World journal of clinical pediatrics最新文献

{"title":"Screen time in preschool-aged children and attention deficit hyperactivity disorder-related behaviors: A literature review.","authors":"Tungki Pratama Umar, Aulia Wiratama Putra, Devin Mahendika, Maureen Miracle Stella, Kevin Tandarto","doi":"10.5409/wjcp.v15.i1.111652","DOIUrl":"10.5409/wjcp.v15.i1.111652","url":null,"abstract":"<p><p>In this digital era, excessive screen usage has been reported to worsen the symptoms of attention deficit hyperactivity disorder (ADHD) in children. However, this connection is found to be bidirectional, with both phenomena impacting each other. The current literature review will summarize some research findings on the correlation between screen time and ADHD-related behaviors. Studies have found that the inattentional and hyperactive/impulsive behaviors of ADHD are positively correlated with screen time. One study showed statistically significant longitudinal correlations between screen time at age three and inattention behaviors and hyperactivity/impulsivity behaviors at age four, but no concurrent association between screen time and either of these behaviors or scores at age three. Crucially, screen usage beyond the two-hours mark was linked to a higher risk of externalizing morbidity that is clinically significant, particularly inattention issues. Meanwhile, screen usage can exacerbate the symptoms of ADHD in children, including aggression, negative emotions, and pressure from life events, according to a summary of pertinent studies.</p>","PeriodicalId":75338,"journal":{"name":"World journal of clinical pediatrics","volume":"15 1","pages":"111652"},"PeriodicalIF":0.0,"publicationDate":"2026-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13010501/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147517371","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 outcomes of two lactose-free formulas in the management of acute childhood diarrhea.","authors":"Nopaorn Phavichitr, Ruangvith Tantibhaedhyangkul, Termpong Dumrisilp, Sittichoke Prachuapthunyachart, Wilaiporn Chanpreecha, Panjachat Ratanamongkol, Voranush Chongsrisawat","doi":"10.5409/wjcp.v15.i1.114953","DOIUrl":"10.5409/wjcp.v15.i1.114953","url":null,"abstract":"<p><strong>Background: </strong>Acute diarrhea is the most common gastrointestinal disease in children under five years of age and is associated with significant morbidity and mortality risks. Lactose-free formulas may be beneficial for hospitalized patients.</p><p><strong>Aim: </strong>To compare the efficacy, safety, and cost-effectiveness of a medium-chain triglyceride-containing lactose-free formula (MLF) with a standard lactose-free formula (SLF) in children hospitalized with acute diarrhea.</p><p><strong>Methods: </strong>In this randomized, double-blind, controlled trial, children aged 6-24 months were randomized to receive MLF or SLF. The primary outcomes were the duration until diarrhea resolution and the frequency of stools after enrollment. Secondary outcomes included length of hospital stay, treatment costs, and caregiver satisfaction.</p><p><strong>Results: </strong>Forty-four children completed the study (MLF = 22, SLF = 22). The median duration of diarrhea after enrollment did not differ significantly between the groups, 24.0 hours [interquartile range (IQR): 21.5] <i>vs</i> 45.0 hours (IQR: 49.0); <i>P</i> = 0.293. The reduction in stool frequency was also comparable [7.5 (IQR: 5.8) <i>vs</i> 4.0 (IQR: 3.8) times/day; <i>P</i> = 0.083]. The Hodges-Lehmann estimated median difference in diarrhea duration was -4 hours (95% confidence interval: -26.0 to 2.0), supporting the noninferiority of MLF. The median length of hospital stay was 2 days in both groups. Formula costs were significantly lower in the MLF group (227.9 Thai Baht <i>vs</i> 373.6 Thai Baht; <i>P</i> < 0.001). Caregiver satisfaction, product acceptance, and safety profiles were comparable between the groups.</p><p><strong>Conclusion: </strong>MLF demonstrated noninferior clinical outcomes and safety compared to SLF, with a significant reduction in formula-related costs. MLF could be an appropriate alternative for the management of acute diarrhea in young children, especially in resource-constrained settings.</p>","PeriodicalId":75338,"journal":{"name":"World journal of clinical pediatrics","volume":"15 1","pages":"114953"},"PeriodicalIF":0.0,"publicationDate":"2026-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13010491/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147517428","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":"Efficacy of vitamin D supplementation for children with acute bronchiolitis: A randomized controlled trial.","authors":"Elsayed Abdelkreem, Yostena Safwat Labeeb, Mostafa Ashry Mohamed","doi":"10.5409/wjcp.v15.i1.114465","DOIUrl":"10.5409/wjcp.v15.i1.114465","url":null,"abstract":"<p><strong>Background: </strong>Previous studies have suggested an association between vitamin D deficiency and bronchiolitis, but the therapeutic benefits of vitamin D supplementation remain uncertain.</p><p><strong>Aim: </strong>To investigate the efficacy of vitamin D supplementation for hospitalized children with acute bronchiolitis.</p><p><strong>Methods: </strong>This two-arm randomized controlled trial included 146 children aged 3-24 months who were hospitalized with bronchiolitis at an Egyptian tertiary care center. Participants were equally randomized to receive a single intramuscular dose of 200000 IU (study group) or a daily oral dose of 400 IU (comparison group) of vitamin D₃. The primary outcome was the time to hospital discharge. Secondary outcomes included time to oxygen weaning, discontinuation of intravenous fluids, and discharge readiness as well as serum 25-hydroxyvitamin D [25(OH)D] levels on day 3 post-randomization. Both the study and comparison groups were compared in the whole cohort (primary analysis) and within the subgroup of participants with baseline serum 25(OH)D levels < 30 ng/mL (prespecified subgroup analysis).</p><p><strong>Results: </strong>In the overall analysis, the study and comparison groups showed no significant differences in median time to discharge (130 hours <i>vs</i> 140 hours, <i>P</i> = 0.149) or in secondary outcomes, except for a higher serum 25(OH)D level in the study group (51 ± 12.8 <i>vs</i> 32 ± 13.2 ng/mL, <i>P</i> < 0.001). However, among the subgroup of participants with baseline serum 25(OH)D levels < 30 ng/mL, the study group demonstrated significantly shorter median times to hospital discharge (120 hours <i>vs</i> 170 hours, <i>P</i> < 0.001), oxygen weaning (56 hours <i>vs</i> 79 hours, <i>P</i> = 0.012), discontinuation of intravenous fluids (55 hours <i>vs</i> 73 hours, <i>P</i> = 0.017), and discharge readiness (118 hours <i>vs</i> 165 hours, <i>P</i> = 0.001) as well as a greater increase in serum 25(OH)D levels (40 ± 6.6 ng/mL <i>vs</i> 20 ± 6.1 ng/mL, <i>P</i> < 0.001) than the comparison group.</p><p><strong>Conclusion: </strong>Vitamin D supplementation may improve clinical outcomes in hospitalized children with bronchiolitis who have vitamin D deficiency or insufficiency, supporting a test-and-treat approach.</p>","PeriodicalId":75338,"journal":{"name":"World journal of clinical pediatrics","volume":"15 1","pages":"114465"},"PeriodicalIF":0.0,"publicationDate":"2026-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13010524/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147517435","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":"Pharmacological management of childhood constipation: Bridging today's gaps with tomorrow's therapies.","authors":"Shaman Rajindrajith, Wathsala Hathagoda, Keshawadhana Balakrishnan, Niranga Manjuri Devanarayana","doi":"10.5409/wjcp.v15.i1.113925","DOIUrl":"10.5409/wjcp.v15.i1.113925","url":null,"abstract":"<p><p>Childhood constipation is a prevalent yet frequently underestimated global health concern, affecting approximately 10% of children across diverse populations. Its impact extends well beyond bowel-related symptoms, with affected children often experiencing extraintestinal manifestations such as pain in multiple sites, behavioral disturbances, and a markedly diminished quality of life. The burden is further compounded in low- and middle-income countries, where financial and logistical constraints limit access to effective treatment. The impact is intensified in developing countries due to limited healthcare resources and the unavailability of pharmacological agents. When left untreated or poorly managed, functional constipation (FC) can lead to significant long-term consequences, including persistent bowel dysfunction, psychological disorders, and progression to chronic constipation and other disorders of gut-brain interaction later in life. Pathophysiology of FC is multifactorial, involving factors such as stool withholding behavior, dietary habits, anorectal dysfunction, and psychological factors. Hence, management of FC is multifaceted, including both pharmacological and non-pharmacological interventions. Pharmacological management remains central to treatment, aimed at relieving symptoms and preventing adverse outcomes. However, current therapeutic strategies rely predominantly on a narrow range of osmotic and stimulant laxatives. Introducing new drugs that have often been shown to be effective in adults, have been found to have limited efficacy in children, with some performing no more effectively than a placebo in clinical trials. This highlights a substantial gap in pediatric pharmacotherapy and emphasizes the pressing need for new, evidence-based interventions tailored to the unique physiological and developmental characteristics of children. In this review, we critically examine the current pharmacologic options for managing childhood constipation, assess their limitations, and explore future directions of these drugs and other novel interventions for the development of more effective, accessible, and child-appropriate treatments for this common yet impactful condition.</p>","PeriodicalId":75338,"journal":{"name":"World journal of clinical pediatrics","volume":"15 1","pages":"113925"},"PeriodicalIF":0.0,"publicationDate":"2026-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13010849/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147517445","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":"Balanced electrolyte solution <i>vs</i> isotonic saline in the resuscitation of children with diabetic ketoacidosis: A randomized controlled trial.","authors":"Sweta Sweety, Swarupa Panda, Rashmi Ranjan Das","doi":"10.5409/wjcp.v15.i1.111304","DOIUrl":"10.5409/wjcp.v15.i1.111304","url":null,"abstract":"<p><strong>Background: </strong>Fluid therapy is a cornerstone in the management of diabetic ketoacidosis (DKA). Normal saline (NS, 0.9%) has traditionally been the fluid of choice; however, concerns about its association with hyperchloremic metabolic acidosis and possible development of acute kidney injury (AKI) have led to an increased interest in balanced electrolyte solutions (BES) as a potentially safer alternative.</p><p><strong>Aim: </strong>To compare BES with NS in the initial resuscitation of children with DKA.</p><p><strong>Methods: </strong>This double-blind, parallel, randomized controlled trial (RCT) was conducted in the Pediatrics department of a tertiary care teaching hospital over two-year period. Children aged 5 to 14 years with DKA as defined by the \"International Society for Pediatric and Adolescent Diabetes\" were included. The primary objective was-the time taken to resolution of acidosis. Secondary objectives were-effect on electrolyte imbalances, development of cerebral edema or AKI, and other clinical outcomes.</p><p><strong>Results: </strong>Sixty patients were enrolled. The mean (SD) age of the patients was 10.7 (1.42) years, and majority were female (73.3%). The time (hour) taken for resolution of acidosis was not significantly different (<i>P</i> = 0.16). The NS group had a higher incidence of hyperchloremia (<i>P</i> = 0.09), AKI (<i>P</i> = 0.07), and prolonged hospitalization (<i>P</i> = 0.23), but all these were not statistically significant. Other outcomes were comparable in both the groups.</p><p><strong>Conclusion: </strong>This trial did not find any significant difference between BES and NS (0.9%) in the initial resuscitation of children with DKA.</p>","PeriodicalId":75338,"journal":{"name":"World journal of clinical pediatrics","volume":"15 1","pages":"111304"},"PeriodicalIF":0.0,"publicationDate":"2026-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13010243/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147517391","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":"Atypical case of Rett syndrome with concurrent <i>MECP2</i> gene mutation and del(15)(q22qter) karyotype: A case report and review of literature.","authors":"Imad Fadl-Elmula, Sara Y Abdel-Raheem, Rayan Khalid","doi":"10.5409/wjcp.v14.i4.109874","DOIUrl":"10.5409/wjcp.v14.i4.109874","url":null,"abstract":"<p><strong>Background: </strong>Rett syndrome is a monogenic X-linked dominant condition that affects 1/(10000-15000) girls due to de novo mutations in the methyl-CpG binding protein 2 (<i>MECP2</i>) gene mapped to chromosome Xq28. The disease-causing gene was identified as a mutation in the <i>MECP2</i> gene, which is found in approximately 80% of patients diagnosed with Rett syndrome. Although chromosomal changes resulting in del(15)(q11q13) are usually associated with Angelman and Prader-Willi syndrome, very few cases, if any, of Rett syndrome with terminal 15q22-qter deletion have been published in English literature.</p><p><strong>Case summary: </strong>In this study, we report an unusual and rare clinical presentation of Rett syndrome in a 12-year-old Sudanese girl. The patient was brought in by her parents, complaining of gradual onset of abnormal walking, abnormal hand movement, loss of speech, and mental retardation for ten years. There was no reported history of convulsions or loss of consciousness. Clinical examination revealed microcephaly with no other apparent dysmorphic features, intact cranial nerves, and abnormal gait. She showed repetitive and stereotyped behaviors, including hand flapping, stimming, and chest pounding, which were concomitant with autism spectrum disorder. Magnetic resonance imaging and electroencephalography investigations were normal, and cytogenetic analysis showed 46,XX, del(15)(q22qter). Further molecular analysis using whole sequencing of <i>MECP2</i> revealed an alteration cytosine > thymine at nucleotide 401, leading to phenylalanine replacing a serine at amino acid position 134.</p><p><strong>Conclusion: </strong>This case, the first reported instance of Rett syndrome in Sudan, is of significant interest. The patient carries both the <i>MECP2</i> gene mutation and the chromosome 15q22-qter deletion, which may explain the autistic behavior with atypical presentation of Rett syndrome. This report expands the genetic diversity of Rett syndrome, demonstrating how co-occurring 15q22-qter deletions can reshape <i>MECP2</i>-associated phenotypes in Rett syndrome.</p>","PeriodicalId":75338,"journal":{"name":"World journal of clinical pediatrics","volume":"14 4","pages":"109874"},"PeriodicalIF":0.0,"publicationDate":"2025-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12620861/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145552173","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":"Determinants of infection for antibiotic initiation at pediatric emergency admission: A prospective observational study.","authors":"Samreen Yusuf, Anil K Goel, Ashish Wasudeo Khobragade, Padma Das, Gudipudi Sai Vamsi Manoj, Anish Kumar Saha, Sai Pratap Reddy, Swasti Keshri, Seema Shah","doi":"10.5409/wjcp.v14.i4.105820","DOIUrl":"10.5409/wjcp.v14.i4.105820","url":null,"abstract":"<p><strong>Background: </strong>Due to non-specific and overlapping features, particularly in infants, and a lack of awareness of important signs and symptoms, early diagnosis of sepsis is difficult.</p><p><strong>Aim: </strong>To identify the determinants for bacterial infection based on clinical evidence and point-of-care (POC) investigations in children at admission to a pediatric emergency medicine (PEM) unit.</p><p><strong>Methods: </strong>This prospective observational study was conducted in a PEM unit of a tertiary care hospital in Central India. A scoring system based on these determinants for initiation of antibiotics in the golden hour (<i>i.e.</i> the first 60 minutes) was developed, termed as the Children's Antibiotic Requirement Evaluation Score (CARES) Index.</p><p><strong>Results: </strong>Out of a total of 1419 children presenting to the PEM, 802 children were enrolled. The best predictors of infection were found to be abnormal color, fever, features of fluid overload, altered sensorium, cellulitis, use of antibiotics, and C-reactive protein. These parameters were amalgamated to form the CARES Index, which showed moderate accuracy for determinants of infection for initiation of antibiotics in a pediatric emergency. Among the POC investigations, the sensitivity of the erythrocyte sedimentation rate (80.00%) was maximum, while specificity was highest for procalcitonin (75.31%).</p><p><strong>Conclusion: </strong>We highlighted the association of clinical parameters, symptoms, and POC investigations in pediatric bacterial infections. Some parameters emerged as strong predictors of sepsis, and no single factor was sufficient for a definitive diagnosis.</p>","PeriodicalId":75338,"journal":{"name":"World journal of clinical pediatrics","volume":"14 4","pages":"105820"},"PeriodicalIF":0.0,"publicationDate":"2025-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12620765/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145552202","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":"Research on gamma globulin unresponsive Kawasaki disease: A review.","authors":"Zu-Chuang Wu, Yan Pan","doi":"10.5409/wjcp.v14.i4.108520","DOIUrl":"10.5409/wjcp.v14.i4.108520","url":null,"abstract":"<p><p>Kawasaki disease (KD) is an acute, self-limited systemic vasculitis that primarily affects children. Treating nonresponding KD with intravenous immunoglobulin (IVIG) presents numerous challenges. This article comprehensively reviews the basic theory, clinical manifestations and diagnosis, treatment strategies, disputes and challenges, historical evolution and current situation, and future research directions of immunoglobulin unresponsive KD. In terms of basic theory, the epidemiological characteristics of KD, the mechanism of IVIG action, and the pathophysiological mechanism of the nonresponsive type are elaborated. In the clinical manifestation and diagnosis section, symptoms, diagnostic criteria, and imaging applications are analyzed. The treatment strategy encompasses drug, nondrug and individualized therapy. Controversies and challenges focus on diagnostic difficulties, treatment disputes, and long-term prognosis research. The historical evolution and current situation review the changes in treatment strategies and the current state of affairs. Future research directions anticipate the role of new therapeutic drug research and development, breakthroughs in basic research, and international cooperation, aiming to provide a comprehensive reference for research and clinical practice in this field.</p>","PeriodicalId":75338,"journal":{"name":"World journal of clinical pediatrics","volume":"14 4","pages":"108520"},"PeriodicalIF":0.0,"publicationDate":"2025-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12620805/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145552237","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":"Sleep disturbances in children and adolescents with attention-deficit/hyperactivity disorder: A narrative review.","authors":"Narpinder Malhi, Margaret Weiss, James Waxmonsky, Raman Baweja","doi":"10.5409/wjcp.v14.i4.110612","DOIUrl":"10.5409/wjcp.v14.i4.110612","url":null,"abstract":"<p><p>Sleep disturbances and disorders are commonly associated with attention-deficit/hyperactivity disorder (ADHD), with affected children frequently experiencing delayed sleep onset, frequent nighttime awakenings, morning fatigue, and excessive daytime sleepiness. A bidirectional relationship exists between ADHD and sleep disturbances: Sleep deprivation is linked to increased inattention and emotional dysregulation, while evening hyperactivity and impulsivity may contribute to difficulty falling asleep. Central nervous system stimulants remain the first-line treatment for managing ADHD symptoms; however, insomnia can be a common side effect. Notably, newer and long-acting stimulants formulations have demonstrated extended benefit into evening with limited impact on sleep in recent studies. This narrative review summarizes the various sleep disorders associated with ADHD, outlines clinical approaches for sleep assessment, and evaluates the impact of ADHD treatments on sleep. It also highlights both non-pharmacological and pharmacological interventions for managing sleep problems in children with ADHD. Finally, the review offers practical recommendations to help clinicians optimize both sleep and daytime functioning in patients with ADHD. ADHD should be conceptualized as a 24-hour disorder, requiring integrated treatment strategies that address both daytime symptoms and nighttime sleep challenges.</p>","PeriodicalId":75338,"journal":{"name":"World journal of clinical pediatrics","volume":"14 4","pages":"110612"},"PeriodicalIF":0.0,"publicationDate":"2025-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12620782/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145552274","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":"Gestational alloimmune liver disease reconsidered: Advocating for a new nomenclature and enhanced diagnosis accuracy.","authors":"Nourane Helali, Hugo Gagnon, Fernando Álvarez","doi":"10.5409/wjcp.v14.i4.106219","DOIUrl":"10.5409/wjcp.v14.i4.106219","url":null,"abstract":"<p><p>Gestational alloimmune liver disease (GALD), previously known as neonatal hemochromatosis, is a rare antenatal immune condition in which maternal antibodies target the fetal liver, leading to a spectrum of liver injury. Although GALD in the leading cause of neonatal liver failure, recent evidence highlights its association with milder phenotypes. A maternal history of miscarriages or stillbirths may be present. GALD is characterized by hepatic and extrahepatic iron overload sparing the reticuloendothelial system. The transferrin saturation coefficient is the most reliable marker of iron overload, and salivary gland biopsy may assist in diagnosis. Early recognition is crucial, as GALD is treatable. Management involves both acute neonatal treatment and preventive strategies for future pregnancies. Recurrence may reach 90% but can be effectively prevented with antenatal intravenous immunoglobulin therapy. We report four cases of GALD managed in gastroenterology unit of the Sainte-Justine center in Montreal, Canada. A literature review was also conducted to explore the etiopathogenesis, diagnosis, treatment options, and outcomes of the GALD. A total of 39 studies published between 2008 and 2024 were identified through PubMed, Google Scholar, and EMBASE using the terms \"gestational alloimmune liver disease\" and \"neonatal hemochromatosis\".</p>","PeriodicalId":75338,"journal":{"name":"World journal of clinical pediatrics","volume":"14 4","pages":"106219"},"PeriodicalIF":0.0,"publicationDate":"2025-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12620785/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145551983","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}