Journal of Clinical Research in Pediatric Endocrinology最新文献

{"title":"The 40^th Minute Cortisol Measurement is the Key Time-Point in the Low-Dose Synacthen Stimulation Test: A Large, Assay-Specific Pediatric Validation Study.","authors":"Busra Gurpinar Tosun, Hazal Arikan Gacemer, Didem Helvacioglu, Serap Turan, Abdullah Bereket, Tulay Guran","doi":"10.4274/jcrpe.galenos.2026.2026-1-17","DOIUrl":"https://doi.org/10.4274/jcrpe.galenos.2026.2026-1-17","url":null,"abstract":"<p><strong>Background: </strong>Low-dose synacthen stimulation test (LDSST) is widely used to assess central adrenal insufficiency (CAI). With the adoption of monoclonal antibody (mAb) cortisol immunoassays, lower basal and peak cortisol concentration thresholds require external validation under real-world clinical conditions.</p><p><strong>Objective: </strong>To externally validate previously defined LDSST sampling strategies, basal cortisol thresholds, and gray-zone cut-offs in a large real-world cohort using mAb immunoassays.</p><p><strong>Methods: </strong>This single-center retrospective study analyzed 646 LDSSTs in patients with suspected CAI, measuring baseline, 40th, and 60th minute cortisol levels after administration of 1 μg of synthetic ACTH. The diagnostic performance of single and combined sampling strategies and previously defined basal cortisol thresholds and grey-zone cut-offs were evaluated across different peak cortisol criteria.</p><p><strong>Results: </strong>Cortisol measurement at 40th minute provided the most reliable single time-point assessment, with significantly fewer false-negative results than at 60th minute (p<0.0001). At the basal cortisol threshold of ≥6.5 μg/dL identified in our previous prospective study, sensitivity decreased from 68% to 57.5% (p=0.21) and specificity remained comparable (73.8% vs. 75.1%, p=0.74), while negative predictive value declined significantly from 91% to 78.4% (p=0.02) and positive predictive value increased to 53% in this retrospective cohort. Validation of basal cortisol gray-zone thresholds confirmed high diagnostic accuracy across different peak cortisol cut-offs.</p><p><strong>Conclusions: </strong>This study provides robust real-world external validation of LDSST sampling strategies and basal cortisol thresholds. Cortisol measurement at 40th minutes, combined with assay-specific basal cortisol interpretation and a gray-zone framework, offers a practical approach for individualized clinical decision-making in suspected CAI.</p>","PeriodicalId":48805,"journal":{"name":"Journal of Clinical Research in Pediatric Endocrinology","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147786569","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":"BMI-SDS Changes During GnRHa Therapy in 150 Girls with Idiopathic Central Precocious Puberty: Follow-up Through Final Height.","authors":"Didem Helvacıoğlu, Busra Gurpinar Tosun, Sefa Öğe, Serap Turan, Tülay Güran, Belma Haliloğlu, Zehra Yavas Abalı, Abdullah Bereket","doi":"10.4274/jcrpe.galenos.2026.2026-3-6","DOIUrl":"https://doi.org/10.4274/jcrpe.galenos.2026.2026-3-6","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate longitudinal changes in body mass index standard deviation score (BMI SDS) in girls with central precocious puberty (CPP) treated with gonadotropin-releasing hormone analogues (GnRHa) from treatment initiation to final adult height.</p><p><strong>Methods: </strong>This retrospective study included 150 girls with idiopathic CPP treated with leuprolide acetate and followed to final adult height. BMI SDS was assessed at treatment initiation, at 1 year of therapy, at treatment completion, and at final adult height. Patients were categorized according to BMI SDS at the time of diagnosis as underweight, normal weight, overweight, or obese. BMI SDS was evaluated at predefined time points and examined within baseline weight groups, and transitions between BMI SDS categories were analyzed across the follow-up period. In addition to baseline weight status, participants were categorized as SGA or AGA based on birth weight for gestational age.</p><p><strong>Results: </strong>In normal-weight girls, BMI-SDS increased significantly during the first treatment year and then declined toward final height, with no difference between baseline and final height. BMI-SDS remained stable in those overweight or obese at treatment initiation. BMI-category distribution changed over follow-up (overall p = 0.014), OW+OB prevalence increased during treatment (48.6%→56.6%) and decreased by final height (45.3%) (baseline vs final p = 0.533). By final height, obesity increased (p = 0.0076) and overweight decreased (p = 0.006), while normal-weight prevalence did not differ from baseline (p = 0.098). In multivariable analysis, baseline BMI-SDS was inversely related to ΔBMI-SDS (treatment end - baseline) (β = -0.174, 95% CI -0.291 to -0.057; p = 0.004).</p><p><strong>Conclusion: </strong>In this large cohort of girls with idiopathic CPP followed through final adult height, BMI SDS showed no sustained increase at final height across baseline weight groups, and the SGA-AGA differences observed earlier were not maintained. Baseline BMI-SDS was the key independent determinant of ΔBMI-SDS (treatment end - baseline), with lower baseline values predicting greater increases.</p>","PeriodicalId":48805,"journal":{"name":"Journal of Clinical Research in Pediatric Endocrinology","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147786594","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 Comparative Assessment of Large Language Models in Congenital Hypothyroidism: Reliability, Quality and Readability.","authors":"Ebru Barsal Çetiner, Berna Singin","doi":"10.4274/jcrpe.galenos.2026.2026-1-15","DOIUrl":"https://doi.org/10.4274/jcrpe.galenos.2026.2026-1-15","url":null,"abstract":"<p><strong>Objective: </strong>To comparatively evaluate the reliability, quality, and readability of responses generated by widely used large language model (LLM)-based chatbots to congenital hypothyroidism (CH)-related patient questions.</p><p><strong>Methods: </strong>Forty CH frequently asked questions (FAQs), derived from clinician-reviewed patient education resources, were submitted under standardized conditions (December 2025) to ChatGPT-4, ChatGPT-5.2, Gemini, and Copilot. The modified DISCERN (mDISCERN) instrument was used to assess reliability, whereas the Global Quality Score (GQS) was used to evaluate quality. Readability was evaluated using Flesch Reading Ease (FRE), Flesch-Kincaid Grade Level (FKGL), Gunning Fog Index (GFI), Coleman-Liau Index (CLI), and Simple Measure of Gobbledygook (SMOG). Scores were compared using Friedman tests with Bonferroni-corrected post hoc analyses.</p><p><strong>Results: </strong>Median mDISCERN scores were 5.0 for ChatGPT-4, ChatGPT-5.2, and Gemini, and 4.0 for Copilot. Median GQS scores were 5.0 for ChatGPT-4, ChatGPT-5.2, and Gemini, and 4.0 for Copilot. Differences among models were significant for both mDISCERN and GQS (p<0.001), with ChatGPT-5.2 outperforming others in key pairwise comparisons. Readability differed significantly across all indices (all p<0.001). ChatGPT-5.2 demonstrated the highest FRE and lowest FKGL, whereas Gemini produced the most complex text. However, all models exceeded the recommended sixth-grade reading level.</p><p><strong>Conclusion: </strong>LLM-based chatbots generated generally moderate-to-high quality CH information, but readability remains suboptimal for patient education. ChatGPT-5.2 showed the best overall performance. LLM outputs may support patient information needs but should complement, not replace, clinician-provided counseling.</p>","PeriodicalId":48805,"journal":{"name":"Journal of Clinical Research in Pediatric Endocrinology","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147730428","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":"Clinical and Genetic Characterization of Noonan Syndrome in a Colombian Pediatric Cohort.","authors":"Silvia C Martínez Rueda, Maria Del Pilar Montilla, Carolina Baquero, Susana Gómez, Maria Victoria Lopera, Nora Alejandra Zuluaga, Adriana Carolina Forero, Gustavo Giraldo, Nicolás Pineda Trujillo, Juan Camilo Martínez, Paola Durán Ventura, Juan Manuel Alfaro","doi":"10.4274/jcrpe.galenos.2026.2025-10-7","DOIUrl":"https://doi.org/10.4274/jcrpe.galenos.2026.2025-10-7","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to describe the clinical manifestations and genetic variants of Noonan syndrome in a Colombian pediatric population and to identify the genes most frequently associated with specific phenotypic features.</p><p><strong>Methods: </strong>A retrospective observational study was conducted on 45 patients under 18 years of age diagnosed with NS between 2013 and 2023. Clinical and molecular data were collected from medical records across several hospitals in Colombia. Molecular confirmation was achieved in all included patients through NGS-based clinical exome sequencing; however, parental samples were not available for segregation analysis in all cases. Descriptive statistical analyses were performed using R version 4.3.1 to evaluate demographic, clinical, and genetic variables.</p><p><strong>Results: </strong>Among 45 patients (21 females, 24 males; the mean age at diagnosis was 7.5 ± 5.2 years), pathogenic variants were identified across 13 genes, with <i>PTPN11</i> being the most frequent (26/45, 57.8%), followed by <i>PPP1CB</i> and several less frequent genes including <i>SOS1, SOS2, LZTR1, RAF1, MAP2K1, KRAS, NRAS, BRAF, CBL, NF1,</i> and <i>SHOC2</i>. The most common phenotypic features were congenital heart defects (80%, 36/45), predominantly pulmonary stenosis (31.1%, 14/45), short stature (66.7%, 30/45), and learning difficulties (51.1%, 23/45). Seven patients developed neoplasms. Juvenile myelomonocytic leukemia was the most frequent neoplasm and occurred mainly in patients with <i>PTPN11</i> variants. Ten patients received growth hormone therapy.</p><p><strong>Conclusion: </strong>This study represents the first genetically characterized Colombian cohort for NS. <i>PTPN11</i> was the predominant gene identified, particularly the p.(Asn308Asp) variant. These findings underscore the genetic heterogeneity of NS and emphasize the importance of early molecular diagnosis to guide clinical management. Multidisciplinary follow-up is essential due to the risks of growth failure, cardiac anomalies, and malignancies.</p>","PeriodicalId":48805,"journal":{"name":"Journal of Clinical Research in Pediatric Endocrinology","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147692910","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 13-Year-Old Girl with Congenital Hyperinsulinemic Hypoglycemia Due to an <i>ABCC8</i> Mutation and Recent Onset of Diabetes Mellitus: A Case Report and Literature Review.","authors":"Aikaterini Kantzavelou, Ekaterini Siomou, Anny Mertzanian, Amalia Sertedaki, Christina Kanaka-Gantenbein, Stelios Tigas, Anastasios Serbis","doi":"10.4274/jcrpe.galenos.2026.2025-10-21","DOIUrl":"https://doi.org/10.4274/jcrpe.galenos.2026.2025-10-21","url":null,"abstract":"<p><p>Congenital hyperinsulinism (HI) is the most prevalent cause of persistent hypoglycemia in infancy and childhood and comprises a heterogeneous group of genetic disorders affecting insulin secretion. The most common etiology involves inactivating mutations in the <i>ABCC8</i> and <i>KCNJ11</i> genes, which encode the SUR1 and Kir6.2 subunits of the pancreatic β-cell ATP-sensitive potassium (KATP) channel. Variants in these genes are associated with a broad phenotypic spectrum, ranging from asymptomatic macrosomia and mild diazoxide-responsive disease to severe, persistent hyperinsulinemic hypoglycemia unresponsive to medical therapy. In some individuals, the clinical course may evolve over time, with progression from early hyperinsulinism to impaired glucose regulation and eventual diabetes mellitus. We describe a 13-year-old girl with diazoxide-unresponsive congenital hyperinsulinism caused by a heterozygous de novo <i>ABCC8</i> variant (c.2147G>A, p.Gly716Asp) who later developed insulin-deficient diabetes mellitus. She was treated with octreotide from 2 months until 7 years of age, when therapy was discontinued after gradual remission of hypoglycemia. At 11 years, evaluation revealed impaired fasting glucose and impaired glucose tolerance, and glibenclamide was initiated. After being lost to follow-up, she presented at 13 years with hyperglycemia and was diagnosed with antibody-negative, insulin-deficient diabetes mellitus. Basal insulin therapy led to progressive normalization of glycemic levels. To our knowledge, this is the first report linking the <i>ABCC8</i> p.Gly716Asp variant to transition from congenital hyperinsulinism to adolescent-onset diabetes, underscoring the phenotypic continuum of ABCC8-related disorders and the necessity for lifelong metabolic surveillance.</p>","PeriodicalId":48805,"journal":{"name":"Journal of Clinical Research in Pediatric Endocrinology","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147677323","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":"Subclinical Hypothyroidism in Children: Natural History, Risk Factors, and Outcomes.","authors":"Nur Şeyma Zengin, Elif Sağsak, Seda Geylani Güleç","doi":"10.4274/jcrpe.galenos.2026.2025-9-27","DOIUrl":"https://doi.org/10.4274/jcrpe.galenos.2026.2025-9-27","url":null,"abstract":"<p><strong>Background: </strong>Subclinical hypothyroidism (SH) is defined by elevated thyroid-stimulating hormone (TSH) with normal thyroid hormone levels and typically presents without specific symptoms in children. Although treatment criteria exist, predictors of progression and treatment need remain uncertain.</p><p><strong>Objective: </strong>To evaluate the natural course of mild SH, identify clinical conditions associated with elevated TSH, determine predictors of progression requiring levothyroxine, and assess growth outcomes.</p><p><strong>Methods: </strong>Records of 111 children (3 months-18 years) with mild SH (TSH 5-10 mIU/L on ≥ 2 measurements) and ≥ 6 months of follow-up were retrospectively reviewed. Demographic, biochemical, anthropometric, etiological, and imaging data were analyzed. Children were categorized as idiopathic or as having associated clinical factors (autoimmune thyroiditis, iodine imbalance, obesity, or medication use). Outcomes were classified as euthyroid, persistent SH, or requiring treatment.</p><p><strong>Results: </strong>During follow-up, 45 children (40.5%) became euthyroid, 49 (44.2%) remained subclinically hypothyroid, and 17 (15.3%) required levothyroxine. Idiopathic cases showed the most favorable course, with only 8.6% requiring therapy. Hashimoto's thyroiditis (HT) was the strongest predictor of progression (42.1% vs. 9.8% in non-HT). A baseline TSH > 7.5 mIU/L increased treatment likelihood by ~3.5-fold. Growth parameters remained within normal limits, with no deterioration in untreated children.</p><p><strong>Conclusions: </strong>Mild pediatric SH is generally benign and self-limited, particularly in idiopathic cases. HT and higher baseline TSH levels are key predictors of progression, while growth remains stable. Management should be individualized based on underlying conditions, TSH severity, and autoimmune status.</p>","PeriodicalId":48805,"journal":{"name":"Journal of Clinical Research in Pediatric Endocrinology","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147582789","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":"Short Stature and Growth Hormone Deficiency in POMC Deficiency: An Unexpected Clinical Association.","authors":"Uğur Cem Yılmaz, Deniz Özalp Kızılay, Damla Gökşen, Samim Özen","doi":"10.4274/jcrpe.galenos.2026.2025-10-19","DOIUrl":"https://doi.org/10.4274/jcrpe.galenos.2026.2025-10-19","url":null,"abstract":"<p><p>Proopiomelanocortin (POMC) deficiency is a rare monogenic obesity syndrome typically characterized by early-onset obesity, red hair, and hypopigmentation, while linear growth is usually preserved. We report an adolescent girl with genetically confirmed POMC deficiency who developed short stature with biochemically confirmed growth hormone deficiency (GHD). She was diagnosed at 3.5 years of age with a homozygous c.64delA (p.Thr22Leufs*29) variant. Progressive growth deceleration became apparent after 12 years of age. At 13 years, her weight was 56.7 kg (+0.8 SDS), height was 143.0 cm (-2.5 SDS), and BMI was 27.1 kg/m² (+2.0 SDS). Growth velocity was 1.64 cm/year (-1.61 SDS), and pubertal stage was Tanner I. At 14 years of age, bone age was 10 years. IGF-1 was low at 82.8 µg/L (SDS: -2.28), and IGFBP-3 was 2.3 mg/L (SDS: -3.84). After euthyroidism had been achieved and estrogen priming had been completed, GH stimulation testing with L-DOPA and clonidine showed peak GH levels of 0.52 and 1.0 µg/L, respectively. Pituitary MRI was normal. Recombinant GH therapy (0.035 mg/kg/day) was initiated at 14 years 3 months. After 9 months, height increased to 150.2 cm (-1.95 SDS), BMI was 26.51 kg/m² (+1.79 SDS), and growth velocity improved to 11.29 cm/year, with no adverse events during follow-up. This case expands the clinical spectrum of POMC deficiency by demonstrating short stature with biochemically confirmed GHD and a notable early growth response to GH therapy. Further studies are needed to clarify the underlying mechanisms and to guide follow-up and management.</p>","PeriodicalId":48805,"journal":{"name":"Journal of Clinical Research in Pediatric Endocrinology","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147475912","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":"Once-Weekly Somatrogon in Pediatric Growth Hormone Deficiency: Real-World Efficacy, Safety, and Quality-of-Life Findings.","authors":"Kübra Şen Küçük, Sebla Güneş, Mustafa Dinçer, Sercan Öztürk, Tolga Ünüvar, Ahmet Anık","doi":"10.4274/jcrpe.galenos.2026.2025-11-4","DOIUrl":"https://doi.org/10.4274/jcrpe.galenos.2026.2025-11-4","url":null,"abstract":"<p><strong>Objective: </strong>To report real-world 6- and 12-month outcomes in children with growth hormone deficiency (GHD) treated with somatrogon or somatropin, including those who transitioned from somatropin to somatrogon.</p><p><strong>Methods: </strong>Eligible patients were categorized into three groups-somatrogon-naïve (naïve), somatrogon-switch (switch), and somatropin-and were followed for 6 or 12 months. Bioimpedance analysis, as well as a standardised, age-appropriate assessment of the Pediatric Quality of Life Inventory (PedsQL), the Child Behavioural Checklist (CBCL) and the Multidimensional Scale of Perceived Social Support (MSPSS), were conducted at baseline and month 6 in the naïve and switch groups. Psychiatric evaluations were also performed according to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision (DSM-5-TR) criteria.</p><p><strong>Results: </strong>A total of 58 patients (58.6% male) were included (naïve: n=20; switch: n=18; somatropin: n=20). Mean ages were 11.1±3.0, 9.7±3.4, and 10.5±3.2 years, respectively. After 12 months, mean changes in height SDS (Δheight SDS) were 0.6±0.3, 0.7±0.3, and 0.7±0.4; and height velocities were 10.0±1.9, 9.1±1.7, and 9.8±1.9 cm/year, respectively. Corresponding increases in IGF-1 SDS (ΔIGF-1 SDS) were 2.2±1.2, 0.9±1.2, and 1.3±1.0, respectively. Among the 38 patients receiving somatrogon, 15.8% (n=6; 3 naïve, 3 switch) developed IGF-1 SDS >+2 during follow-up, managed successfully with observation or dose adjustment. No serious adverse events were observed. Bioimpedance analyses demonstrated a favorable but non-significant trend toward improved body composition in somatrogon-naïve children. At six months, PedsQL domains, CBCL scales, and MSPSS scores remained stable (all p > 0.05).</p><p><strong>Conclusion: </strong>Once-weekly somatrogon demonstrated efficacy and safety comparable to daily somatropin with stable quality of life and psychosocial outcomes in children with GHD.</p>","PeriodicalId":48805,"journal":{"name":"Journal of Clinical Research in Pediatric Endocrinology","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147469754","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":"Early Childhood Obesity: Multifactorial Influences with a Prominent Familial Contribution.","authors":"İsmail Hakkı Akbeyaz, Yasemin Akın, Berkin Berk Akbeyaz, Saygın Abalı","doi":"10.4274/jcrpe.galenos.2026.2025-12-23","DOIUrl":"https://doi.org/10.4274/jcrpe.galenos.2026.2025-12-23","url":null,"abstract":"<p><strong>Background: </strong>Early childhood obesity is an increasing public health problem with long-term consequences. Identifying risk factors is essential for effective prevention strategies.</p><p><strong>Aim: </strong>To evaluate prenatal, perinatal, and postnatal influences; breastfeeding and nutritional practices, lifestyle and daily habits; household, sociocultural, and economic conditions; and parental anthropometric characteristics to better elucidate the determinants of obesity in early childhood.</p><p><strong>Methods: </strong>This cross-sectional study included 210 children aged 12-60 months, comprising 104 children with obesity and 106 non-obese controls. Standardized anthropometric assessments were performed in all participants. Parents completed a structured questionnaire capturing perinatal characteristics, infant feeding practices, dietary intake, medical history, lifestyle behaviors, and household-level factors.</p><p><strong>Results: </strong>A total of 210 children (113 females) were included (106 obese and 104 non-obese), with comparable age between groups (3.4 ± 1.3 vs. 3.3 ± 1.3 years). Both maternal and paternal BMI values were significantly higher in the obese group, and maternal employment (27.4% vs. 5.8%) and maternal obesity (42.5% vs. 21.2%) were more prevalent. Maternal smoking during pregnancy (23.6% vs. 7.7%) and gestational diabetes (22.6% vs. 9.6%) were also more frequent. Feeding practices and current dietary patterns did not differ significantly between groups. In multivariable analysis, maternal employment (aOR 3.74), sibling obesity (aOR 2.21), and extended family obesity burden (aOR 1.19) independently predicted childhood obesity.</p><p><strong>Conclusion: </strong>Familial obesity burden showed the strongest associations with obesity, highlighting the need for early identification of high-risk children and family-centered preventive strategies focusing on physical activity, diet, and daily routines.</p>","PeriodicalId":48805,"journal":{"name":"Journal of Clinical Research in Pediatric Endocrinology","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147469696","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":"Late-Onset and Recurrent Agranulocytosis During Low-Dose Methimazole Therapy in an Adolescent with Graves' Disease.","authors":"Betül Demircan Coşkun, Şebnem Yılmaz, Balahan Bora, Ayhan Abacı, Ece Böber, Korcan Demir","doi":"10.4274/jcrpe.galenos.2026.2025-12-3","DOIUrl":"https://doi.org/10.4274/jcrpe.galenos.2026.2025-12-3","url":null,"abstract":"<p><p>Graves' disease (GD) is the most common cause of thyrotoxicosis in the pediatric population. Methimazole (MMI) is the first-line therapy; however, it may rarely cause agranulocytosis, a potentially life-threatening adverse effect. Recurrent or delayed-onset agranulocytosis presents diagnostic and therapeutic challenges due to the scarcity of reported cases. This report aims to describe a pediatric case with recurrent MMI-induced agranulocytosis and to discuss potential mechanisms and management strategies. We describe a 16-year-old female with GD who developed recurrent MMI-induced agranulocytosis. The initial episode was identified during routine monitoring at the 16th month of treatment, in the absence of clinical signs of infection. MMI was promptly discontinued, and infection precautions were implemented. Treatment with granulocyte colony-stimulating factor (G-CSF) led to rapid neutrophil recovery. However, intermittent neutropenia recurred, requiring repeated G-CSF administration. Despite persistent thyroid-stimulating immunoglobulin (TSI) positivity, the patient remained euthyroid and did not require further antithyroid therapy during 20 months of follow-up. Autoimmune serology revealed positive antinuclear antibody (ANA) and anti-centromere protein B (anti-CENP-B) antibodies, while bone marrow and genetic analyses were unremarkable. This case illustrates the complex and variable course of methimazole-induced agranulocytosis in pediatric GD. Recurrent neutropenia may occur even after initial resolution, emphasizing the need for individualized management. Persistent TSI positivity alone may not necessarily reflect ongoing disease activity or justify continued antithyroid therapy.</p>","PeriodicalId":48805,"journal":{"name":"Journal of Clinical Research in Pediatric Endocrinology","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147469748","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}