Pediatric Endocrinology, Diabetes and Metabolism最新文献

{"title":"Severe adrenal insufficiency coexisting with autoimmune thyroiditis (Schmidt's syndrome) - case report.","authors":"Katarzyna Dubas, Maciej Flader, Marek Niedziela","doi":"10.5114/pedm.2026.163360","DOIUrl":"10.5114/pedm.2026.163360","url":null,"abstract":"<p><p>We present a case report of a 14-year-old girl with Schmidt's syndrome, also known as autoimmune polyglandular syndrome type 2. The previously healthy child began experiencing symptoms including weight loss, nausea, abdominal pain, and poor exercise tolerance. Symptoms worsened during infections, resulting in multiple hospitalisations at a district hospital. During one hospitalisation, autoimmune thyroiditis was diagnosed, and levothyroxine therapy was initiated. After starting levothyroxine treatment, the patient's condition deteriorated, and episodes of syncope appeared. She was admitted urgently to the Department of Paediatric Endocrinology and Rheumatology, where primary adrenal insufficiency was diagnosed, and autoimmune thyroid disease was confirmed, constituting the two main components of Schmidt's syndrome. Hydrocortisone treatment was initiated, followed by levothyroxine therapy after three days. It should be remembered that patients with autoimmune thyroiditis may have other coexisting autoimmune diseases, including life-threatening adrenal insufficiency.</p>","PeriodicalId":39165,"journal":{"name":"Pediatric Endocrinology, Diabetes and Metabolism","volume":"32 3","pages":"230-233"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13628188/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149231318","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":"Ketoacidosis in new-onset type 1 diabetes: return to pre-COVID-19 pandemic reality?","authors":"Rita Gomes Alvelos, Paula Santos, Mariana Sebastião, Catarina Tavares, Inês Barros Rua, Joana Serra-Caetano, Rita Cardoso, Isabel Dinis, Alice Mirante","doi":"10.5114/pedm.2026.159708","DOIUrl":"10.5114/pedm.2026.159708","url":null,"abstract":"<p><strong>Introduction: </strong>Type 1 diabetes mellitus (T1D) is one of the most common chronic diseases in childhood, with its incidence increasing globally. The coronavirus disease 2019 (COVID-19) pandemic has been associated with an increase in severity of cases of diabetic ketoacidosis.</p><p><strong>Aim of the study: </strong>Type 1 diabetes mellitus (T1D) is one of the most common chronic diseases in childhood, with its incidence increasing globally. The coronavirus disease 2019 (COVID-19) pandemic has been associated with an increase in severity of cases of diabetic ketoacidosis.</p><p><strong>Material and methods: </strong>A retrospective cohort study was conducted, using patients' clinical records, between March 2016 and March 2024. The sample was divided in three groups: pre-pandemic (March 2016 to March 2020), pandemic (March 2020 to March 2021), and post-pandemic (March 2021 to March 2024).</p><p><strong>Results: </strong>A retrospective cohort study was conducted, using patients' clinical records, between March 2016 and March 2024. The sample was divided in three groups: pre-pandemic (March 2016 to March 2020), pandemic (March 2020 to March 2021), and post-pandemic (March 2021 to March 2024).</p><p><strong>Conclusions: </strong>There was an improvement in the post-pandemic period, with a lower severity at presentation. However, the rate of ketoacidosis remained high, and the focus must remain on implementing preventative measures.</p>","PeriodicalId":39165,"journal":{"name":"Pediatric Endocrinology, Diabetes and Metabolism","volume":"32 1","pages":"32-37"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13153753/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147784258","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":"Examination of factors affecting adropin levels in healthy and obese children.","authors":"Esra Dişçi, Serap Kılıç Kaya, Ayşe Sena Dönmez, Atilla Cayir, Esra Laloğlu, Kamber Kaşali, Büşra Nur Akgül","doi":"10.5114/pedm.2026.163376","DOIUrl":"10.5114/pedm.2026.163376","url":null,"abstract":"<p><strong>Introduction: </strong>There are very different reports regarding whether adropin levels are low, moderate, or high in childhood obesity and obesity-related comorbidities. However, data on the effects of age, sex, and puberty are insufficient.</p><p><strong>Material and methods: </strong>We planned a case-control study consisting of 59 obese patients (female [F] = 35/male [M] = 24) and 40 healthy controls (F = 21/M = 19). Additionally, obese children were re-evaluated following a 12-week diet intervention. Serum glucose, insulin, lipid profiles, liver function tests, and adropin levels were examined.</p><p><strong>Results: </strong>While age (12.5 ±4.1 years vs. 9.9 ±4.7 years, p = 0.006), body mass index (BMI) standard deviation score (SDS) (3.1 ±0.7 standard deviation [SD] vs. -0.3 ±0.8 SD, p &lt; 0.001), and alanine aminotransferase (ALT) (30 ±16.9 U/l vs. 17.7 ±7.1 U/l, p &lt; 0.001) were higher in obese children, adropin (212.2 ±67.7 ng/l vs. 369.2 ±64.6 ng/l, p &lt; 0.001) was lower than healthy controls. When age, sex, BMI SDS, and ALT were evaluated together in multivariate regression analysis (all patients), BMI SDS was found to be the only independent factor effecting adropin level ( = -0.6, p &lt; 0.001). We observed an increase in adropin levels compared to baseline following 12-week diet intervention, in obese children (212.2 ±67.7 ng/l vs. 237.4 ±87.3 ng/l, p = 0.03).</p><p><strong>Conclusions: </strong>The effect of parameters such as age, sex, and BMI SDS on adropin shows that the only independent factor effecting the alteration of adropin level is BMI SDS.</p>","PeriodicalId":39165,"journal":{"name":"Pediatric Endocrinology, Diabetes and Metabolism","volume":"32 3","pages":"193-200"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13628200/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149231097","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":"Changes in the diagnosis and management of polycystic ovary syndrome in adolescents based on recommendations of scientific societies over the last decade.","authors":"Gabriela Kamińska, Szymon Chmiela, Anna Kucharska","doi":"10.5114/pedm.2026.163212","DOIUrl":"10.5114/pedm.2026.163212","url":null,"abstract":"<p><strong>Introduction: </strong>he paper presents a systematic review of current guidelines from scientific societies regarding polycystic ovary syndrome (PCOS) in adolescents published over the past decade.</p><p><strong>Aim of the study: </strong>To summarize and compare recent international and national PCOS guidelines with emphasis on areas of consensus and divergence.</p><p><strong>Material and methods: </strong>A systematic review of guidelines published between 2015 and 2025 was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 statement. Ultimately, twelve documents containing adolescent-specific content were included.</p><p><strong>Results: </strong>In adolescents with PCOS, clinical symptoms of hyperandrogenism and menstrual irregularities are the main diagnostic criteria, whereas polycystic ovarian morphology and anti-Müllerian hormone concentration are not considered reliable indicators in adolescents. The current approach to PCOS also emphasizes the assessment and management of metabolic and psychological comorbidities.</p><p><strong>Conclusions: </strong>The diagnosis and treatment of PCOS in girls require a separate approach related to age and ongoing puberty. According to the latest recommendations, lifestyle changes should be a mandatory part of therapy regardless of the background of the presented disorder. The pharmacological treatment should be tailored to the dominant symptoms.</p>","PeriodicalId":39165,"journal":{"name":"Pediatric Endocrinology, Diabetes and Metabolism","volume":"32 3","pages":"201-218"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13628202/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149231289","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":"Study of some biological markers in cord blood of preterm and term infants and their association with neonatal sepsis.","authors":"Juhi Aggarwal, Jyoti Batra, Urvashi Midha, Alka Aggarwal, Mahmood Ahmad Khan, Vishwajeet Rohil","doi":"10.5114/pedm.2025.148398","DOIUrl":"https://doi.org/10.5114/pedm.2025.148398","url":null,"abstract":"<p><strong>Introduction: </strong>Neonatal sepsis is the third leading cause of neonatal mortality, which occurs due to bacterial infection and is a major public health problem, especially in developing countries. Efforts to reduce the rates of infection in this vulnerable population are one of the most important interventions in neonatal care. This study aimed to compare the levels of biomarkers such as presepsin, procalcitonin, interleukin 6 (IL-6), fetuin, and CRP in cord blood between preterm and term infants and evaluate their association with neonatal sepsis.</p><p><strong>Material and methods: </strong>A total of 176 infants were included in this study. Cord blood samples were collected from preterm (gestational age < 37 weeks) and term (gestational age ≥ 37 weeks) infants immediately after delivery. Umbilical cord blood was assessed for C-reactive protein (CRP), presepsin, procalcitonin, IL-6, and fetuin by using enzyme-linked immunosorbent assay (ELISA). The Pearson correlation coefficient test (r) was used to test for a positive or negative relationship between 2 (presepsin and fetuin) variables with CRP and procalcitonin. A receiver operating characteristic (ROC) analysis was executed to describe a cutoff value of the studied biomarkers.</p><p><strong>Results: </strong>When compared to term newborns, preterm infants have considerably higher values for CRP, presepsin, procalcitonin, and IL-6. Elevated levels of presepsin, procalcitonin, and IL-6 in cord blood were significantly associated with an increased risk of neonatal distress in both preterm and term infants (p < 0.05). Fetuin levels showed a trend towards association with neonatal distress but did not reach statistical significant. A Pearson correlation study between CRP and presepsin and fetuin shows that CRP is positively correlated with presepsin; however, procalcitonin shows positive correlation with fetuin. Further, these results were confirmed with ROC analysis.</p><p><strong>Conclusions: </strong>In early diagnosis of neonatal sepsis, compared with procalcitonin, presepsin and IL-6 seems to provide better early diagnostic value with consequent rapid therapeutic decision making and possible positive impact on neonatal prognosis. Elevated levels of these biomarkers are associated with risk of neonatal distress, highlighting their potential utility as early markers for identifying at-risk infants.</p>","PeriodicalId":39165,"journal":{"name":"Pediatric Endocrinology, Diabetes and Metabolism","volume":"31 1","pages":"17-24"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12051100/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144040634","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":"Epidemiology of type 1 diabetes in Podlasie region, Poland, in years 2010-2022 - 13-years-single-center study, including COVID-19 pandemic perspective.","authors":"Maciej Szabłowski, Paweł Klimas, Natalia Wiktorzak, Michał Okruszko, Joanna Peczyńska, Milena Jamiołkowska-Sztabkowska, Hanna Borysewicz-Sańczyk, Agnieszka Polkowska, Aneta Zasim, Klaudyna Noiszewska, Artur Bossowski, Barbara Głowińska-Olszewska","doi":"10.5114/pedm.2025.149201","DOIUrl":"10.5114/pedm.2025.149201","url":null,"abstract":"<p><strong>Introduction: </strong>Diabetes is undeniably a pandemic of the 21st century. Although type 1 diabetes mellitus (T1DM) only represents 10% of all diabetes cases, it dominates the pediatric population. The number of T1DM cases is accelerating, and Poland is one of the countries with the fastest increase in incidence.</p><p><strong>Aim of the study: </strong>To evaluate the epidemiological situation in T1DM in Podlaskie region, Poland.</p><p><strong>Material and methods: </strong>The study included 777 patients (369 girls and 408 boys) under 18. Incidence rates were calculated and standardized to an age-matched population (general population of Poland 2010).</p><p><strong>Results: </strong>We showed an upward trend in the number of cases during the analyzed period (R2 = 0.6, p = 0.001). The average incidence rate grew during the study period from 19.22/100,000 in 2010 to 34.11/100,000 in 2022, a 1.77-fold increase over the study period. The youngest age group (0-4 years old) showed the most prominent, nearly 2.3-fold rise, from 9.86/100,000 in 2010 to 22.56/100,000 in 2022. We have also demonstrated the possible impact of the COVID pandemic - after a decrease in 2020 we observed an increase of the incidence rate in 2021 up to 38.05/100,000 and in 2022 to 34/100,000.</p><p><strong>Conclusions: </strong>The incidence of type 1 diabetes in Podlaskie Voivodeship, Poland, continues its upward trend. Various factors may influence this, but the potential impact of the COVID-19 pandemic is worth considering.</p>","PeriodicalId":39165,"journal":{"name":"Pediatric Endocrinology, Diabetes and Metabolism","volume":"31 1","pages":"9-16"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12051105/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144031696","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":"Current controversies surrounding low-carbohydrate diets in children with type 1 diabetes.","authors":"Emilia Odyjewska, Monika Kupińska, Artur Bossowski, Barbara Głowińska-Olszewska","doi":"10.5114/pedm.2025.154383","DOIUrl":"10.5114/pedm.2025.154383","url":null,"abstract":"<p><p>The carbohydrate-restricted diets are becoming increasingly popular among the general public, as well as among obese and insulin-resistant individuals, and patients with both type 2 and type 1 diabetes (T1D), including children and adolescents. Nevertheless, the scientific evidence supporting the effectiveness of these diets in T1D is limited. While current general guidelines for childhood nutrition recommend a moderate carbohydrate intake of about 45% of daily calorie requirements, there is no research to establish a single optimal amount of carbohydrate in the diet of people with diabetes. The main reasons for patients to restrict carbohydrates in their diet are the potential to reduce postprandial glycemia variability, improve metabolic control, and reduce the risk of weight gain due to lower insulin doses. On the other hand, the greatest concerns of physicians are the potential to induce dyslipidemia, hypoglycemia, eating disorders, disruption of normal childhood development, or the transition of ketonemia caused by a low-carbohydrate diet (LCD) to diabetic ketoacidosis. We aimed to summarize the latest findings on low-carbohydrate diets, the potential consequences of their use, as well as their suggested benefits and impact on glycemic control in youths with type 1 diabetes.</p>","PeriodicalId":39165,"journal":{"name":"Pediatric Endocrinology, Diabetes and Metabolism","volume":"31 3","pages":"113-119"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12612580/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145507310","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":"Primary hyperparathyroidism in children: Insights from a single-center cohort.","authors":"Henrique Alexandrino, Nuno Rocha Jesus, Carlos Tavares Bello, Joana Lopes, Isabel Dinis, Alice Mirante","doi":"10.5114/pedm.2025.152595","DOIUrl":"10.5114/pedm.2025.152595","url":null,"abstract":"<p><strong>Introduction: </strong>Primary hyperparathyroidism (PHPT) is a rare endocrine disorder in children, often presenting with symptomatic hypercalcemia and end-organ damage.</p><p><strong>Aim of the study: </strong>We aim to describe the clinical features, treatment outcomes, and follow-up of pediatric PHPT patients at a tertiary center in Portugal.</p><p><strong>Material and methods: </strong>A retrospective study including all patients under 18 years diagnosed with PHPT between 2012 and 2024. Data on demographics, clinical features, laboratory results, imaging studies, genetic testing, surgical outcomes, and follow-up were collected and analyzed.</p><p><strong>Results: </strong>Six patients (66.6% male) with a median age of 16 years (range: 9-17) were included. Half of the patients (n = 3) presented with symptoms, including bone pain and nephrolithiasis. A genetic mutation was identified in 50% of cases: 2 patients with MEN 1 and 1 patient with CDC73 mutation. Ultrasound and Tc99m-sestamibi scans demonstrated high concordance (80%) for adenoma localization. Of the four patients who underwent surgery, all had solitary adenomas, achieving biochemical cure with a median follow-up of 103 months. Postoperative complications were minimal, with transient hypocalcemia in 2 patients and one case of hungry bone syndrome. No cases of persistent or recurrent PHPT were observed.</p><p><strong>Conclusions: </strong>Solitary parathyroid adenoma is the leading cause of pediatric PHPT. Surgical treatment is highly effective and safe, with excellent cure rates and few complications. Genetic testing and individualized imaging strategies are crucial for optimal management. Larger studies are needed to establish evidence-based guidelines for pediatric PHPT.</p>","PeriodicalId":39165,"journal":{"name":"Pediatric Endocrinology, Diabetes and Metabolism","volume":"31 2","pages":"52-58"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12302949/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144776457","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":"Erratum to the article: Aldosterone synthase deficiency due to homozygous CYP11B2 pathogenic variant with coexisting celiac disease: A case study and literature review. Pediatr Endocrinol Diabetes Metab 2025; 31 (3): 133-140. DOI: https://doi.org/10.5114/pedm.2025.155104.","authors":"Zuzanna Gawlik, Konrad Kaleta, Martyna Wróblewska, Maria Szwarkowska, Ewelina Preizner-Rzucidło, Krystian Jażdżewski, Sebastian Wardak, Jerzy B Starzyk, Dominika M Januś","doi":"10.5114/pedm.2026.158713","DOIUrl":"10.5114/pedm.2026.158713","url":null,"abstract":"","PeriodicalId":39165,"journal":{"name":"Pediatric Endocrinology, Diabetes and Metabolism","volume":"31 4","pages":"227"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12928149/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146203278","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":"Clinical significance of pyuria in pediatric diabetic ketoacidosis: evidence against empirical antibiotic use.","authors":"Ali Jameel Jasim, Muneera Fadhil Ridha, Wassan Nori","doi":"10.5114/pedm.2025.155109","DOIUrl":"10.5114/pedm.2025.155109","url":null,"abstract":"<p><strong>Introduction: </strong>Diabetic ketoacidosis (DKA) can be associated with severe morbidity and mortality in pediatric patients with type 1 diabetes mellitus, such as pyuria. Clinical association of pyuria with urinary tract infections (UTIs) remains unclear. Misinterpretation of sterile pyuria may lead to unnecessary antimicrobial treatment and hospitalization. The aim of the study was to assess pyuria frequency and its clinical relevance by examining clinical, laboratory, and biochemical parameters in pediatric cases with DKA.</p><p><strong>Material and methods: </strong>The prospective observational study enrolled 150 children with DKA (1-14 years) who were diagnosed based on the International Society for Pediatric and Adolescent Diabetes criteria and admitted to the Children Welfare Teaching Hospital emergency department. Cases were evaluated by clinical history, physical examination, and laboratory parameters (urinalysis, urine culture, random blood sugar, white blood cell count, platelet count, arterial blood gas analysis, bicarbonate level, blood urea, and serum creatinine). Clinical and laboratory parameters were compared between pyuric (63/150) and non-pyuric groups (87/150).</p><p><strong>Results: </strong>Pyuria was observed in 42% of DKA cases; only 4.7% had culture-confirmed UTIs. Pyuria was significantly associated with older age (p = 0.02), female sex (p < 0.001), lower random blood glucose (p = 0.03), and lower PaO2 (p = 0.009). Degree of dehydration, level of consciousness, serum ketones, and total leukocyte count were insignificant.</p><p><strong>Conclusions: </strong>Pyuria is common among pediatric patients with DKA but rarely indicates UTIs. Its presence in DKA patients and correlation with various clinical and biochemical parameters may reflect kidney inflammation, urging more clarification. Routine antibiotic therapy based solely on pyuria is not recommended without clinical or microbiological evidence.</p>","PeriodicalId":39165,"journal":{"name":"Pediatric Endocrinology, Diabetes and Metabolism","volume":"31 3","pages":"89-96"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12612576/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145507354","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}