Clinical and Experimental Pediatrics最新文献

{"title":"C3 glomerulopathy in children: experience at a resource-limited center.","authors":"Soumya Reddy, Abhishek Ghante, Mahesha Vankalakunti, Anil Vasudevan","doi":"10.3345/cep.2024.01256","DOIUrl":"10.3345/cep.2024.01256","url":null,"abstract":"<p><strong>Background: </strong>In children, C3 glomerulopathy (C3G) is a heterogeneous disease characterized by diverse clinicopathological profiles and kidney outcomes. However, diagnostic work-up in resource-limited settings is challenging because of the unavailability of complement assays and limited access to electron microscopy or genetic testing.</p><p><strong>Purpose: </strong>This study aimed to describe the clinicopathological features and response to immunosuppression and evaluate renal outcomes among children with C3G in a resource-limited setting.</p><p><strong>Methods: </strong>This retrospective cohort study involved a review of the hospital records of 46 children (2013-2021) diagnosed with C3G on kidney biopsy. Their clinical, laboratory, treatment, and outcome details at onset and follow-up were noted.</p><p><strong>Results: </strong>The mean (standard deviation) age was 9 (4) years. The common presentation was acute nephritis (27 [58.6%]), while 1 in 5 (19.5%) presented with rapidly progressive glomerulonephritis. Focal crescentic glomerulonephritis (14 [30.4%]) was the common histological pattern. Electron microscopy was performed in 22 (47.8%), of which 17 were C3 glomerulonephritis and 4 were dense deposit disease (DDD). None of the patients underwent complement assay or genetic testing. Almost two-thirds (63%) received empirical immunosuppressive therapy, most commonly steroids. Of the 31/46 who completed follow-up (median [interquartile range] duration, 11.5 [6-24] months), 6 (19.4%) demonstrated complete kidney recovery, while the other 25 (80.7%) had kidney sequelae; of them, 5 (16.1%) progressed to end-stage kidney disease and 2 (4.3%) died by the last follow-up.</p><p><strong>Conclusion: </strong>Pediatric C3G has a variable clinicopathological spectrum, while DDD is less common. Most patients present with glomerulonephritis and significant morbidities. The lack of genetic and C3Nephritic factor testing is a barrier to the comprehensive phenotyping and management of C3G in resource-limited settings.</p>","PeriodicalId":36018,"journal":{"name":"Clinical and Experimental Pediatrics","volume":" ","pages":"311-318"},"PeriodicalIF":3.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11969206/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142751893","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":"Myopia: a review of current concepts, association with nonophthalmological conditions, and treatment strategy in children and adolescents.","authors":"Yeon Woong Chung","doi":"10.3345/cep.2025.00115","DOIUrl":"https://doi.org/10.3345/cep.2025.00115","url":null,"abstract":"<p><p>Myopia, among the most common vision disorders worldwide, is projected to affect approximately 50% of the world's population by 2050. Its prevalence is particularly high in East Asia, posing a considerable public health challenge. In particular, high myopia, defined as ≤6.0 diopters, significantly increases an individual's lifetime risk of vision-threatening complications. Moreover, recent studies revealed that non-ophthalmological factors such as body stature, sleep patterns, and nutritional status are strongly correlated with the progression of myopia, particularly in childhood and adolescence, underscoring the need for a systemic approach to its control. Current therapeutic approaches include optical correction, pharmacological treatment, and increased outdoor activity. Optically, defocus-incorporated multi-segment spectacle lenses and orthokeratology have shown efficacy at controlling the progression of myopia through peripheral retinal defocus and corneal reshaping, respectively. Pharmacologically, atropine eye drops, especially at low concentrations (0.05%), have demonstrated efficacy at myopia control with minimal side effects, making them a preferred treatment option for progressive myopia. Behaviorally, increased outdoor activity (minimum 2 h daily) and decreased excessive near work, particularly on digital devices, can help prevent the progression of myopia. Furthermore, studies have aimed to prevent the progression from pre-myopia to myopia.</p>","PeriodicalId":36018,"journal":{"name":"Clinical and Experimental Pediatrics","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144019130","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":"Lifelong impact of elevated blood pressure from childhood to adulthood.","authors":"Junhyun Kwon, Eunji Kim","doi":"10.3345/cep.2024.01445","DOIUrl":"10.3345/cep.2024.01445","url":null,"abstract":"<p><p>Elevated blood pressure (BP) during childhood and adolescence is increasingly being recognized as a precursor to adult hypertension and cardiovascular disease (CVD). This review examines the existing evidence of the relationship between early BP elevations and long-term cardiovascular (CV) outcomes. Previous studies demonstrated a moderate association between childhood BP and adult hypertension, with early BP elevations contributing to subclinical CV changes such as left ventricular hypertrophy and increased carotid intima-media thickness as well as major premature CVD events in adulthood. However, evidence also indicates that BP normalization before adulthood may mitigate these risks, suggesting a critical interventional window before irreversible CV changes occur. Multiple modifiable and nonmodifiable factors contribute to early-life BP elevations, including genetic predisposition, a high sodium intake, obesity, sedentary behavior, and sleep disturbances. Although establishing a direct causal association between childhood BP and adult hypertension or CVD remains challenging owing to the need for longterm follow-up and large sample sizes, further research is essential to addressing the existing knowledge gaps in pediatric hypertension prevention, detection, impact, and treatment. This review highlights the importance of preventing BP elevations early in life to reduce the longterm burden of hypertension and CVD. Promoting healthy behaviors, such as maintaining a healthy weight, reducing one's sodium intake, engaging in physical activity, and ensuring adequate sleep, is essential for managing BP at an early age. These efforts reduce individual CV risk and help alleviate the broader future public health burden of hypertension and CVD.</p>","PeriodicalId":36018,"journal":{"name":"Clinical and Experimental Pediatrics","volume":" ","pages":"278-286"},"PeriodicalIF":3.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11969203/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142751896","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":"Role of miRNA-146a and miRNA-125b in Helicobacter pylori.","authors":"Nashwa Mohamed, Ola Behairy, Manal El-Defrawy, Mona Elsayed, Naglaa Alhusseini","doi":"10.3345/cep.2025.00192","DOIUrl":"https://doi.org/10.3345/cep.2025.00192","url":null,"abstract":"<p><strong>Background: </strong>Helicobacter pylori (H. pylori) infection is a common gastrointestinal pathogen associated with gastritis and peptic ulcers. The early detection of H. pylori-related gastritis is crucial to its effective management, especially in pediatric patients with dyspepsia.</p><p><strong>Purpose: </strong>This study aimed to assess the expression of miRNA-146a and miRNA-125b as potential indicators of H. pylori-associated gastritis in children.</p><p><strong>Methods: </strong>This cross-sectional study included 70 H. pylori-positive children and 50 H. pylori-negative controls aged ≤ 18 years with recurrent abdominal pain who underwent upper gastrointestinal endoscopy. The miRNA-146a and miRNA-125b expression levels in gastric biopsies were determined using quantitative reverse transcription polymerase chain reaction.</p><p><strong>Results: </strong>H. pylori-positive children had significantly higher levels of miRNA-146a than H. pylori-negative children across all endoscopic findings (range, 2.2-2.7 vs. 1.07-1.2; p<0.001) and histologic grades of gastritis (range, 2.0-2.4 vs. 1.2-1.3; p<0.001). Conversely, the H. pylori-positive group showed consistently lower miRNA-125b levels across all parameters (range, 0.3-0.8 vs. 0.4-0.9; p<0.001). Both miRNAs differentiated H. pylori status with an area under the curve of >0.95.</p><p><strong>Conclusion: </strong>The altered expression of miRNA-146a and miRNA-125b in gastric biopsies of H. pylori-positive children suggests their potential role as molecular markers of H. pylori-associated gastritis.</p>","PeriodicalId":36018,"journal":{"name":"Clinical and Experimental Pediatrics","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144051496","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":"Telemedicine in pediatrics: things to consider.","authors":"Sandhya J Kadam, Archana Reddy Bongurala","doi":"10.3345/cep.2024.01788","DOIUrl":"10.3345/cep.2024.01788","url":null,"abstract":"","PeriodicalId":36018,"journal":{"name":"Clinical and Experimental Pediatrics","volume":" ","pages":"326-328"},"PeriodicalIF":3.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11969201/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143123801","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":"NLRP3 inflammasome: A key player in neonatal brain injury.","authors":"Cagla Kiser, Ilkcan Ercan, Defne Engur, Sermin Genc","doi":"10.3345/cep.2024.01935","DOIUrl":"https://doi.org/10.3345/cep.2024.01935","url":null,"abstract":"<p><p>Among neonates, hypoxic-ischemic encephalopathy is the most significant cause of mortality and hypoxia-ischemia is among the leading causes of brain damage. The microglia are primary mediators of neuroinflammation. NOD-like receptor family pyrin domain containing 3 (NLRP3) inflammasome activation is the first line of defense in the central nervous system. Numerous studies have shown that the NLRP3 inflammasome is activated and pro-inflammatory cytokines are upregulated upon hypoxia-ischemia-induced brain damage. However, aberrant activation of the NLRP3 inflammasome results in cell death and brain tissue damage. Given that neonates are particularly vulnerable to neuroinflammation, which may cause lifelong disabilities, it is important to target the pathways involved in its complex nature to improve their prognosis. The potential use of compounds or drugs that target inflammasome activation to relieve hypoxia-induced brain damage has become significant. This review describes the NLRP3 inflammasome in neonates to contribute to the development of therapeutic approaches.</p>","PeriodicalId":36018,"journal":{"name":"Clinical and Experimental Pediatrics","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144015510","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 macrophage migration inhibitory factor gene and growth differentiation factor 15 gene polymorphisms and circulating levels with respiratory distress syndrome among preterm neonates.","authors":"Ali Helmi Bakri, Mohammed H Hassan, Khaled Abdalla Abd-Elbaseer, Mahmoud Abo-Alhassan Sayed, Ahmed Alamir Mahmoud Abdallah, Eman Ahmed Abd-Elmawgood","doi":"10.3345/cep.2025.00416","DOIUrl":"https://doi.org/10.3345/cep.2025.00416","url":null,"abstract":"<p><strong>Background: </strong>In preterm newborns, neonatal respiratory distress syndrome (RDS) is among the main causes of respiratory failure and mortality. However, the effect of macrophage migration inhibitory factor (MIF) on neonatal developmental lung disease is not well documented in the literature. Moreover, little is known about the effects of growth differentiation factor-15 (GDF-15) on lung maturity in preterm infants.</p><p><strong>Purpose: </strong>To evaluate serum MIF and GDF-15 levels in preterm infants with and without RDS and analyze the genetic profile of single nucleotide polymorphisms (SNPs) for MIF rs755622 G>C and GDF-15 rs4808793 C>G.</p><p><strong>Methods: </strong>In this case-control study, 90 preterm newborns were categorized into three groups: group A included 30 preterm newborns with mild-to-moderate RDS, group B included 30 preterm newborns with severe RDS, and group C included 30 healthy preterm newborns. Enzyme-linked immunosorbent assay methods were used to measure serum MIF and GDF-15 levels. The MIF rs755622 G>C and GDF-15 rs4808793 C>G SNPs were analyzed by restriction fragment length polymorphism-polymerase chain reaction.</p><p><strong>Results: </strong>Significantly higher median MIF and GDF-15 blood levels were noted among neonates with severe RDS (17.32 µg/L and 3.19 pg/mL, respectively) versus those with mild to moderate RDS (5.5 µg/L and 0.71 pg/mL, respectively) (p <0.05 for both). A significantly higher frequency of a mutant C-allele of MIF rs755622 G>C was noted among cases (37.5%) versus controls (13.3%) (p=0.001; odds ratio, 0.256; 95% confidence interval, 0.112-0.589). A significantly higher frequency of a mutant G-allele of GDF-15 rs4808793 C>G SNPs was noted among cases (49.2%) versus controls (30%) (odds ratio, 0.443; 95% confidence interval, 0.229-0.856).</p><p><strong>Conclusion: </strong>These findings suggest that serum MIF and GDF-15 levels are strongly associated with RDS severity among preterm neonates. Moreover, polymorphisms of MIF and GDF-15 could be genetic risk factors for the development of neonatal RDS among preterm babies.</p>","PeriodicalId":36018,"journal":{"name":"Clinical and Experimental Pediatrics","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144017817","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":"Clinical course of children with postinfectious bronchiolitis obliterans with versus without comorbid bronchopulmonary dysplasia.","authors":"Lamia Medghoul, Julien Grosjean, Christophe Marguet, Hortense Petat","doi":"10.3345/cep.2025.00122","DOIUrl":"https://doi.org/10.3345/cep.2025.00122","url":null,"abstract":"<p><strong>Background: </strong>Post-infectious bronchiolitis obliterans (PIBO) is a rare chronic obstructive pulmonary disease that occurs after a respiratory infection. Its diagnosis is generally based on clinical history, respiratory symptoms, and computed tomography (CT) findings.</p><p><strong>Purpose: </strong>Here we evaluated the frequency of exacerbations, clinical progress, and inhaled corticosteroid (ICS) usage in children diagnosed with PIBO with or without comorbid bronchopulmonary dysplasia (BPD).</p><p><strong>Methods: </strong>This retrospective observational study was conducted in Rouen, France. The inclusion criteria were as follows: child diagnosed with PIBO (history of respiratory infection, airway obstruction with no or poor response to bronchodilation treatment, and/or mosaic pattern or trapping on chest high-resolution CT (HRCT) in 2009-2024 treated with intravenous corticosteroid pulses.</p><p><strong>Results: </strong>Fifty-seven patients were included: 13 (23%) with BPD and 44 (77%) without BPD. The mean age at diagnosis was 7 ± 3.6 months, with no significant intergroup difference. We observed a significant reduction in exacerbations following corticosteroid pulse treatment as soon as 6 months (p<0.001), with persistent effects observed up to 24 months (p=0.02). We also noted a reduced daily ICS dose starting at 12 months (p=0.03). Respiratory syncytial virus is the most commonly identified causative virus, followed by rhinoviruses and adenoviruses. The viral co-detection rates were 18% and 61% in the BPD and non-BPD groups, respectively.</p><p><strong>Conclusion: </strong>In our cohort, intravenous corticosteroid pulse treatment effectively treated PIBO, with a rapid and long-lasting reduction in exacerbations and ICS requirements. BPD was a significant comorbidity of PIBO.</p>","PeriodicalId":36018,"journal":{"name":"Clinical and Experimental Pediatrics","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144014029","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":"Hematopoietic stem cell transplantation in pediatric patients with type VI mucopolysaccharidosis.","authors":"Vedat Uygun, Koray Yalçın, Hayriye Daloğlu, Seda Öztürkmen, Suna Çelen, Suleimen Zhumatayev, Gülsün Karasu, Akif Yeşilipek","doi":"10.3345/cep.2024.02033","DOIUrl":"https://doi.org/10.3345/cep.2024.02033","url":null,"abstract":"<p><strong>Background: </strong>It is uncertain whether hematopoietic stem cell transplantation (HSCT), versus standard enzyme replacement therapy (ERT), is effective for type VI mucopolysaccharidosis (MPS VI).</p><p><strong>Purpose: </strong>New related advances in HSCT prompted an examination of the transplant procedures performed in a recent cohort.</p><p><strong>Methods: </strong>This single-center retrospective study reviewed the medical records of 17 pediatric patients with MPS VI who underwent allogeneic HSCT in 2021-2023. All conditioning regimens were myeloablative. Engraftment days, complications, and survival data were recorded. As follow-up was short, we recorded only 6-min walk test distance before versus after HSCT.</p><p><strong>Results: </strong>The patients underwent transplantation at a median of 6 years post-diagnosis. All were engrafted and had a full or mixed chimerism. Enzyme levels were within normal ranges. Walking tests of all evaluable patients improved at a median 9-month follow-up.</p><p><strong>Conclusion: </strong>HSCT aims to improve the disease and provides a permanent solution at the enzyme level, eliminating enzyme replacement therapy. Our study showed that HSCT, a less expensive and permanent treatment option, should be offered to patients with MPS VI.</p>","PeriodicalId":36018,"journal":{"name":"Clinical and Experimental Pediatrics","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143626401","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":"Efficacy and safety of carbon dioxide versus room-air insufflation in pediatric colonoscopy: a randomized controlled trial.","authors":"Ajay Aravind, Ujjal Poddar, Anshu Srivastava, Moinak Sen Sarma","doi":"10.3345/cep.2024.02012","DOIUrl":"https://doi.org/10.3345/cep.2024.02012","url":null,"abstract":"<p><strong>Background: </strong>Adequately powered studies in children are scarce and there are reports on the risk of carbon dioxide (CO2) retention after colonoscopy.</p><p><strong>Purpose: </strong>This study investigated the efficacy and safety of CO2 insufflation in children undergoing colonoscopy.</p><p><strong>Methods: </strong>This prospective randomized clinical trial was conducted at a tertiary care hospital between March 2023 and July 2024. We recruited 200 consecutive children (age, 5-18 years; n=100 in each arm) who underwent colonoscopy under conscious sedation. Patients were randomized to receive CO2 or room air using a random number table. The primary outcome measure was postprocedural pain assessed by using a visual analog scale. Secondary outcome measures included time to reach the cecum, total procedure duration, abdominal distension, and end-tidal CO2 level. Complications were recorded.</p><p><strong>Results: </strong>Pain scores at 2 and 4 h post-procedure were significantly lower in the CO2 versus room-air group (1.12 vs. 1.66, p=0.001 at 2 h and 0.37 vs. 0.61, p=0.002 at 4 h). The time to reach the cecum was significantly higher in the CO2 group (39.6 vs. 26.6 min, p=0.01). A greater proportion of children in the room-air group (29% vs. 19%, p=0.04) reported significant pain (visual analog scale score, ≥3). The subgroup analysis revealed a significantly longer time to reach the cecum and total procedure duration in the CO2 group among first-year trainees. End-tidal CO2 levels were significantly higher in the CO2 group (36 [interquartile range, 35-37] mmHg vs. 34 [interquartile range, 32-35] mmHg, p=0.001), but none developed any signs of CO2 retention. No significant intergroup differences were noted in abdominal girth, bloating sensation, analgesic requirements, or procedure-related complications.</p><p><strong>Conclusion: </strong>s: CO2 insufflation is safer and makes the procedure less painful but slower than room-air insufflation, especially in first-year trainees, without an increased risk of retention.</p>","PeriodicalId":36018,"journal":{"name":"Clinical and Experimental Pediatrics","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143626379","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}