Ana Varea, Liliana Disalvo, Marisa Sala, Natalia Matamoros, María V Fasano, Horacio F González
{"title":"Anemia and iron deficiency in healthy, exclusively breastfed infants: Prevalence and association with sex and birth weight.","authors":"Ana Varea, Liliana Disalvo, Marisa Sala, Natalia Matamoros, María V Fasano, Horacio F González","doi":"10.5546/aap.2026-11073.eng","DOIUrl":"https://doi.org/10.5546/aap.2026-11073.eng","url":null,"abstract":"<p><p>Introduction. Anemia and iron deficiency (ID) negatively affect health and neurocognitive development. There is controversy over whether breast milk meets iron requirements between four and six months of age, especially in populations with a high prevalence of anemia. Objective. To determine the prevalence of anemia, ID, and iron-deficiency anemia (IDA) in healthy infants who are exclusively breastfed (EBF), and to analyze their association with sex and birth weight. Population and methods. A retrospective, observational, cross-sectional analytical study. Data were analyzed from healthy infants who received exclusive breastfeeding and were seen at a pediatric center in La Plata from 2013 to 2016. Sex and birth weight (classified as lower birth weight if 2500-2999 g) were recorded. At six months of age, the following were assessed: anemia (hemoglobin <10.5 g/dL), ID (serum ferritin <12 µg/L), and IDA (meeting both criteria). Associations were evaluated, and the odds ratio (95% CI) was estimated using logistic regression (adjusted for sex). Results. A total of 254 infants were included. The prevalence rates of anemia, ID, and IDA were 42.5%, 26.7%, and 13.3%, respectively. The geometric mean ferritin level was lower in boys (p = 0.002). An association was observed between ID and lower birth weight (adjusted OR = 4.45 [95% CI 2.08-9.67]). Conclusion. The prevalence of anemia, ID, and IDA was high. Ferritin levels were lower in male infants. Infants with lower birth weight were more likely to develop DH.</p>","PeriodicalId":8338,"journal":{"name":"Archivos argentinos de pediatria","volume":" ","pages":"e202611073"},"PeriodicalIF":0.5,"publicationDate":"2026-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148597974","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}
Yasemin F Bahar, Kürşat Çetin, Zeynep Donbaloğlu, Mesut Parlak, Hale Ü Tuhan
{"title":"Longitudinal changes in nonfunctioning pituitary neuroendocrine tumors in children receiving growth hormone therapy: A comparison with untreated patients.","authors":"Yasemin F Bahar, Kürşat Çetin, Zeynep Donbaloğlu, Mesut Parlak, Hale Ü Tuhan","doi":"10.5546/aap.2026-11133.eng","DOIUrl":"https://doi.org/10.5546/aap.2026-11133.eng","url":null,"abstract":"<p><p>Background: Growth hormone deficiency (GHD) may result from structural abnormalities or space-occupying lesions of the pituitary gland; therefore, pituitary magnetic resonance imaging (MRI) is routinely performed as part of the etiological assessment. The reported prevalence of incidentally detected pituitary neuroendocrine tumors (PitNETs) in pediatric patients with GHD ranges from 0.5% to 20.3% across studies. PitNETs are rare in childhood and account for approximately 2.7% of supratentorial pediatric tumors and 3.6-6% of surgically treated PitNETs. Insulin-like growth factor-1 (IGF-I), a mitogenic agent elevated during recombinant human growth hormone (rhGH) therapy, has raised theoretical concerns regarding tumor growth stimulation. Objective: To evaluate longitudinal changes in tumor size of nonfunctional PiNETs, in patients with pre-existing PitNETs receiving rhGH therapy compared with untreated controls. Methods: This single-center retrospective cohort study included 15 GHD patients with PitNETs detected before rhGH initiation and 30 control patients with nonfunctional incidental PitNETs who did not receive rhGH therapy. Radiological follow-up was performed at baseline and at 6, 12, 18, 24, and 36 months. Results: No significant longitudinal changes in PitNETs width or length were observed in either group. One rhGH-treated patient underwent PitNET excision. Indications for pituitary imaging in the control group were predominantly central precocious puberty, headache, central hypothyroidism, and short stature. Conclusion: RhGH therapy was not associated with significant progression of nonfunctional PitNETs during a 36-month follow-up, supporting its safety when accompanied by regular radiological surveillance.</p>","PeriodicalId":8338,"journal":{"name":"Archivos argentinos de pediatria","volume":" ","pages":"e202611133"},"PeriodicalIF":0.5,"publicationDate":"2026-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148598101","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":"The AI dilemma in pediatrics: Are we losing our clinical skills?","authors":"Paula Otero","doi":"10.5546/aap.2026-11179.eng","DOIUrl":"https://doi.org/10.5546/aap.2026-11179.eng","url":null,"abstract":"","PeriodicalId":8338,"journal":{"name":"Archivos argentinos de pediatria","volume":" ","pages":"e202611179"},"PeriodicalIF":0.5,"publicationDate":"2026-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148534852","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":"Correlation of MTHFR (methylenetetrahydrofolate reductase) gen polymorphism, folate and neonatal hyperbilirubinemia.","authors":"Zhen Zhang, Weifeng Bai, Youhong Duan, Haitao Liu, Pengfei Guo","doi":"10.5546/aap.2026-11089.eng","DOIUrl":"https://doi.org/10.5546/aap.2026-11089.eng","url":null,"abstract":"<p><p>Objective. Investigate the distribution of methylenetetrahydrofolate reductase (MTHFR) genotypes in newborns with hyperbilirubinemia and explore their correlation with folate concentration and bilirubin elevation. Methods. Neonates with hyperbilirubinemia were categorized into mild, moderate, and severe elevation groups based on total bilirubin levels. MTHFR C677T genotype (CC wild-type, CT heterozygous mutant, TT homozygous mutant) was detected using PCR fluorescent probe and folate by chemiluminescence assay. Chi-square tests, ANOVA, and ordered logistic regression were used for analysis. Results. A total of 132 neonates were included. The moderate and severe elevation groups predominantly exhibited the CT genotype (54.9% and 58.8%), while the mild elevation group predominantly showed the CC genotype (43.3%). The mutant (CT+TT) proportions in the moderate and severe groups were 76.5% and 90.2%, respectively, greater than the 67.1% reported in a large-scale Chinese investigation. Genotype (χ² = 13.665, P = 0.008) and allele (χ² = 6.081, P = 0.048) distributions differed significantly among groups. Folate levels were significantly lower in the mutant genotype than in the wild-type (t = 2.162, P = 0.032). Ordered logistic regression analysis indicated a negative correlation between folate levels and the degree of hyperbilirubinemia (P ≤0.001). TT (95% CI: 1.012-1.974, P = 0.042) and CT (95% CI: 1.069-1.823, P = 0.014) genotypes were identified as risk factors for elevated bilirubin. Conclusion. MTHFR C677T polymorphism and serum folate levels are associated with the severity of neonatal hyperbilirubinemia. MTHFR C677T mutation may exacerbate bilirubin metabolism disorders by inhibiting folate metabolism and promoting homocysteine accumulation, offering potential references for disease risk assessment.</p>","PeriodicalId":8338,"journal":{"name":"Archivos argentinos de pediatria","volume":" ","pages":"e202611089"},"PeriodicalIF":0.5,"publicationDate":"2026-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148534872","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}
Carolina Giudice, María F Galletti, Graciela B Jiménez, Gonzalo L Mariani
{"title":"Diagnostic accuracy of presepsin and C-reactive protein in the early stages of neonatal sepsis: A prospective study.","authors":"Carolina Giudice, María F Galletti, Graciela B Jiménez, Gonzalo L Mariani","doi":"10.5546/aap.2025-10961.eng","DOIUrl":"https://doi.org/10.5546/aap.2025-10961.eng","url":null,"abstract":"<p><p>Introduction. Neonatal sepsis is a common complication in the neonatal intensive care unit (NICU). Biomarkers have certain limitations, and recent studies suggest that presepsin (PSEP) could be used for early diagnosis. Objective. To determine the early diagnostic accuracy of PSEP in newborns with suspected sepsis and to compare it with C-reactive protein (CRP). Population and methods. A prospective, cross-sectional study of newborns with suspected early- or late-onset sepsis. We defined confirmed sepsis as a positive blood culture or cerebrospinal fluid culture and excluded patients with congenital anomalies, those currently receiving antibiotic treatment, and those for whom parental informed consent was not obtained. ROC curves were plotted for PSEP and CRP. Results. A total of 150 suspected sepsis events in 122 newborns were included. The median gestational age was 32 weeks (IQR 29-37) and the median birth weight was 1530 grams (IQR 990-2705). The incidence of confirmed sepsis was 12% (95% CI, 7.3-18.3), and the median PSEP was 511 pg/mL (IQR, 392-785), with no statistically significant differences among confirmed sepsis, clinical sepsis, and no sepsis. The ROC curve for PSEP in confirmed sepsis was 0.62 (95% CI 0.48-0.76) and 0.77 (95%CI 0.68-0.86) for CRP. The optimal cutoff value for PSEP was 447 pg/mL and 14.8 mg/dL for CRP. Conclusion. The diagnostic accuracy of PSEP is low in the early stages of sepsis.</p>","PeriodicalId":8338,"journal":{"name":"Archivos argentinos de pediatria","volume":" ","pages":"e202510961"},"PeriodicalIF":0.5,"publicationDate":"2026-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148534899","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}
Rosana M Flores, Paola A Clerico Mosina, Cecilia I Crowe, María F Scacchi, Lidia N Barabini, Ana M Giachetti, Margarita Larralde, María D Salduna, Paola Berra, Mario Pelizzari, Silvia P D Amato, Guillermo F Alonso, Ana C Keselman, Mariana Costanzo, Mariana Aziz, María S Rodríguez Azrak, Silvia E Martin, María F Kuspiel, Sabrina P Martín Benítez, Viviana Pipman, Viviana Bengolea, Elisabeth Boulgourdjian, Natalia Tkalenko, Alejandra Casanovas, Analía Solari Moro, Guadalupe A Geli, María M Regalado Villamil, Mariela V Buscio, Juliana Pochetti, Sebastián E Bardavid, Santiago Galicchio, Alejandra A Boto, Patricia Elmeaudy, María C Martinoli, Verónica Bindi, Viviana Abudi, Gabriel Negrete, Melisa Laje, Roberta Calvano, Romina I Armando, María G Obregón, Juan I Appendino, Valeria Muro, Patricia Ciavarelli, Blanca Diez, Alejandro Fainboim, María V García Coppola, María E Giovo, Gabriela Pichichero, María F Maccario, Marcelo D Coirini
{"title":"[Neurofibromatosis Type 1 in Pediatrics: Recommendations for Diagnosis and Management].","authors":"Rosana M Flores, Paola A Clerico Mosina, Cecilia I Crowe, María F Scacchi, Lidia N Barabini, Ana M Giachetti, Margarita Larralde, María D Salduna, Paola Berra, Mario Pelizzari, Silvia P D Amato, Guillermo F Alonso, Ana C Keselman, Mariana Costanzo, Mariana Aziz, María S Rodríguez Azrak, Silvia E Martin, María F Kuspiel, Sabrina P Martín Benítez, Viviana Pipman, Viviana Bengolea, Elisabeth Boulgourdjian, Natalia Tkalenko, Alejandra Casanovas, Analía Solari Moro, Guadalupe A Geli, María M Regalado Villamil, Mariela V Buscio, Juliana Pochetti, Sebastián E Bardavid, Santiago Galicchio, Alejandra A Boto, Patricia Elmeaudy, María C Martinoli, Verónica Bindi, Viviana Abudi, Gabriel Negrete, Melisa Laje, Roberta Calvano, Romina I Armando, María G Obregón, Juan I Appendino, Valeria Muro, Patricia Ciavarelli, Blanca Diez, Alejandro Fainboim, María V García Coppola, María E Giovo, Gabriela Pichichero, María F Maccario, Marcelo D Coirini","doi":"10.5546/aap.2026-11104","DOIUrl":"https://doi.org/10.5546/aap.2026-11104","url":null,"abstract":"<p><p>Neurofibromatosis type 1 (NF1) is the most prevalent neurocutaneous syndrome, affecting approximately 1 in 3000 individuals. This genetic disorder involves multiple organ systems and exhibits marked variability in clinical presentation, with characteristic cutaneous, ophthalmological, neurological, cardiovascular, skeletal, and neurodevelopmental features. It may also be associated with multiple neoplasms. Timely and accurate diagnosis is essential to ensure optimal patient care. A lifelong, multidisciplinary management approach is recommended. The objective of this consensus is to summarize the clinical manifestations and provide evidence-based recommendations for the diagnosis and management of NF1.</p>","PeriodicalId":8338,"journal":{"name":"Archivos argentinos de pediatria","volume":" ","pages":"e202611104"},"PeriodicalIF":0.5,"publicationDate":"2026-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148534724","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}
Micaela Valdez, María A Quiroga Viola, Rosario Flores, Sofía De la Rosa, Jorgelina Voigt, Oscar Gómez Lund
{"title":"Malnutrition and hypernatremic dehydration as the initial presentation of nephrogenic diabetes insipidus in an infant.","authors":"Micaela Valdez, María A Quiroga Viola, Rosario Flores, Sofía De la Rosa, Jorgelina Voigt, Oscar Gómez Lund","doi":"10.5546/aap.2025-11001.eng","DOIUrl":"https://doi.org/10.5546/aap.2025-11001.eng","url":null,"abstract":"<p><p>Congenital nephrogenic diabetes insipidus (CNDI), also known as arginine vasopressin resistance, is a rare inherited disorder of water homeostasis in which the kidneys lose their ability to concentrate urine, leading to polyuria, polydipsia, and a risk of hypertonic dehydration. We report the case of a 3-month-old infant with symptoms present for approximately 2 months, characterized by episodes of fever, irritability, and poor growth. Upon admission, severe malnutrition and dehydration were noted. A diagnosis of CNDI was made based on vasopressin levels, plasma and urine osmolarity values, hypernatremia, and family history. The patient's treatment was challenging; he responded favorably and remains under outpatient follow-up. The presentation, results of additional tests, and short-term course are described.</p>","PeriodicalId":8338,"journal":{"name":"Archivos argentinos de pediatria","volume":" ","pages":"e202511001"},"PeriodicalIF":0.5,"publicationDate":"2026-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148350415","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":"Toward a new paradigm in kidney care: An urgent need.","authors":"Andrea Exeni","doi":"10.5546/aap.2026-11138.eng","DOIUrl":"https://doi.org/10.5546/aap.2026-11138.eng","url":null,"abstract":"","PeriodicalId":8338,"journal":{"name":"Archivos argentinos de pediatria","volume":" ","pages":"e202611138"},"PeriodicalIF":0.5,"publicationDate":"2026-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148300320","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}
Juan E Balinotti, Martín Medin, Ángela Lacera Rincón, Grecia Frías, María Esnaola Azcoiti, Gabriela Ropelato, Marina Khoury, Alejandro Teper
{"title":"Primary ciliary dyskinesia: Clinical and tomographic characterization using a combined diagnostic approach.","authors":"Juan E Balinotti, Martín Medin, Ángela Lacera Rincón, Grecia Frías, María Esnaola Azcoiti, Gabriela Ropelato, Marina Khoury, Alejandro Teper","doi":"10.5546/aap.2025-10814.eng","DOIUrl":"https://doi.org/10.5546/aap.2025-10814.eng","url":null,"abstract":"<p><p>Introduction. Primary ciliary dyskinesia (PCD) is a clinically heterogeneous condition that is difficult to diagnose. This study aimed to describe the clinical and imaging characteristics and the results of diagnostic tests in patients with suspected PCD, by implementing an unvalidated diagnostic strategy that combines screening questionnaires, nasal nitric oxide (nNO), high-speed videomicroscopy (HSVM), and genetic analysis. Population and methods. A cross-sectional observational study that included all patients referred for clinically suspected PCD between 2022 and 2025. Diagnostic tests: nNOn, HSVM, and genetic testing. Two clinical questionnaires were used to screen for PCD. Results. A total of 110 patients referred for suspected PCD were evaluated and classified into three groups: highly likely PCD (52 cases), highly unlikely PCD (54 cases), and indeterminate (4 cases). The diagnosis of PCD was made at a median age of 8.8 years. Most patients showed pulmonary involvement on their CT scans. Using the proposed diagnostic algorithm, PCD was highly unlikely in 49% of the referred cases. Conclusion. The age at diagnosis for patients with a high suspicion of PCD in our country was later than in other countries. At the time of diagnosis, the patients presented with lung damage confirmed by chest CT scans.Diagnosing PCD is a challenge in resource-limited countries. The initial approach combines screening questionnaires, nNO, and HSVM, and avoids genetic testing when a diagnosis of PCD is highly unlikely.</p>","PeriodicalId":8338,"journal":{"name":"Archivos argentinos de pediatria","volume":" ","pages":"e202510814"},"PeriodicalIF":0.5,"publicationDate":"2026-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148300734","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":"School violence: An oxymoron.","authors":"María S Ciruzzi","doi":"10.5546/aap.2026-11166.eng","DOIUrl":"https://doi.org/10.5546/aap.2026-11166.eng","url":null,"abstract":"","PeriodicalId":8338,"journal":{"name":"Archivos argentinos de pediatria","volume":" ","pages":"e202611166"},"PeriodicalIF":0.5,"publicationDate":"2026-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148300331","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}
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