BMC Pediatrics最新文献

{"title":"The efficacy and safety of rhGH treatment combined with letrozole/GnRHa in adolescent boys.","authors":"Ying Zhang, Xin Yuan, Kenneth McCormick, Xiao-Hong Yang, Shi-Jun Chen, Rui-Min Chen","doi":"10.1186/s12887-025-05408-y","DOIUrl":"10.1186/s12887-025-05408-y","url":null,"abstract":"<p><strong>Objective: </strong>In boys during puberty who were undergoing recombinant human growth hormone (rhGH) treatment, we compared the therapeutic efficacy on growth, and any adverse reactions, of co-therapy with either letrozole or gonadotropin-releasing hormone analog (GnRHa).</p><p><strong>Methods: </strong>Fifty-six pubertal growth hormone deficiency (GHD) boys were studied, they were treated with the combination of letrozole and rhGH (letrozole group, n = 28) or the combination of GnRHa and rhGH (GnRHa group, n = 28) for at least one year. Eighteen patients in the letrozole group and seventeen patients in the GnRHa group attained final adult height (FAH).</p><p><strong>Results: </strong>The increase in height of the letrozole group was significantly more than the GnRHa group both in the first year [(10.37 ± 2.19) vs. (7.78 ± 1.55) cm] and at two years [(18.82 ± 2.49) vs. (13.84 ± 2.17) cm] (p < 0.05), however, there was no significant group difference in the advancement of bone age (BA) of in the first year or at two years (p > 0.05). The mean FAH in two groups were similar, but the treatment duration of the letrozole group was significantly less than GnRHa group. There was a significant body mass index (BMI) SDS increase in the letrozole vs. GnRHa groups. Of concern, bone mineral density (BMD) decreased in both groups after treatment, but more so in the letrozole cohort.</p><p><strong>Conclusion: </strong>The combination of letrozole/rhGH in pubertal GHD boys was similar to GnRHa/rhGH in terms of the progression of BA and FAH, but the former co-therapy was superior in the gain of height. Disconcertingly, however, this combination may adversely affect BMI and BMD.</p><p><strong>Clinical trial registration number: </strong>ChiCTR2300068405.</p>","PeriodicalId":9144,"journal":{"name":"BMC Pediatrics","volume":"25 1","pages":"59"},"PeriodicalIF":2.0,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11761712/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143036913","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neonatal indicator data in Tanzania District Health Information System: evaluation of availability and quality of selected newborn indicators, 2015-2022.","authors":"Josephine Shabani, Nahya Salim, Christine Bohne, Louise Tina Day, Claud Kumalija, Ahmad Mohamed Makuwani, Felix Bundala, Habib Ismail, Joy E Lawn, Eric O Ohuma","doi":"10.1186/s12887-025-05417-x","DOIUrl":"10.1186/s12887-025-05417-x","url":null,"abstract":"<p><strong>Background: </strong>The Every Newborn Action Plan (ENAP) indicators are essential in monitoring neonatal healthcare coverage and quality. The District Health Information System (DHIS2), an open-source platform in over 80 countries, supports health data collection and analysis, enabling progress tracking at national and subnational levels. This study evaluates the availability and quality of maternal and newborn health indicators, explicitly focusing on ENAP indicators within Tanzania's DHIS2.</p><p><strong>Methods: </strong>Using the EN-MINI tool, we assessed data availability for 20 ENAP indicators by analysing their numerators and denominators in Tanzania's DHIS2 (2015-2022) across all healthcare levels. World Health Organization's (WHO) data quality framework was adapted to examine four dimensions: (a) availability of indicators, (b) completeness of indicator reporting, (c) internal consistency of related indicators, and (d) indicator plausibility by comparing DHIS2 data with population-based Demographic and Health Survey (DHS) data.</p><p><strong>Results: </strong>Of the 20 ENAP indicators, 14 were available in Tanzania's DHIS2, with definitions, numerators and denominators aligned with WHO standards. Between 2015 and 2022, the number of facilities reporting at least one delivery annually increased by 19% from 5,898 to 7,016. During this period, 75% to 97% of facilities consistently reported data on skilled attendance at birth and early breastfeeding initiation. In contrast, 4% to 54% of facilities reported on maternal and newborn outcomes, including complications such as stillbirths and maternal mortality. Internal consistency was high (> 94%). However, neonatal mortality rates reported in DHIS2 were lower than those reported in Tanzania DHS for similar periods, even after a 20% adjustment to account for home births.</p><p><strong>Conclusion: </strong>Tanzania's DHIS2 captures many ENAP indicators; however, notable variability in data quality persists, with substantial data gaps related to maternal and newborn outcomes and complications. To address these challenges, it is crucial to strengthen routine data review, implement robust quality checks, enhance validation processes, provide targeted training, deliver constructive feedback, and conduct supportive supervision. Placing greater emphasis on using DHIS2 data to monitor progress will help identify gaps and drive improvements in data quality, ultimately supporting better maternal and newborn health outcomes.</p>","PeriodicalId":9144,"journal":{"name":"BMC Pediatrics","volume":"23 Suppl 2","pages":"658"},"PeriodicalIF":2.0,"publicationDate":"2025-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11755859/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143027770","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effect of azithromycin treatment on respiratory morbidity in children with down syndrome.","authors":"Inbal Golan-Tripto, Omer Dor, Noga Arwas, Itai Hazan, Guy Hazan, Aviv Goldbart","doi":"10.1186/s12887-025-05421-1","DOIUrl":"10.1186/s12887-025-05421-1","url":null,"abstract":"<p><strong>Background: </strong>Children with Down syndrome (DS) often experience recurrent and prolonged hospitalizations from respiratory infections. While Azithromycin has been increasingly used for lower-respiratory tract infections (LRTIs) in children, its potential benefits for DS patients are unexplored. This study evaluates the effect of chronic azithromycin treatment on respiratory morbidity in children with DS.</p><p><strong>Methods: </strong>In this retrospective cohort study, we analyzed data from children with DS aged 0-6 years treated with Azithromycin for at least 6 weeks (10 mg/kg, thrice weekly). Respiratory morbidity indicators, such as primary care visits, medication consumption, emergency department visits, hospitalizations, and hospital length of stay (LOS), were assessed and compared six months before and after the Azithromycin treatment.</p><p><strong>Results: </strong>Twenty-three episodes of Azithromycin treatment (≥ 6 weeks) in eighteen children with DS (mean age of 2.3 years, 78% males) during 2016-2023 were included. A significant reduction in mean respiratory LOS was observed (13.6 vs. 4.7 days, p = 0.05) when comparing pre to post-Azithromycin treatment. Other secondary respiratory outcomes showed no significant differences.</p><p><strong>Conclusion: </strong>The significant reduction in respiratory LOS suggests the potential benefits of Azithromycin in children with DS, and emphasizes the need for larger clinical trials to determine optimal use and long-term effects in this vulnerable population.</p>","PeriodicalId":9144,"journal":{"name":"BMC Pediatrics","volume":"25 1","pages":"53"},"PeriodicalIF":2.0,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11753151/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143022126","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Relationship between platelet distribution width and non-dipping pattern in children with essential hypertension.","authors":"Ling Sun, Bo Wang, Daoping Yang, Wanping Zhou, Yunjia Tang, Xuan Li, Haitao Lv, Miao Hou","doi":"10.1186/s12887-025-05420-2","DOIUrl":"10.1186/s12887-025-05420-2","url":null,"abstract":"<p><strong>Background: </strong>Hypertension has shown a trend of prevalence at younger ages, and the non-dipping pattern is associated with target organ damage in hypertension. However, few studies have yet investigated the clinical characteristics and risk factors of non-dipper status in essential hypertension children. This study aimed to explore the clinical characteristics and possible indicators associated with non-dipper status in children with essential hypertension.</p><p><strong>Methods: </strong>A total of 125 children (99 boys, 26 girls) with untreated essential hypertension were retrospectively included in this study. Non-dipping was defined as a nocturnal drop in systolic or diastolic BP (SBP, DBP) < 10%. Clinical data, ambulatory blood pressure monitoring (ABPM), laboratory and echocardiography parameters were recorded from the hospital database.</p><p><strong>Results: </strong>Non-dipping pattern was found in 74 (59.2%) children and the dipping pattern in 51(40.8%) children, and the nocturnal SBP drop was 8.43 ± 0.71 (%), and the DBP drop was 14.44 ± 0.86 (%). The proportion of children with left ventricular hypertrophy was higher in the non-dipping group than in the dipping group. The platelet distribution width, high-sensitivity C-reactive protein (hs-CRP) and triglycerides (TG) levels were higher in the non-dipping group compared with the dipping group. In multivariate logistic regression analysis, PDW, TG and hs-CRP were found to be associated with the non-dipping pattern.</p><p><strong>Conclusion: </strong>Non-dipping pattern in children hypertension is common, and the proportion of left ventricular hypertrophy is higher in non-dipping hypertension children. Moreover, higher PDW, hs-CRP and TG levels are the risk factors for non-dipping status in essential hypertension children.</p>","PeriodicalId":9144,"journal":{"name":"BMC Pediatrics","volume":"25 1","pages":"54"},"PeriodicalIF":2.0,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11752664/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143022120","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Theoretical impact of a bedside decision-making tool on antibiotic use for suspected neonatal healthcare-associated infection: an observational study.","authors":"Lizel Georgi Lloyd, Mirjam Maria van Weissenbruch, Adrie Bekker, Cecilia Ferreyra, Birgitta Gleeson, Angela Dramowski","doi":"10.1186/s12887-024-05323-8","DOIUrl":"10.1186/s12887-024-05323-8","url":null,"abstract":"<p><strong>Background and objectives: </strong>Healthcare-associated infections (HAI) are a leading contributor to morbidity and mortality in hospitalised neonates. Diagnosing neonatal HAI is challenging owing to non-specific symptoms and lack of definitive diagnostic markers, contributing to high rates of inappropriate antibiotic use. This study evaluated the theoretical impact of implementing a bedside tool for decision-making on antibiotic length of therapy (LOT).</p><p><strong>Methods: </strong>This prospective observational physician-blinded study consecutively enrolled patients with suspected HAI events at a large South African neonatal unit from September 2022 to September 2023. The antibiotic decision-making tool included an infection prediction score (NeoHoP), and a point-of-care C-reactive protein test (CRP) performed at HAI diagnosis and 24 h later. The theoretical impact of the tool on antibiotic LOT was calculated.</p><p><strong>Results: </strong>We recruited 180 neonates with 214 episodes of suspected HAI, of which 22 (10.3%) were proven HAI, 56 (26.2%) were presumed HAI and 136 (63.6%) had HAI ruled out. The median observed antibiotic LOT was three days (9 days for proven HAI, 7 days for presumed HAI, and 3 days for no HAI). The antibiotic decision-making tool would theoretically reduce overall antibiotic LOT by 2 days (p < 0.001), particularly in neonates where HAI was subsequently excluded.</p><p><strong>Conclusion: </strong>We developed an antibiotic decision-making tool to support the clinical evaluation of suspected neonatal HAI and demonstrated a significant potential impact on reducing antibiotic LOT. Given increasing antibiotic resistance rates globally, this tool should be further evaluated to minimise unnecessary antibiotic use in hospitalised neonates.</p>","PeriodicalId":9144,"journal":{"name":"BMC Pediatrics","volume":"25 1","pages":"52"},"PeriodicalIF":2.0,"publicationDate":"2025-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11749325/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142999963","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction: The effect of educational programs on parents' knowledge, behavior, and practices regarding aluminum phosphide poisoning and its first-aid measures.","authors":"Mabrouka Attia Ali Nada, Ahmed Kamal Eldin Elsayed Elfeky, Hamida Ahmed Mustafa Darweesh, Farida Khalil Ibrahim Mohamed, Loujain Saud Sharif, Faten Shawky Kandil, Fatma Ahmed Elsobky, Samah Abdallah Mohamed Amer","doi":"10.1186/s12887-025-05404-2","DOIUrl":"10.1186/s12887-025-05404-2","url":null,"abstract":"","PeriodicalId":9144,"journal":{"name":"BMC Pediatrics","volume":"25 1","pages":"51"},"PeriodicalIF":2.0,"publicationDate":"2025-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11748237/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142999343","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence and risk factors for childhood asthma: a systematic review and meta-analysis.","authors":"Weijun Zhou, Jia Tang","doi":"10.1186/s12887-025-05409-x","DOIUrl":"10.1186/s12887-025-05409-x","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to systematically review and perform a meta-analysis on epidemiological studies in order to estimate the global and regional prevalence and to identify risk factors associated with childhood asthma.</p><p><strong>Methods: </strong>A comprehensive search of the PubMed, Embase, and Cochrane Library electronic databases was conducted for relevant literature published from their inception to March 31, 2023. The primary endpoint was the prevalence of childhood asthma. Secondary endpoint focused on the identification of risk factors associated with childhood asthma.</p><p><strong>Results: </strong>A total of 1,547,404 children participated in the 164 studies selected for the meta-analysis. The overall prevalence of childhood asthma was 10.2% (95% CI: 9.5-11.0%), while the prevalence of childhood asthma in Asia, Europe, Latin America, North America, Oceania, Africa, or Eurasia were 10% (95%CI: 7-13%), 9% (95%CI: 7-12%), 14% (95%CI: 9-20%), 13% (95%CI: 12-14%), 23% (95%CI: 19-28%), 11% (95%CI: 7-19%), and 8% (95%CI: 2-27%), respectively. Moreover, the identified risk factors for childhood asthma included older age, male sex, obesity, parental smoking, high education of the mother, premature birth, cesarean section, no breastfeeding, family history of asthma, rhinitis, eczema, pets, high density of road traffic, meat, margarine, fast food, paracetamol use, and antibiotic use.</p><p><strong>Conclusion: </strong>Childhood asthma is common, and the prevalence of asthma is highest in Oceania, with a lower prevalence in Eurasia. Moreover, the risk factors for childhood asthma were comprehensively identified, and health education should be provided to prevent modifiable factors.</p>","PeriodicalId":9144,"journal":{"name":"BMC Pediatrics","volume":"25 1","pages":"50"},"PeriodicalIF":2.0,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11744885/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142999826","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Effect of auriculotherapy on sleep quality in children with attention deficit hyperactivity disorder: a randomized clinical trial.","authors":"Laleh Mohammadi, Zahra Tagharrobi, Khadijeh Sharifi, Zahra Sooki, Mohammad Zare, Fatemeh Zare Joshaghani","doi":"10.1186/s12887-024-05371-0","DOIUrl":"10.1186/s12887-024-05371-0","url":null,"abstract":"<p><strong>Introduction: </strong>Considering the importance of sleep disorders in children with attention-deficit/hyperactivity disorder (ADHD) and effective therapeutic strategies, the present study aimed to investigate the effects of auriculotherapy on sleep quality in children with ADHD.</p><p><strong>Materials and methods: </strong>This clinical trial was conducted in children with ADHD in Kashan, Iran, 2021-2022. Fifty-two eligible samples were selected using convenience sampling and randomly assigned to intervention and sham groups. The intervention group used Vacaria seeds to apply ear acupressure to Shenmen, Sympathetic, Subcortex, Heart, and Endocrine points for four weeks, while the sham group received adhesives without seeds and pressure. Sleep quality was assessed using children's sleep habits questionnaire at the beginning (T0), at the end of the intervention (T1), and one month later (T2). Data from 45 children (23 and 22 children in the intervention and sham groups, respectively) were analyzed using the per-protocol and intention-to-treat designs using repeated measures analysis of variance.</p><p><strong>Results: </strong>The background variables did not significantly differ between two groups. The between-group analysis revealed a significant interaction effect of time and intervention on sleep quality (Effect Size = 0.545, p < 0.0001). The sleep quality score in the intervention group was significantly greater than in the sham group at T1 and T2 (p < 0.0001). The within-group analysis of the intervention group revealed a significant difference in sleep quality scores at three time points (Effect Size = 0.672, p < 0.05). In the sham group, sleep quality score increased significantly over time (Effect Size = 0.511, p < 0.05).</p><p><strong>Conclusions: </strong>The findings suggest that auriculotherapy may be a beneficial complementary treatment for improving sleep quality in children with ADHD.</p>","PeriodicalId":9144,"journal":{"name":"BMC Pediatrics","volume":"25 1","pages":"48"},"PeriodicalIF":2.0,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11744890/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142999839","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Case report: a rare concurrence of dense deposit disease in an adolescent patient with IgA nephropathy.","authors":"Jian-Hui Zhang, Hong-Ping Yu, Ying Chen, Qian Chen, Xiao-Ling Zheng, Jie-Wei Luo, Li Zhang","doi":"10.1186/s12887-025-05415-z","DOIUrl":"10.1186/s12887-025-05415-z","url":null,"abstract":"<p><strong>Background: </strong>Dense deposit disease (DDD) is a rare renal disorder major affecting adolescents and children, characterized by an absence of distinctive clinical symptoms. Its coexistence with other renal conditions complicates both diagnosis and treatment in clinical practice.</p><p><strong>Case presentation: </strong>We described a 15-year-old male adolescent presenting with nephrotic syndrome as the initial manifestation, with urinalysis indicating significantly elevated protein and erythrocytes. Unexpectedly, the renal pathological biopsy of the patient exhibited strong positivity for both IgA and C3, characterized by petaloid deposition of C3 along glomerular capillary loops and the glomerular mesangial region, as well as linear deposition in Bowman's capsule and portions of the renal tubular basement membrane. Consequently, the patient was diagnosed with both DDD and IgA nephropathy. The presence of both in a single patient may result in more intricate pathogenic pathways.</p><p><strong>Conclusions: </strong>This specific case elucidates the pathological characteristics of both diseases while investigating the intricate connections and lesion correlations that may occur between them, offering novel insights into their pathogenesis.</p>","PeriodicalId":9144,"journal":{"name":"BMC Pediatrics","volume":"25 1","pages":"47"},"PeriodicalIF":2.0,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11744802/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143000186","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The role of partial splenic artery embolization in the management of refractory esophageal variceal bleeding due to portal vein thrombosis.","authors":"Büşra Tetik Dinçer, Nafiye Urgancı, Aylin Hasanefendioğlu Bayrak, Özlem Durmaz, İlgin Özden","doi":"10.1186/s12887-025-05414-0","DOIUrl":"10.1186/s12887-025-05414-0","url":null,"abstract":"<p><strong>Background: </strong>Gastro-esophageal variceal hemorrhage (GEVH) is one of the major causes of life-threatening gastrointestinal bleeding in children. Medical, endoscopic, angiographic, and surgical interventions can be utilized in treatment. In this case report, we describe partial splenic artery embolization for refractory GEVH due to portal vein thrombosis.</p><p><strong>Case presentation: </strong>A 3-year-old male patient was admitted with abdominal distension. He had been followed up for hepatosplenomegaly for 2 years. The patient's body weight was 15.5 kg (50-75th percentile, 0.69 SDS) and height was 96 cm (50-75th percentile, 0.27 SDS). The general condition was moderate, and the skin appeared pale. The liver was palpable 2 cm, and the spleen was palpable 6 cm below the costal margin. Other system examinations were normal. Laboratory findings included hemoglobin (Hgb) of 7.1 g/dL, hematocrit (Hct) of 24%, white blood cell count of 9800/mm3, platelets of 67000/mm3, and INR of 1.3. Abdominal CT angiography demonstrated a hypodense thrombus at the portal confluence, almost completely occluding the lumen. Endoscopy revealed esophageal varices at the 2 and 7 o'clock positions in the distal esophagus, which became more prominent with insufflation and had red spots on them. Hyperemia was observed in the corpus and antrum of the stomach. Findings were consistent with stage 3 esophageal varices and increased vascularity in the duodenum due to portal vein thrombosis. Medical treatment with a proton pump inhibitor and beta-blocker was initiated. The patient underwent endoscopic band ligation (EBL) three times over 9 months. Despite EBL, the patient presented with GEVH three times during a 1.5-year follow-up. Due to newly developed multiple varices observed on control endoscopy a decision was made to perform splenic artery embolization. Interventional radiology performed selective lower splenic pole embolization. Six months later, the patient underwent another selective embolization. The patient has been followed up for 3 years without GEVH.</p><p><strong>Conclusions: </strong>In this case, splenic artery embolization was observed to be an effective, repeatable, and safe treatment method for patients with hypersplenism caused by portal hypertension and refractory esophageal variceal bleeding.</p>","PeriodicalId":9144,"journal":{"name":"BMC Pediatrics","volume":"25 1","pages":"49"},"PeriodicalIF":2.0,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11744803/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142999962","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}