BMC Pediatrics[JOURNAL]
Sun
200 papers
Analysis of clinical characteristics and risk factors for severe EBV infection in children-a single-center retrospective cohort study.
Tang X, Sun T, Zhu G … +4 more , Zhou Y, Zhang Y, Chen R, Cui Y
BMC Pediatr · 2026 Jun · PMID 42231200 · Full text
BACKGROUND: To investigate the clinical features and risk factors of severe Epstein-Barr virus (EBV) infection in children. METHODS: A retrospective analysis of the medical records of 144 cases admitted to the PICU (Pedi...
BACKGROUND: To investigate the clinical features and risk factors of severe Epstein-Barr virus (EBV) infection in children. METHODS: A retrospective analysis of the medical records of 144 cases admitted to the PICU (Pediatric Intensive Care Unit) and pediatric general wards of Shanghai Children's Hospital from January 2019 to March 2024 for Epstein-Barr virus (EBV) infection was conducted. The cases were categorized into severe and IM (Infectious Mononucleosis) groups according to the presence or absence of organ dysfunction. RESULTS: The children in the severe group exhibited elevated incidences of gastrointestinal symptoms, cervical lymph node enlargement, hepatomegaly, and gallbladder and bile duct involvement (P ≤ 0.05). The plasma EBV DNA copy number of children in the severe group was higher than that in the IM group. Additionally, hemoglobin levels, D-dimer levels, lymphocyte subsets, and cytokines IL (Interleukin)-10 and IFN (Interferon)-γ were statistically different between the two groups (all P ≤ 0.05). Independent risk factors for severe EBV infection were identified as hemoglobin, IFN-γ and D-dimer. The predicted AUC (Area Under Curve) for hemoglobin was 0.83, with a critical value of 11.1 g/dL (P = 0.02); for D-dimer, the AUC was 0.93, with a critical value of 2.4 mg/L (P = 0.04); and for IFN-γ, the AUC was 0.80, with a critical value of 243.7 pg/ml (P = 0.04). CONCLUSION: This study suggests that hemoglobin, IFN-γ and D-dimer may are risk factors for progression of EBV infection to severe disease.
Urban environmental and climatic correlates of pediatric respiratory infection: microscale spatiotemporal evidence from Fuzhou, China.
Dong Y, Rao Y, Zhang J … +2 more , Tang Q, Wang Z
BMC Pediatr · 2026 May · PMID 42226231 · Full text
Urban environmental and climatic conditions are closely linked to pediatric respiratory health, yet their associations with specific infectious diseases such as mycoplasma pneumoniae pneumonia (MPP) remain poorly underst...
Urban environmental and climatic conditions are closely linked to pediatric respiratory health, yet their associations with specific infectious diseases such as mycoplasma pneumoniae pneumonia (MPP) remain poorly understood. To address this gap, this study investigated the spatiotemporal dynamics of pediatric MPP across 46 urban subdistricts in Fuzhou, China. Using global and local spatial autocorrelation, space-time scan statistics, and interpretable machine learning models, we assessed both incidence patterns and progression to severe disease, as well as their built-environment correlates. Key findings include: (1) A pronounced seasonality of MPP is observed, with autumn-winter peaks and summer troughs. High-risk clusters are concentrated in central urban areas, whereas peripheral regions exhibit weaker clustering. These patterns are consistent with variations in climate, population density, transport networks, greenspace, and school-term cycles. (2) The autumn-winter period represents the critical risk window, encompassing a large share of cases and repeatedly centering on repeatedly high-incidence subdistricts. Demographically, boys and children aged 5-9 years face the highest risk, whereas the 10-14 age group-particularly girls-shows the lowest incidence. (3) Machine learning identified age, near-road exposure, and selected land-use/amenity intensities as core predictors, especially for severe MPP cases. Age exhibits a non-monotonic incidence profile, while distance from primary roads follows a steep inverse gradient, with elevated risk confined to a 100-150 m roadside buffer zone. School density shows a monotonic positive association, whereas greenspace is a broadly negative association. These findings may help inform seasonally tailored, microscale interventions, strengthened school health monitoring, and targeted urban design in high-prevalence corridors.
Relatively high prevalence of subclinical iron deficiency in Japanese children: evidence from a preoperative screening cohort.
Hanawa Y, Baba Y, Murasaki W … +2 more , Namba H, Oishi K
BMC Pediatr · 2026 Jun · PMID 42226200 · Full text
BACKGROUND: Iron deficiency (ID), even in the absence of anemia, is one of the most common micronutrient deficiencies in childhood and remains particularly relevant during infancy and early childhood, when brain developm...
BACKGROUND: Iron deficiency (ID), even in the absence of anemia, is one of the most common micronutrient deficiencies in childhood and remains particularly relevant during infancy and early childhood, when brain development is rapid. Iron plays an essential role in myelination, neurotransmitter synthesis, mitochondrial function, and neuronal energy metabolism. Contemporary longitudinal and mechanistic studies suggest that early-life iron deficiency may be associated with later deficits in attention, executive function, and educational performance, although the magnitude and reversibility of these effects remain incompletely defined. METHODS: We retrospectively reviewed pediatric patients who underwent elective surgery between January 2021 and June 2024. Patients with hematologic disorders, severe chronic disease, ongoing iron therapy, clinically active inflammatory conditions, or preoperative C-reactive protein (CRP) > 1.0 mg/dL were excluded. ID was defined as age-specific low serum ferritin and/or transferrin saturation (TSAT) < 16%. Anemia was defined using the 2024 World Health Organization hemoglobin cutoffs. Cases with discordant ferritin and TSAT results were classified as ID if either criterion was abnormal. RESULTS: Of 199 eligible patients, 129 were included (76 males, 53 females). The majority were aged 6 months to 4 years. ID was identified in 26 children (20.2%), including 23 with ID without anemia and 3 with IDA (2.3%); all were asymptomatic. The ID group showed lower hemoglobin, MCV, MCH, serum iron, and ferritin, and higher RDW-CV, platelet count, and UIBC than the non-ID group. CONCLUSIONS: Subclinical ID was common among asymptomatic Japanese children undergoing elective surgery, indicating that clinically silent iron deficiency may be present even in children who appear otherwise well. Rather than supporting surgery-based screening as a stand-alone strategy, these findings underscore the importance of careful dietary and clinical risk assessment during routine pediatric care and the need for context-sensitive approaches to early identification of children at risk for iron deficiency.
Physical activity profiles of attention-deficit/hyperactivity disorder symptoms among preschool children.
Zhang L, You C, Ma J … +6 more , Miao X, Fan M, Zeng X, Li W, Yin X, Hu Y
BMC Pediatr · 2026 Jun · PMID 42226168 · Full text
BACKGROUND: Physical activity (PA) has gained attention as a potential behavioral marker for ADHD, yet findings remain inconsistent. Most research focuses on school-aged children, leaving a critical gap in understanding...
BACKGROUND: Physical activity (PA) has gained attention as a potential behavioral marker for ADHD, yet findings remain inconsistent. Most research focuses on school-aged children, leaving a critical gap in understanding PA patterns in preschoolers with ADHD symptoms. AIM: The study aims to investigate the association of physical activity level and ADHD symptoms and focus on characterizing physical activity profiles of preschool children with ADHD symptoms. METHODS: Totally 18 children with ADHD symptoms and 66 typically developing children were enrolled in this study. Physical activity was objectively assessed using actigraphy over five school days. Two-sample Wilcoxon rank-sum test was used to assess differences between groups. Multivariate regression models were further employed to control potential confounding variables. RESULTS: Preschool children with ADHD symptoms had less time in most of the daily physical activities. Especially, ADHD groups had lower light (24.11 min vs. 27.25 min, P = 0.023), moderate (16.56 min vs. 20.43 min, P = 0.009) and moderate-to-vigorous physical activities (MVPA, 23.26 min vs. 29.20 min, P = 0.018) than control group. Potential interactive effects among light, moderate, MVPA and routine afterschool physical activities were further investigated using multivariate regression analysis. CONCLUSIONS: The observed pattern of reduced PA in preschool children with ADHD symptoms may reflect behavioral characteristics associated with early ADHD manifestations. However, further longitudinal research is needed to determine whether activity differences could serve as potential early markers for ADHD.
Children's weight status and parental perception in Croatia.
Jerković G, Musić Milanović S, Unić Šabašov I
BMC Pediatr · 2026 Jun · PMID 42226157 · Full text
BACKGROUND/OBJECTIVES: Parental recognition of children's weight status is an important factor in promoting healthy growth and preventing obesity. This study aimed to examine individual and contextual predictors of paren...
BACKGROUND/OBJECTIVES: Parental recognition of children's weight status is an important factor in promoting healthy growth and preventing obesity. This study aimed to examine individual and contextual predictors of parental perceptions of their children's weight as well as to compare these perceptions within WHO BMI classification criteria. METHODS: The data were obtained from the CroCOSI survey conducted in Croatia in 2021/2022, using a nationally representative, regionally stratified sample of second and third grade primary school children (N = 5,603, aged 6-10 years). Multinomial logistic regression was used to examine associations between parental perception of a child's weight and BMI, child's gender, maternal and paternal BMI, parent gender and region of residence while socioeconomic status was controlled. RESULTS: Most parents perceived their children as having normal weight, with a tendency to underestimate overweight cases. Child BMI and gender were consistent and strong predictors of parental perception of child's weight. Maternal BMI had a minor effect, while paternal BMI, parent gender and region of residence were not significantly associated with perception of child's weight. Socioeconomic status was a significant predictor, underscoring the role of social factors in shaping parental assessments. CONCLUSIONS: Parental perception of children's weight status in Croatia displayed a consistent tendency toward underestimation of obesity, with most parents perceiving their children as having normal weight despite WHO BMI classifications. Child BMI, gender and socioeconomic status were key predictors of perception, highlighting the importance of both individual and social factors in shaping parental perception of child weight.
Early life factors and genetic interactions in allergic rhinitis: a genome-wide study.
Huang S, Zhang Z, Zhang H … +6 more , Qiu K, Shu T, Xu W, Meng J, Zhao Y, Ren J
BMC Pediatr · 2026 May · PMID 42226146 · Full text
BACKGROUND: Early life factors play an important role in the development and progression of allergic rhinitis (AR), but their relationship and underlying genetic mechanisms still remains unclear. METHODS: Using cross-sec...
BACKGROUND: Early life factors play an important role in the development and progression of allergic rhinitis (AR), but their relationship and underlying genetic mechanisms still remains unclear. METHODS: Using cross-sectional data from the UK Biobank (UKB) and West China Hospital (WCH), we assessed the associations between nine early life factors-birth weight, body size and height at age 10, multiple births, maternal smoking around birth, breastfeeding, long-term/recurrent antibiotic usage as a child or teenager (LTRAU), cesarean delivery, and maternal age-and the development of AR through multivariable logistic regression models. We also conducted a genome-wide gene-environment interaction study (GWGEIS) to explore the correlation between polygenic risk scores (PRS) derived from GWGEIS and AR risk. RESULTS: In both UKB and WCH cohorts, LTRAU (UKB cohort: OR = 1.49, P < 0.001; WCH cohort: OR = 2.18, P < 0.001), and born by cesarean delivery (UKB cohort: OR = 1.26, P = 0.0014; WCH cohort: OR = 1.47, P = 0.008) were identified as independent risk factors for AR. Notably, the association between cesarean delivery and an increased risk of AR was confined to female offspring who developed AR before the age of 16. In contrast, the detrimental effects of LTRAU remained significant in offspring who developed AR after the age of 16. Additionally, GWGEIS identified an interaction between the ATE1 gene and LTRAU (rs4752620, P = 2.51E-8, β = -0.30). Furthermore, the PRS derived from GWGEIS results was significantly associated with the risk of AR (OR = 1.06, P = 0.038). CONCLUSIONS: These findings enhance our understanding of how early life factors, particularly LTRAU, and genetic factors synergistically affect AR risk, offering valuable insights for prevention and treatment strategies.
Inflammatory biomarkers and symptom presence in pediatric corrosive substance ingestion: a retrospective study.
İpek H, Doğan G, Metin M … +2 more , Çoşkun N, Afşarlar ÇE
BMC Pediatr · 2026 Jun · PMID 42226133 · Full text
BACKGROUND: Corrosive substance ingestion is a significant clinical problem in the pediatric population, with challenges in early assessment due to the inconsistent relationship between symptoms and the severity of esoph...
BACKGROUND: Corrosive substance ingestion is a significant clinical problem in the pediatric population, with challenges in early assessment due to the inconsistent relationship between symptoms and the severity of esophageal injury. Easily accessible inflammatory biomarkers have been proposed as adjunctive tools for early clinical evaluation. This study aimed to evaluate the association between inflammatory biomarkers and symptom presence in pediatric patients with corrosive substance ingestion and to assess their discriminative performance. METHODS: This retrospective study included 213 pediatric patients (aged 0-18 years) with corrosive substance ingestion. Patients were classified according to the type of ingested substance and the presence of symptoms. Inflammatory biomarkers including neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), systemic immune-inflammation index (SII), systemic inflammatory response index (SIRI), and pan-immune-inflammation value (PIV) were calculated, and their association with symptom presence was analyzed. RESULTS: The proportion of symptomatic patients was 8.5% (n = 18), with vomiting and hypersalivation being the most common symptoms. Neutrophil levels were higher (P = 0.016) and lymphocyte levels were lower (P = 0.007) in symptomatic patients, resulting in significantly elevated NLR (P = 0.002). PLR (P = 0.006), SII (P = 0.004), SIRI (P = 0.020), and PIV (P = 0.019) were also higher. NLR showed the best discriminative performance (AUC = 0.723; 95% CI: 0.557-0.888), with 61.1% sensitivity and 90.3% specificity at a cut-off of 2.15. Logistic regression confirmed a significant association between elevated NLR and symptom presence. CONCLUSIONS: Inflammatory biomarkers, particularly NLR, were associated with symptom presence; however, their diagnostic or prognostic value is limited. They should not replace endoscopic evaluation. Further prospective studies are needed to validate their clinical utility.
Psychiatric and psychosocial characteristics of children with premature adrenarche: a prospective study.
Arslan G, Şar T, Imıl P … +4 more , Erbaş İM, Tabanlı G, Durak FS, Özkan B
BMC Pediatr · 2026 Jun · PMID 42226038 · Full text
AIM: Although psychiatric disorders such as depression and anxiety have been reported to be more common in children with precocious puberty, the psychosocial characteristics of puberty variants remain unclear. This study...
AIM: Although psychiatric disorders such as depression and anxiety have been reported to be more common in children with precocious puberty, the psychosocial characteristics of puberty variants remain unclear. This study aimed to investigate the psychosocial characteristics of children with premature adrenarche (PA) and evaluate their relationships with clinical and laboratory findings. METHOD: This prospective case-control study included 34 patients aged 4-8 years diagnosed with PA who presented to our clinic between June and December 2023. Socio-demographic data were collected, and psychological assessments were performed using the Child Behaviour Checklist (CBCL) and the Revised Child Anxiety and Depression Scale-Child (RCADS-Child). A control group consisting of 35 age- and sex-matched healthy children was also included. RESULTS: Pubic hair was present in most patients with PA, and the majority were at Tanner stage 2 for pubic hair. The median dehydroepiandrosterone sulfate (DHEAS) level was 82.5 μg/dL. Among the psychiatric scales, only the RCADS-Child panic disorder and obsessive-compulsive disorder scores were significantly higher in children with PA compared with controls (p = 0.019 and p = 0.020). Possible psychiatric conditions were also more frequent in the PA group than in the control group (33.3% vs. 8.6%, p = 0.007). No significant association was found between DHEAS levels and psychiatric scale scores. CONCLUSION: Children with premature adrenarche showed higher psychiatric symptom scores compared with healthy controls, suggesting a possible association. Similar to precocious puberty, premature adrenarche may affect psychosocial adaptation to pubertal development, highlighting the importance of monitoring potential psychosocial problems in these patients.
Sleep duration and risk of high blood pressure in adolescents: a cross-sectional study from the Thai National Health Examination Survey VI, 2020 (NHES-VI).
Pirojsakul K, Boonmanunt S, Siwarom S … +6 more , Bumrerraj S, Neelapaichit N, Chariyalertsak S, Assanangkornchai S, Taneepanichskul S, Aekplakorn W
BMC Pediatr · 2026 Jun · PMID 42219470 · Full text
BACKGROUND: Sleep duration has been shown to affect blood pressure, yet conflicting results persist. The present study aimed to investigate whether sleep duration was associated with high blood pressure in adolescents fr...
BACKGROUND: Sleep duration has been shown to affect blood pressure, yet conflicting results persist. The present study aimed to investigate whether sleep duration was associated with high blood pressure in adolescents from the Thai National Health Examination Survey, VI (2020). MATERIALS AND METHODS: The survey was a nationwide, cross-sectional survey that used a multistage, stratified sample of the Thai population in both urban and rural areas across 5 regions, including Bangkok, Northern, Central, North-eastern, and Southern regions. Data from 4053 adolescents (2,029 females) aged 10-19, including demographic data, blood pressure, fasting lipid and glucose levels, sleep duration, and outdoor activity time, were collected. High blood pressure was diagnosed using the 2017 American Academy of Pediatrics guidelines. The results are presented as odds ratios (95% CI, p-values) for logistic regression and β coefficient (95% CI, p-values) for linear regression. RESULTS: The prevalence of high blood pressure was about 10% (weighted prevalence of 12.6%). Average sleep duration was 8.65 ± 1.28 h. The high blood pressure group had a higher body mass index (BMI), higher triglycerides (TG), longer weekday sleep duration, and lower high-density lipoprotein cholesterol than the normotensive group. In the multivariable logistic regression, BMI and TG were independently associated with high blood pressure, with ORs of 1.15 (95% CI: 1.11-1.20, p-value < 0.001) and 1.003 (95% CI 1.000-1.006, p-value = 0.048), respectively. Although sleep duration was not associated with high blood pressure (OR = 0.99, 95% CI 0.87-1.13), it was positively associated with systolic blood pressure in a multivariable linear regression model (β = 0.41, 95% CI 0.064- 0.764, p-value = 0.023). CONCLUSIONS: The prevalence of high blood pressure was about 10% in Thai adolescents. Although longer sleep duration was associated with higher systolic blood pressure, its effect was modest.
Trifid epiglottis in a neonate with choanal atresia and hydrometrocolpos: the third reported case and the first symptomatic neonatal presentation.
Khorashadizadeh M, Doostparast A, Sabahi MA … +1 more , Ghahramani S
BMC Pediatr · 2026 May · PMID 42218462 · Full text
BACKGROUND: Trifid epiglottis (TE) is an extremely rare congenital laryngeal anomaly. To the best of our knowledge, only two cases have previously been reported in the literature. Both of them have been incidentally dete...
BACKGROUND: Trifid epiglottis (TE) is an extremely rare congenital laryngeal anomaly. To the best of our knowledge, only two cases have previously been reported in the literature. Both of them have been incidentally detected and associated with polydactyly. CASE PRESENTATION: We report the third known case of TE in a two-day-old female neonate who was admitted to the emergency department due to abdominal distension, oliguria, and poor feeding within the first 24 h of life. Examination revealed stridor during crying, left postaxial polydactyly, right syndactyly, and an anteriorly displaced anus. Imaging findings revealed hydrometrocolpos followed by bilateral hydronephrosis. Her distension and oliguria were successfully treated with surgical drainage. Due to persistent stridor, airway evaluation confirmed right choanal atresia and TE. Other evaluations, including echocardiography, spinal ultrasonography, endocrine studies, and brain magnetic resonance imaging (MRI), were normal. The patient remained stable during one year of follow-up. CONCLUSION: To the best of our knowledge, this appears to be the first reported symptomatic neonatal case of TE associated with choanal atresia and hydrometrocolpos. It highlights the importance of early diagnosis and comprehensive evaluation of rare congenital laryngeal anomalies in neonates. Reporting such cases is crucial to expand the understanding of their clinical spectrum, guide airway management, and perform multidisciplinary care.
Clinical analysis of tracheobronchial foreign body aspiration in children aged six years and older.
Zhang X, Zhu L
BMC Pediatr · 2026 May · PMID 42218432 · Full text
OBJECTIVE: Foreign body aspiration (FBA) occurs across all age groups but predominantly affects children under three years of age. Clinical evidence suggests that tracheobronchial foreign bodies in school-age children (>...
OBJECTIVE: Foreign body aspiration (FBA) occurs across all age groups but predominantly affects children under three years of age. Clinical evidence suggests that tracheobronchial foreign bodies in school-age children (> 6 years) present distinct characteristics in terms of foreign body types, clinical progression, and management strategies compared to younger children. This study aimed to analyze the clinical features and outcomes of school-age children who underwent rigid bronchoscopy for suspected FBA and to propose a clinically applicable management algorithm. MATERIALS AND METHODS: A retrospective single-center study was conducted involving 58 patients over six years of age who underwent rigid bronchoscopy for suspected foreign body aspiration between January 2019 and December 2023. All patients underwent imaging evaluation, including low-dose computed tomography (CT) following the ALARA principle when clinically indicated. RESULTS: The cohort included 51 males (87.9%) and 7 females (12.1%), with a mean age of 9.14 years (range: 6.17-13.83 years). The most common clinical manifestations were cough (94.8%) and wheezing (89.7%). Pen caps (43.1%) and watermelon seeds (17.2%) were the most frequently aspirated foreign bodies. Most patients (62.1%) presented within 24 h. Bronchoscopic removal was successful within 30 min in 56.9% of cases. Two patients (3.4%) required thoracotomy following unsuccessful bronchoscopic attempts. CONCLUSION: FBA in school-age children demonstrates distinct clinical characteristics, with non-food foreign bodies such as pen caps being predominant. Low-dose CT plays an important diagnostic role, while rigid bronchoscopy remains the primary treatment for central airway foreign bodies, and flexible bronchoscopy is useful for distal airway involvement. A structured algorithmic approach may facilitate timely diagnosis and appropriate intervention.
Impact of optimized antiretroviral therapy on virological and nutritional outcomes among HIV infected adolescents in Cameroon.
Penda CI, Eboumbou PE, Ngondi GD … +12 more , Anaba SJN, Ndongo FA, Penda SM, Ndengue P, Enone JPM, Betoko RM, Djiyou AD, Douala AM, Ekoube CE, Iyawa H, Koum DMK, Moukoko CEE
BMC Pediatr · 2026 May · PMID 42218410 · Full text
BACKGROUND: Optimization of antiretroviral therapy (ART) is one of the key recommendations of the World Health Organization (WHO) since 2019 to achieve 95% viral suppression. The transition to optimized therapeutic regim...
BACKGROUND: Optimization of antiretroviral therapy (ART) is one of the key recommendations of the World Health Organization (WHO) since 2019 to achieve 95% viral suppression. The transition to optimized therapeutic regimens (OTRs) in pediatrics began in Cameroon at 2020. The objective of our study was to evaluate the impact of OTRs on HIV-infected adolescents (HIA) in healthcare facilities in the city of Douala. METHODS: A multicenter cross-sectional study was conducted from February to June 2022 in five hospitals in Douala. All HIA aged 10-19 years receiving ART for at least six months were included. Sociodemographic, clinical, therapeutic, and data related to the transition to optimized regimens were collected. Statistical analyses were performed using SPSS version 25. A p-value < 0.05 was considered statistically significant. RESULTS: Out of the 613 adolescents on antiretroviral therapy (ART), 599 (97.7%) were included in the study at a median age of 15 years (interquartile range [IQR]: 13-18 years). The male-to-female ratio was 0.9, and most adolescents (94.0%) had acquired HIV through mother-to-child transmission. Among the 599 HIV-infected adolescents (HIV), 391 (65.3%) were receiving optimized therapy, with a mean ART duration of exposure of 11.6 ± 5.7 months. Before switching to optimized therapy, 329 adolescents (84.2%) had viral suppression, compared to 370 (94.6%) after switching. Adolescents receiving optimized antiretroviral therapy were significantly 3.3 times more likely to have viral load suppression (OR: 3.3; 95% CI: 2.0-5.6; p < 0.001). These optimized regimens significantly reduced moderate malnutrition (OR: 0.38; 95% CI: 0.16-0.91; p = 0.042) and improved nutritional status, with mean weight increasing from 43.2 ± 13.0 kg to 46.7 ± 13.3 kg (p < 0.001) and body mass index increasing from 18.8 ± 3.2 to 19.6 ± 3.0 kg/m² (p < 0.001). CONCLUSION: Optimized antiretroviral regimens significantly improved viral suppression and moderate malnutrition among HIV infected adolescents in Douala, Cameroon.
Iron status, hepcidin, and CRP in children with endoscopically confirmed adenotonsillar hypertrophy: a controlled cross-sectional study.
Keskin S, Keskin N
BMC Pediatr · 2026 May · PMID 42216118 · Full text
BACKGROUND: Adenotonsillar hypertrophy (ATH) may influence iron homeostasis through low-grade inflammation and upper airway obstruction, but findings in children remain inconsistent. This study aimed to compare hematolog...
BACKGROUND: Adenotonsillar hypertrophy (ATH) may influence iron homeostasis through low-grade inflammation and upper airway obstruction, but findings in children remain inconsistent. This study aimed to compare hematologic, iron-related, and inflammatory parameters in school-aged children with and without endoscopically confirmed ATH. METHODS: This controlled cross-sectional study included 300 children aged 6-12 years (150 with ATH and 150 controls). Hemoglobin, serum iron, ferritin, mean corpuscular volume (MCV), C-reactive protein (CRP), and hepcidin were measured. Iron deficiency and anemia were defined according to World Health Organization criteria. Continuous variables were compared using parametric or nonparametric tests as appropriate, and categorical variables were analyzed using Pearson's chi-square test. RESULTS: No statistically significant between-group differences were found in hematologic, iron-related, or inflammatory parameters. Iron deficiency was identified in 30% of children with ATH and 24% of controls (p = 0.24), whereas iron-deficiency anemia was present in 10% and 8%, respectively (p = 0.55). CRP and hepcidin levels were also comparable between groups. CONCLUSION: In this outpatient cohort, ATH was not associated with significant differences in routine iron indices, CRP, or hepcidin. These findings do not support routine iron evaluation solely on the basis of ATH, although targeted assessment may be considered in children with relevant clinical findings.
Prenatal diagnosis and pregnancy outcome of fetuses with 15q11.2 BP1-BP2 microdeletion syndrome: a single-center retrospective study of 34 cases.
Chen Y, Zhang Y
BMC Pediatr · 2026 May · PMID 42215947 · Full text
BACKGROUND: To investigate the clinical phenotype, genetic counseling and pregnancy outcome of fetus with 15q11.2 BP1-BP2 microdeletion syndrome (Burnside-Butler syndrome, BBS), and to provide scientific prenatal diagnos...
BACKGROUND: To investigate the clinical phenotype, genetic counseling and pregnancy outcome of fetus with 15q11.2 BP1-BP2 microdeletion syndrome (Burnside-Butler syndrome, BBS), and to provide scientific prenatal diagnosis and genetic counseling for parents of BBS fetuses. METHODS: A single-center retrospective analysis method was used to analyze the data from September 2017 to April 2025. Data of 34 pregnant women with BBS fetuses who met the indications for prenatal diagnosis and underwent karyotype analysis of amniotic fluid, cord blood, and peripheral blood and single-nucleotide polymorphism array (SNP-array) for chromosomal copy number variations (CNVs) were collected. The CNVs detected were judged according to the American College of Medical Genetics and Genomics (ACMG) classification of genetic variants. RESULTS: A total of 34 BBS fetuses were detected in 9689 cases of SNP array, and the detection rate was 0.35% (34/9689). The median size of 15q11.2 microdeletion was 507.0 (490.6~512.3) kb. Among the 34 cases of BBS, the proportion of prenatal ultrasound abnormalities (55.6% vs. 52.0%), abnormal results of Down's syndrome screening or non-invasive prenatal testing (NIPT) screening, (44.4% vs. 20.0%) and advanced maternal age (≥ 35 years; 55.6% vs. 44.0%), were all higher in the pathogenic (P) group compared to the variant of uncertain significance (VUS) group. Among the 34 BBS fetuses, 25 were classified as having ACMG variants of unknown clinical significance and 9 were classified as pathogenic. Among the 9 cases of BBS, parental traceability test showed that 1 case was paternal origin, 3 cases were maternal origin and 5 cases were not verified. Among the 9 BBS cases in the P group, 5 cases were not verified. The parentage tracing test showed that the genetic inheritance from the maternal source was higher than that from the paternal source (33.3% vs. 11.1%). Among the 27 follow-up cases, the 88.89% (24/27) were inherited from parents, while de novo cases were relatively few 11.11% (3/27). CONCLUSION: The detection rate of BBS fetus in this study was 0.35%. The fetal manifestations of BBS are diverse, and SNP array is of great value in the detection of fetal chromosomal microdeletions including 15q11.2. Among the BBS cases, the majority were inherited from parents, while de novo cases were relatively few. Pregnancies involving BBS fetuses require adequate prenatal counseling. For women who choose to continue their pregnancies, increased supervision and extended postpartum monitoring are warranted.
Extreme hyperleukocytosis and blueberry muffin skin lesions as the initial presentation of neonatal leukemia: a case report.
Bustamante-Ordoñez MA, Macavilca-Toribio MA, Arenas-Vasquez JR … +3 more , Roman-Lazarte V, Zavaleta-Corvera C, Samanez-Obeso Á
BMC Pediatr · 2026 May · PMID 42215936 · Full text
BACKGROUND: Neonatal leukemia is a rare and aggressive hematologic malignancy, accounting for less than 1% of pediatric leukemias. Mixed phenotype acute leukemia (MPAL) is particularly uncommon in this age group and pose...
BACKGROUND: Neonatal leukemia is a rare and aggressive hematologic malignancy, accounting for less than 1% of pediatric leukemias. Mixed phenotype acute leukemia (MPAL) is particularly uncommon in this age group and poses significant diagnostic and therapeutic challenges. Hyperleukocytosis and leukostasis are life-threatening complications requiring urgent intervention. CASE PRESENTATION: We report the case of a 7-day-old male neonate, small for gestational age, who presented with extreme hyperleukocytosis (peak leukocyte count: 615,400/µL), severe anemia, thrombocytopenia, and generalized purpuric skin lesions consistent with blueberry muffin syndrome. The clinical course was complicated by coagulopathy and a high risk of tumor lysis syndrome. Cytoreductive management included manual partial exchange transfusion due to the unavailability of leukapheresis, achieving transient leukoreduction. Flow cytometry identified two abnormal populations: B-lineage blasts expressing CD19, CD79a, and cytoplasmic CD22, and a myeloid/monocytic population expressing myeloperoxidase (MPO), CD13, and CD33. Lineage assignment was established according to World Health Organization (WHO, 5th edition) and International Consensus Classification (ICC) lineage-defining criteria, confirming MPAL, B/myeloid subtype. Cytogenetic analysis revealed a karyotype 46,XY, add(19)(p13), while molecular testing for KMT2A rearrangements and other recurrent fusion genes was negative. Induction chemotherapy was initiated after initial stabilization; however, the patient died 45 days after diagnosis due to disease progression. CONCLUSION: This case highlights the diagnostic complexity and aggressive clinical course of neonatal MPAL, particularly in the absence of KMT2A rearrangements, and emphasizes the biological heterogeneity of this entity. Strict application of WHO/ICC lineage-defining criteria is essential to ensure accurate classification. Exchange transfusion may serve as a feasible bridging cytoreductive strategy in neonates with life-threatening hyperleukocytosis when leukapheresis is not available, although its effects are temporary and do not replace definitive therapy. Early recognition, prompt supportive management, and improved molecular characterization are critical to optimizing outcomes in this rare and high-risk population.
Association between perioperative metabolic disorders and disease time course with pyloric morphological characteristics in infants with infantile hypertrophic pyloric stenosis.
Zhao B, Li B, Ren H … +1 more , Cui R
BMC Pediatr · 2026 May · PMID 42215928 · Full text
OBJECTIVE: To identify risk factors for perioperative metabolic disorders in infants with infantile hypertrophic pyloric stenosis (IHPS) and examine their associations with disease time course and ultrasound-measured pyl...
OBJECTIVE: To identify risk factors for perioperative metabolic disorders in infants with infantile hypertrophic pyloric stenosis (IHPS) and examine their associations with disease time course and ultrasound-measured pyloric morphology. METHODS: In this retrospective cohort study, consecutive surgical IHPS patients (2019-2025) were included. Data on demographics, disease timeline (age at onset, age at surgery), and preoperative ultrasound parameters (pyloric muscle thickness, canal length) were collected. Univariate and multivariate logistic regression identified independent risk factors, and a decision tree prediction model was developed. RESULTS: Among 323 infants, 43.7% had preoperative metabolic disorders. Multivariate analysis identified independent risk factors: age at surgery (per 1 week delay, aOR = 1.438), pyloric muscle thickness (per 1 mm increase, aOR = 1.408), pyloric canal length (per 1 mm increase, aOR = 1.614), and pyloric index (per 10-unit increase, aOR = 1.671). In the decision tree model, pyloric canal length showed the highest predictive importance (100%), with > 20.75 mm as the primary split point. The model achieved 87.9% accuracy and 90.1% sensitivity. CONCLUSION: Perioperative metabolic disorders in IHPS reflect both obstruction duration and pyloric structural changes. Pyloric canal length is a potentially valuable imaging predictor. The preliminary threshold of > 20.75 mm may serve as a high-risk warning for metabolic disorders; combined with metabolic laboratory assessment, it could help optimize preoperative management and surgical timing.
Low expression of miR-126 constitutes a risk factor for perioperative respiratory adverse events among pediatric patients under general anesthesia.
Luo W, Lv K, Liu J … +4 more , Han X, Ma X, Li M, Feng Z
BMC Pediatr · 2026 May · PMID 42215901 · Full text
AIM: This study aims to investigate the diagnostic value of miR-126 in Perioperative respiratory adverse events (PRAEs). METHODS: This study included 228 pediatric patients undergoing anesthesia and surgery, who were div...
AIM: This study aims to investigate the diagnostic value of miR-126 in Perioperative respiratory adverse events (PRAEs). METHODS: This study included 228 pediatric patients undergoing anesthesia and surgery, who were divided into two groups based on the occurrence of PRAEs. RT-qPCR was used to detect miR-126 levels, the CCK-8 assay was employed to evaluate cell proliferation capacity, and ELISA kits were utilized to measure TNF-α, IL-6, and IL-13 concentrations. The diagnostic value of miR-126 was assessed through receiver operating characteristic curve analysis. RESULTS: miR-126 is significantly downregulated in the serum of children with PAREs. Low expression of miR-126 is one of the risk factors for PRAEs occurrence. miR-126 level shows a negative correlation with the inflammatory levels in children with PRAEs. Overexpression of miR-126 promotes cell proliferation activity. CONCLUSION: miR-126 may contribute to the suppression of PRAEs by regulating proliferation and inflammatory responses in BEAS-2B cells and may serve as a diagnostic biomarker.
The role of objective testing in urban adolescents with asthma symptoms in an African centre.
Mphahlele R, Mosler G, Oyenuga V … +2 more , Grigg J, Masekela R
BMC Pediatr · 2026 May · PMID 42210191 · Full text
INTRODUCTION: Urban African adolescents suffer from undiagnosed and uncontrolled asthma symptoms. The purpose of this pilot study was to identify factors related to poorly controlled asthma symptoms and evaluate whether...
INTRODUCTION: Urban African adolescents suffer from undiagnosed and uncontrolled asthma symptoms. The purpose of this pilot study was to identify factors related to poorly controlled asthma symptoms and evaluate whether the objective measures suggested by the European Respiratory Society task force (ERS-TF) diagnostic algorithm for children assisted with asthma diagnosis. METHODS: Between July 2019 and November 2021, we conducted a cross-sectional cohort study of urban school-going adolescents between 12 and 14 years as part of the Achieving Control of Asthma in Children in Africa (ACACIA) project. The study comprised two stages; (a) screening for asthma symptoms and diagnosis and (b) asthma control test (ACT), pre and post-bronchodilator spirometry, and FeNO measurements in those who were screen-positive. RESULTS: Of 2093 adolescents screened, 180 were included, and 56% were female. Most participants had severe asthma symptoms (n = 128; 71%) and uncontrolled asthma (n = 157; 87%). Half (n = 90) had a previous asthma diagnosis, and were more likely to have uncontrolled asthma, p = 0.04. A significantly higher number of adolescents with uncontrolled asthma were exposed to traffic near their home (58% vs. 35%, p value < 0.01). Those who were exposed to kerosene lamps and insect sprays were more likely to have airway inflammation; p = 0.02 and p = 0.01; respectively. The prevalence of abnormal spirometry and bronchodilator response (BDR) was 12%. By performing the BDR test in those with normal spirometry, we increased the diagnostic yield of the ERS-TF algorithm by 50%. CONCLUSION: In this at-risk population, asthma symptoms are common, uncontrolled and related to environmental factors. In over half of those who undergo screening procedures such as spirometry, BDR and FeNO, the likelihood of a diagnosis remains low. Additional research involving non symptomatic control groups and longitudinal assessment is required to validate these results.
Pediatric osmotic demyelination syndrome triggered by post-traumatic pituitary stalk injury: a case report.
Sheng M, Zhang M, Lu W
BMC Pediatr · 2026 May · PMID 42210168 · Full text
BACKGROUND: Osmotic demyelination syndrome (ODS) is an acute neurological disorder resulting from demyelination, typically triggered by rapid osmotic shifts. This syndrome is rare in adults and even more uncommon in chil...
BACKGROUND: Osmotic demyelination syndrome (ODS) is an acute neurological disorder resulting from demyelination, typically triggered by rapid osmotic shifts. This syndrome is rare in adults and even more uncommon in children.To date, no reported cases have documented ODS secondary to hyponatremia caused by post-traumatic pituitary stalk injury. We report a pediatric patient with traumatic brain injury who developed ODS subsequent to pituitary stalk disruption and hyponatremia, and discuss the corresponding diagnostic and therapeutic strategies. CASE PRESENTATION: We report the case of a 13-year-old Chinese girl who presented with seizures, central diabetes insipidus, dysarthria, dysphagia, and painful hypertonia following traumatic brain injury. Laboratory investigation revealed Severe hyponatremia. Magnetic resonance imaging (MRI)confirmed the diagnosis of ODS. The child was managed accordingly and demonstrated a favorable clinical response, with substantial recovery in physical function and quality of life. CONCLUSION: Early diagnosis of ODS is based on recognizing key risk factors, typical clinical symptoms, and characteristic neuroimaging findings. Contrast-enhanced MRI can be critical in elucidating the underlying etiology. B-complex vitamins and hyperbaric oxygen therapy have the potential to improve disease outcomes.
Mayer-Rokitansky-Küster-Hauser syndrome type II complicated by strangulated left inguinal ovarian-fallopian tube hernia in a pediatric patient: a case report.
Su H, Yuan T
BMC Pediatr · 2026 May · PMID 42210158 · Full text
BACKGROUND: Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome is a congenital disorder characterized by Müllerian duct anomalies. Patients have a significantly higher incidence of inguinal hernia (6.4%-15.6%) compared to th...
BACKGROUND: Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome is a congenital disorder characterized by Müllerian duct anomalies. Patients have a significantly higher incidence of inguinal hernia (6.4%-15.6%) compared to the general female population. These hernias frequently contain ovarian or tubal tissue and are associated with a high risk of strangulation, posing a threat to future fertility. This case report details a rare pediatric presentation of MRKH syndrome type II with a strangulated inguinal ovarian-tubal hernia. CASE PRESENTATION: A 7-year-5-month-old girl presented with a 28-hour history of an irreducible left inguinal mass. Ultrasound revealed a left incarcerated inguinal hernia and a right ectopic kidney. Emergency surgery confirmed a left strangulated inguinal hernia containing a necrotic ovary and fallopian tube, along with a contralateral occult hernia. Findings of uterine and vaginal agenesis with a 46,XX karyotype confirmed MRKH syndrome type II. A literature review of 24 cases (including ours) showed that inguinal hernias in MRKH are predominantly left-sided (45.8%) or bilateral (41.7%), with ovarian involvement in 87.5% of cases. In type II MRKH, renal malformations were observed in 91.7% of cases and were consistently associated with an ipsilateral inguinal hernia. CONCLUSION: Inguinal hernias in MRKH syndrome commonly involve gonadal tissue and carry a high incarceration risk. The presence of reproductive organs within a hernia sac or associated renal anomalies should raise strong suspicion for MRKH syndrome. Early diagnosis, timely surgical intervention to preserve viable ovarian tissue, and multidisciplinary management are crucial for protecting reproductive potential and improving long-term outcomes.
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