Bahraini patients (odds ratio, 0.744; 95% confidence interval, 0.633- 0.875; P<0.001).</p><p><strong>Conclusion: </strong>The introduction of routine childhood varicella vaccination in Bahrain resulted in a substantial decline in the incidence of varicella, particularly among vaccine-eligible children. Severe diseases requiring hospitalization are rare and occur only in unvaccinated individuals. Age and nationality were independent predictors of vaccine uptake.</p>","PeriodicalId":36018,"journal":{"name":"Clinical and Experimental Pediatrics","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148991664","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Atherogenic lipid profile changes and their cardiovascular consequences across degrees of obesity in children and adolescents: a structured narrative review.","authors":"Ashraf Soliman, Fawzia Alyafei, Nada Alaaraj, Noor Hamed, Shayma Ahmed, Rasha Amin","doi":"10.3345/cep.2026.01739","DOIUrl":"https://doi.org/10.3345/cep.2026.01739","url":null,"abstract":"<p><p>Childhood and adolescent obesity is strongly associated with an atherogenic lipid profile and silent cardiovascular injury that begins early and evolves over time. In this structured review, we synthesized PubMed-indexed evidence from the past 25 years on lipid profile changes in children and adolescents with varying degrees of obesity- overweight, obesity, and severe obesity-and their cardiovascular consequences from childhood through young adulthood, as well as interventions that improve lipid profile and cardiovascular risk. Obesity-related dyslipidemia consistently involves elevated triglyceride, reduced high-density lipoprotein cholesterol (HDL-C), and elevated non-HDL-C levels, as well as increased triglyceride/ HDL-C ratio, whereas low-density lipoprotein cholesterol levels, although clinically important, are less consistently abnormal; the burden rises with obesity severity. In childhood, this pattern manifests with subclinical endothelial dysfunction and early carotid intimal thickening; during adolescence, arterial stiffness, elevated blood pressure levels, and early left ventricular remodeling with diastolic dysfunction become detectable, particularly in severe obesity; by young adulthood, these changes progress into accelerated atherosclerosis and clinical car diovascular risk. Mechanistically, visceral adiposity increases free fatty acid flux and promotes hepatic very-lowdensity lipoprotein overproduction, while adipose tissue inflammation, low adiponectin levels, oxidative stress, and impaired nitric oxide bioavailability link the lipid profile to vascular and cardiac injury through insulin resistance. Lifestyle interventions and improving physical fitness and dietary quality remain first-line treatments. Antiobesity pharmacotherapy and metabolic-bariatric surgery can improve weight and cardiometabolic risk in selected adolescents with severe obesity, but long-term pediatric cardiovascular outcome data remain limited. Routine lipid profile screening combined with blood pressure, insulin resistance, and obesity severity assessments should be integrated with early, family-centered intervention to reduce lifelong cardiovascular risk.</p>","PeriodicalId":36018,"journal":{"name":"Clinical and Experimental Pediatrics","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148991745","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prenatal stress via chronic immobilization amplifies N-methyl-D-aspartate-induced spasm-like seizure susceptibility and neuroinflammation in neonatal rats.","authors":"Hyeok Hee Kwon, Seungyeon Bin, Seung Gyu Choi, Hyo Jung Shin, Joon Won Kang","doi":"10.3345/cep.2026.01403","DOIUrl":"https://doi.org/10.3345/cep.2026.01403","url":null,"abstract":"<p><strong>Background: </strong>Prolonged stress during pregnancy is associated with various neurodevelopmental abnormalities and an increased risk of neurological disorders. Although prenatal stress is implicated in altered brain development, its contribution to infant seizures remains unclear. Specifically, the effects of prolonged prenatal stress on seizure susceptibility and the mechanisms underlying this association remain unclear.</p><p><strong>Purpose: </strong>Infantile spasms, also known as West syndrome, are age-specific epileptic seizures. Most affected patients exhibit signs of delayed development. Using a pharmacologically induced N-methyl-D-aspartate (NMDA)-induced spasm-like seizure model, this study aimed to determine whether long-term prenatal stress increases susceptibility to these spasm-like events and examine the associated changes in glial activation and gamma-aminobutyric acid (GABA)ergic signaling.</p><p><strong>Methods: </strong>Pregnant Sprague-Dawley rats were subjected to acute immobilization stress (AIS; single 45-min restraint on gestational day 15) or chronic immobilization stress (CIS; daily 2-hour restraint on gestational days 15-19). Their offspring were assigned to the control, AIS, and CIS groups. NMDA (15 mg/kg, intraperitoneal) was administered to the resulting offspring on postnatal day 15, and spasm-like behavior was scored 75 minutes after the injection by an observer blinded to the group assignment. Immunohistochemical, quantitative reverse transcription polymerase chain reaction, and Sholl analyses were performed to assess glial activation and GABA-related protein expression.</p><p><strong>Results: </strong>We observed that exposure to long-term prenatal stress increased spasm frequency and decreased latency to spasm onset compared to exposure to short-term prenatal stress. Prenatal immobilization stress increased seizure susceptibility to NMDA-triggered spasms on postnatal day 15 and markedly increased microglial activation in the hippocampus. These findings were observed in acute and CIS models and were accompanied by increased microglial and astrocyte activation and decreased GAD67 expression.</p><p><strong>Conclusion: </strong>Long-term prenatal stress, particularly CIS, enhances susceptibility to NMDA-induced spasm-like seizures and is associated with enhanced glial activation and altered GABAergic signaling. As the present findings are associative, further studies are needed to determine whether neuroinflammation and GABAergic dysfunction causally contribute to the increased susceptibility.</p>","PeriodicalId":36018,"journal":{"name":"Clinical and Experimental Pediatrics","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148931480","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Health literacy and emergency preparedness in pediatric tracheostomy and home ventilation: a practical review.","authors":"Megan Pilcher, Weerapong Lilitwat","doi":"10.3345/cep.2026.01802","DOIUrl":"https://doi.org/10.3345/cep.2026.01802","url":null,"abstract":"<p><p>Children with tracheostomy and home ventilation are vulnerable to rapidly evolving airway and equipment emergencies after discharge. Health literacy in this setting is the functional capacity to access, understand, appraise, communicate, and apply child-specific information under stress. This narrative review synthesizes health-literacy literature, American Thoracic Society (ATS) guidance, caregiver education and simulation studies, outpatient emergency-knowledge studies, and health-system data to address the implementation gap between guideline-concordant discharge education and reliable caregiver action. The evidence is heterogeneous and largely observational or based on small educational interventions. In one cohort of 92 children, 44% had an Emergency Department visit with hospital admission within 90 days of discharge, 36% of which were tracheostomy- or respiratory-related. In an outpatient study of 52 caregivers, only 46.2% answered all 3 tracheostomy-emergency scenarios correctly, while 80% reported at least one tracheostomy-related emergency after discharge. We propose an author-derived 6-domain framework-baseline recognition, airway, ventilator/equipment, emergency action, communication, and system navigation-developed by mapping multidimensional health-literacy constructs, ATS safety recommendations, and recurrent caregiver tasks in pediatric tracheostomy/home-ventilation literature. Educational strategies include staged multimodal teaching, teach-back and show-back, simulation, mastery-oriented assessment, and longitudinal reassessment. Korean data illustrate how workforce, geography, and home-care organization modify implementation, but the framework is intended to be adaptable across healthcare systems. Health literacy should be treated as a safety capacity that connects guideline-defined structures to observable caregiver performance.</p>","PeriodicalId":36018,"journal":{"name":"Clinical and Experimental Pediatrics","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148931412","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Telomere biology disorders in childhood interstitial lung disease: from genetic diagnosis to bedside suspicion - A commentary on \"Telomere biology disorders associated with childhood interstitial lung disease\".","authors":"Weerapong Lilitwat","doi":"10.3345/cep.2026.01760","DOIUrl":"10.3345/cep.2026.01760","url":null,"abstract":"","PeriodicalId":36018,"journal":{"name":"Clinical and Experimental Pediatrics","volume":" ","pages":"751-752"},"PeriodicalIF":3.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13547717/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148841626","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"B4GALT1-related congenital disorder of glycosylation mimicking Ehlers-Danlos syndrome: a child with multisystem involvement and nephrotic syndrome.","authors":"Marifat Ganieva, Muqaddas Boltaboeva, Umida Ganiyeva, Oksana Efimenko, Abdulhamid Haydarov, Sherzod Toshboev","doi":"10.3345/cep.2026.00563","DOIUrl":"10.3345/cep.2026.00563","url":null,"abstract":"","PeriodicalId":36018,"journal":{"name":"Clinical and Experimental Pediatrics","volume":" ","pages":"748-750"},"PeriodicalIF":3.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13547719/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148621575","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Longitudinal changes in serum soluble C5b-9 levels following immunomodulatory therapy for multisystem inflammatory syndrome in children.","authors":"Amrita Pattanaik, Prasad Varamballi, Srilatha Marate, Sushma Bhandarkar B, Shrikiran Aroor, Somashekar A R, Suchetha S Rao, Chiranjay Mukhopadhyay","doi":"10.3345/cep.2026.01179","DOIUrl":"10.3345/cep.2026.01179","url":null,"abstract":"<p><strong>Background: </strong>Multisystem inflammatory syndrome in children (MIS-C) is a postinfectious hyperinflammatory condition that can follow a sudden acute respiratory syndrome coronavirus 2 infection. Although several inflammatory markers are used to guide its clinical management, biomarkers that reflect immunomodulatory therapy responses remain limited.</p><p><strong>Purpose: </strong>Evaluate intrapatient changes in serum soluble membrane attack complex/C5b-9 levels before and after immunomodulatory therapy in children with MIS-C.</p><p><strong>Methods: </strong>In this longitudinal observational study, paired serum samples from 100 children diagnosed with MIS-C across 3 tertiary care centers in India were analyzed for soluble C5b-9 (sC5b-9) concentrations before the initiation of immunomodulatory therapy and at clinical recovery. Intrapatient changes were evaluated using paired nonparametric statistical methods. Clinical phenotypes at presentation were documented and explored in relation to baseline sC5b-9 levels.</p><p><strong>Results: </strong>Serum sC5b-9 concentrations significantly declined following immunomodulatory therapy across the cohort (P<0.0001). Elevated pretherapy sC5b-9 levels were observed in patients presenting with shock, multiorgan dysfunction, or cardiac involvement. Although most patients exhibited reduced sC5b-9 levels following therapy, the magnitude of the change varied among individuals, with a subset showing persistently elevated levels at discharge.</p><p><strong>Conclusion: </strong>Serum sC5b-9 levels decreased after immunomodulatory therapy in children with MIS-C, suggesting its potential utility as a longitudinal marker of treatment response. The interpretation of absolute concentrations is limited by the serum-based sampling methodology; however, consistent intrapatient trends support further investigations using optimized complement sampling protocols.</p>","PeriodicalId":36018,"journal":{"name":"Clinical and Experimental Pediatrics","volume":"69 9","pages":"726-732"},"PeriodicalIF":3.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13547718/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148882084","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}