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        <title>Frontiers in Pediatrics | New and Recent Articles</title>
        <link>https://www.frontiersin.org/journals/pediatrics</link>
        <description>RSS Feed for Frontiers in Pediatrics | New and Recent Articles</description>
        <language>en-us</language>
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        <pubDate>2026-05-08T04:17:51.916+00:00</pubDate>
        <ttl>60</ttl>
        <item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fped.2026.1762616</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fped.2026.1762616</link>
        <title><![CDATA[Case Report: Progressive limb necrosis as a portal to multifocal osteomyelitis in pediatric septic shock: a tissue-oriented management paradigm]]></title>
        <pubdate>2026-05-08T00:00:00Z</pubdate>
        <category>Case Report</category>
        <author>Cheng Yang</author><author>Wansha Zhou</author><author>Ximeng Huang</author><author>Jiawei Li</author>
        <description><![CDATA[BackgroundLimb necrosis in pediatric septic shock may serve as a persistent source of deep infection, but its role in hematogenous dissemination is underrecognized.Case presentationA 12-year-old boy with septic shock developed progressive left foot necrosis. This was followed by septic arthritis, multifocal osteomyelitis with extensive osteolytic destruction and pathological fracture of the femur, recurrent pneumothorax, and deep vein thrombosis, complicated by multidrug-resistant infections.Management strategiesSource control was achieved via ultrasound-guided drainage of septic arthritis, pathogen-directed antibiotics, and multidisciplinary conservative management prioritizing medical treatment over high-risk surgery.ResultsClinical stabilization occurred after more than 90 days of intensive care before transfer to a general ward.ConclusionThis case illustrates that limb necrosis in septic shock may precede disseminated osteomyelitis. Early bedside ultrasound and multidisciplinary source control are essential when deep infection is suspected.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fped.2026.1746048</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fped.2026.1746048</link>
        <title><![CDATA[Neonatal-onset dilated cardiomyopathy as the initial manifestation of Alström syndrome: a case report]]></title>
        <pubdate>2026-05-07T00:00:00Z</pubdate>
        <category>Case Report</category>
        <author>Hua Wang</author><author>Wandong Ma</author><author>Jingshi Chen</author><author>Bo Li</author>
        <description><![CDATA[BackgroundObesity–retinopathy–diabetes syndrome, also known as Alström syndrome (AS), is an extremely rare autosomal recessive disorder caused by pathogenic variants in the Alström syndrome 1 (ALMS1) gene. Its estimated incidence is 1–9 cases per million, with approximately 1,050 cases reported worldwide. AS is characterized by progressive, multisystem dysfunction with age-related and variable clinical features, often leading to multi-organ failure and premature death.Case descriptionWe report a female infant who initially presented with reversible heart failure in early infancy and subsequently developed nystagmus at six months of age. Genetic testing identified compound heterozygous pathogenic variants in the ALMS1 gene, confirming the diagnosis of AS.ConclusionAS is characterized by multisystem involvement and variable age-related clinical expression. Cardiac dysfunction may precede classic features such as nystagmus or obesity, emphasizing the need for early genetic screening in infants with unexplained cardiomyopathy. Prompt diagnosis facilitates targeted management and improves outcomes.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fped.2026.1826300</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fped.2026.1826300</link>
        <title><![CDATA[Feasibility and safety of endoscopic retrograde appendiceal foreign body removal in children]]></title>
        <pubdate>2026-05-07T00:00:00Z</pubdate>
        <category>Original Research</category>
        <author>Tianjiao Gao</author><author>Kuku Ge</author><author>Lina Sun</author><author>Bianhua Liu</author><author>Dan Nan</author><author>Zhao Yang</author><author>Ying Fang</author><author>Xiaoxia Ren</author>
        <description><![CDATA[ObjectiveEndoscopic retrograde appendicitis therapy (ERAT), developed for acute appendicitis, enables minimally invasive access to the appendix for diagnosis and therapy. Based on the ERAT technique, endoscopic retrograde appendiceal foreign body removal has emerged as a logical yet technically advanced extension, offering a potential minimally invasive alternative to surgical appendectomy. The aim of this study was to evaluate the efficacy and safety of endoscopic retrograde appendiceal foreign body removal in children with appendiceal foreign bodies.MethodsThis retrospective case series included six children (n = 6) who underwent endoscopic retrograde appendiceal foreign body removal at Xi'an Children's Hospital between January 2022 and May 2025. Clinical data, imaging findings, and procedural details were analyzed.ResultsSix male patients (9.2 ± 2.2 years) were included. One patient had a clear history of foreign body ingestion but was asymptomatic. Five patients denied foreign body ingestion history and presented with varying degrees of right lower quadrant or diffuse abdominal pain. All procedures were successful without perioperative complications. Mean procedure duration was 77.5 ± 41.9 min. Retrieved foreign bodies included a wooden strip, button battery, fruit peel, metal object, fruit shell, and pinworms. Average postoperative hospitalization was 3.2 ± 1.5 days. No patient experienced recurrence of symptoms, appendicitis, or complications during the 6-month follow-up.ConclusionEndoscopic retrograde appendiceal foreign body removal appeared feasible in this small series for removing non-sharp appendiceal foreign bodies with low-grade impaction in children, preserving appendiceal function and avoiding surgery.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fped.2026.1818666</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fped.2026.1818666</link>
        <title><![CDATA[Procedural pain in pediatric care: educational, ethical, and public health imperatives]]></title>
        <pubdate>2026-05-07T00:00:00Z</pubdate>
        <category>Opinion</category>
        <author>Christoffer Krug</author><author>Michael Knipper</author><author>Philipp Stieger</author>
        <description></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fped.2026.1817016</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fped.2026.1817016</link>
        <title><![CDATA[A clustered pulmonary Tuberculosis outbreak at a technical school in Shenzhen, China]]></title>
        <pubdate>2026-05-07T00:00:00Z</pubdate>
        <category>Original Research</category>
        <author>Jing Tang</author><author>Mingbin Xie</author><author>Congyang Li</author><author>Fan Huang</author><author>Liai Peng</author><author>Yali Qu</author><author>Jinzhou Mei</author><author>Zhenyang Liu</author><author>Eryong Liu</author><author>Yanfang Guo</author><author>Yunxia Wang</author>
        <description><![CDATA[BackgroundOn 11 June 2025, a clustered outbreak of pulmonary tuberculosis (TB) was detected in a vocational school class in Shenzhen.MethodsA two-phase screening investigation was conducted in accordance with Chinese tuberculosis prevention and treatment guidelines. Screening procedures included symptom assessment, Interferon-Gamma Release Assays (IGRA), and chest radiography (CXR). Confirmed, clinically diagnosed, and suspected cases were identified by specialized pulmonologists following the Diagnostic Criteria for Pulmonary Tuberculosis (WS 288–2017). To assess transmission patterns, a comparative analysis of dormitory and class distributions among individuals with a positive IGRA result was performed. Additionally, whole genome sequencing (WGS) of clinical isolates was conducted to determine genetic relatedness and infer potential transmission pathways.ResultsAfter the initial report of two cases, two rounds of screening were conducted at the school. In the first round, 453 individuals were screened. IGRA yielded valid results for 421 individuals, with a positivity rate of 9.3% (39/421); in the second round, the IGRA positivity rate was 5.1% (9/176). The abnormal CXR rates were 2.4% (11/453) and 1.1% (2/176), respectively. Across both screenings, a total of 7 cases of active tuberculosis were confirmed (including one negative for IGRA), and 42 cases of latent infection were identified. A comparative analysis of the dormitory and class distributions among individuals with a positive IGRA result showed that the IGRA positivity rate in the affected class was 62.2 % (23/37), significantly exceeding rates observed in other classes (P < 0.05). The four dormitories with the highest positivity rates were all occupied by students from Class 2302 (Room 310: 100%, Room 309: 62.5%, Room 506: 50.0%, and Room 308: 37.5%). WGS analysis revealed that five isolates belonged to the Beijing genotype and exhibited high genetic homology with minimal divergence, confirming a single clonal outbreak with slight genetic variation.ConclusionsThis outbreak stemmed from intertwined factors: close contact, poor ventilation, delayed detection, and insufficient prevention. Early syndromic surveillance, enhanced health education for students and staff, improved environmental hygiene, and timely implementation of preventive treatment for latent tuberculosis infection are vital strategies for preventing and controlling TB clusters in educational settings.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fped.2026.1792500</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fped.2026.1792500</link>
        <title><![CDATA[Ophthalmologic assessment and intracranial pressure in children: diagnostic methods, clinical correlations, and future directions]]></title>
        <pubdate>2026-05-07T00:00:00Z</pubdate>
        <category>Review</category>
        <author>Elena Hernández-García</author><author>Barbara Burgos-Blasco</author><author>Noemi Güemes-Villahoz</author><author>Laura Morales-Fernandez</author><author>Jose Ignacio Fernandez-Vigo</author><author>Enrique Santos-Bueso</author><author>Rosario Gomez-de-Liaño</author><author>Julian García-Feijóo</author>
        <description><![CDATA[Increased intracranial pressure (ICP) in the pediatric population represents a critical and potentially life-threatening condition that may lead to severe neurological sequelae, including brain herniation, cerebral ischemia, and irreversible neurological impairment, such as visual loss. The diagnosis of elevated ICP in children is particularly complex, as clinical manifestations are frequently subtle and non-specific, especially in infants and young children. Symptoms such as irritability, poor feeding, lethargy, and failure to thrive often overlap with a wide range of common pediatric disorders, thereby contributing to delayed diagnosis and an increased risk of adverse neurological outcomes. Within this context, ophthalmologic evaluation constitutes a key non-invasive tool in the early detection of increased ICP. Fundoscopic examination provides critical diagnostic information, with optic disc abnormalities among the most sensitive markers of elevated ICP. However, these findings may be less pronounced or exhibit distinct characteristics in children compared to adults, and their interpretation is further complicated by age-related variability in ocular anatomy and intracranial pressure norms. This review provides an integrated synthesis of current diagnostic strategies for assessing elevated ICP in children, with a particular focus on ophthalmologic assessment. It examines the association between specific ocular findings and ICP, with the aim of improving early recognition, guiding clinical management, and enhancing patient outcomes. Furthermore, it addresses the inherent challenges of pediatric ICP diagnosis and highlights key gaps in the literature that warrant further investigation.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fped.2026.1815201</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fped.2026.1815201</link>
        <title><![CDATA[Association between a four-locus gene model including IL13, IL4, FCER1B, and ADRB2 and asthma outcomes]]></title>
        <pubdate>2026-05-07T00:00:00Z</pubdate>
        <category>Original Research</category>
        <author>Shasha Bai</author><author>Linlin Qin</author><author>Tingting Zhou</author><author>Shaomin Chen</author><author>Fen Yang</author><author>Li Hua</author><author>Yixiao Bao</author>
        <description><![CDATA[BackgroundThis study aimed to explore the association between a four-locus gene model and asthma outcomes.MethodsFour single-nucleotide polymorphisms were genotyped in 139 patients with different asthma outcomes (clinical remission, relapse, or persistence). The high-risk and low-risk genotypes for asthma were evaluated according to the different genotypes that they carried. Differences in asthma outcomes and the factors affecting asthma prognosis were analyzed.ResultsMore patients with high-risk genotypes had severe asthma attacks than those with low-risk genotypes. Compared with patients in asthma clinical remission, patients with severe asthma attacks were at risk for asthma relapse and asthma persistence. In addition, smoking was a risk factor for asthma persistence. The older the age of asthma onset, the more likely it was to be persistent. More patients in the high-risk genotype group had an age of asthma onset younger than 6 years old and an asthma course longer than 4 years than in the low-risk genotype group, regardless of the confounding factors.ConclusionsThe patients with high-risk genotypes not only had more severe asthma attacks and a younger age of asthma onset but also had a longer course, which suggested that the gene model could serve as a tool for asthma prognosis assessment with moderate utility.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fped.2026.1794811</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fped.2026.1794811</link>
        <title><![CDATA[Multi-omics integration reveals BPGM downregulation and potential plasma metabolite biomarkers for childhood asthma]]></title>
        <pubdate>2026-05-07T00:00:00Z</pubdate>
        <category>Original Research</category>
        <author>Junlin Zhao</author><author>Zhiyuan Wang</author><author>Yanan Wang</author><author>Qianqian Dai</author><author>Menghua Li</author><author>Aliya Maimaitiniyazi</author><author>Zhenzhen Guo</author><author>Liang Ru</author>
        <description><![CDATA[ObjectiveThis study aimed to identify potential diagnostic biomarkers and candidate therapeutic targets through multi-omics integration of peripheral blood transcriptomics and metabolomics in children with asthma. We specifically investigated the association between bisphosphoglycerate mutase (BPGM) downregulation and metabolic alterations in the glycine-serine-threonine pathway, seeking to explore potential mechanisms underlying asthma-related metabolic reprogramming.MethodsIn this exploratory multi-omics study, we integrated public transcriptomic data (GSE35571, n = 124 samples: 60 asthma, 64 controls) with in-house untargeted metabolomics (n = 30 samples: 15 asthma, 15 controls) from treatment-naive, normal-weight children aged 6–14 years. The transcriptomic cohort was derived from a US population (Detroit, Michigan) while the metabolomic cohort was from Xinjiang, China. While this cross-population design precludes direct gene–metabolite correlation at the individual level, pathway-level convergence across ethnically and geographically distinct cohorts may suggest conserved disease-related biological processes, although the pathway intersection should be interpreted as indirect concordance supporting hypothesis generation rather than establishing mechanistic linkage.ResultsTranscriptomics identified 15 differentially expressed genes (p < 0.05, |log2FC| > 0.25), including significant BPGM downregulation (log2FC = −0.2731, p = 0.0422). Metabolomics revealed 516 differential metabolites [p < 0.05, variable importance in projection (VIP) > 1]. Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway intersection identified glycine-serine-threonine metabolism (hsa00260) as the core shared pathway, enriched with BPGM and three upregulated metabolites: L-tryptophan, 5-aminolevulinic acid, and L-aspartate semialdehyde. These metabolites demonstrated good diagnostic performance with area under the curve (AUC) values of 0.818, 0.844, and 0.818, respectively. 5-Aminolevulinic acid showed optimal diagnostic accuracy with 80% sensitivity and 80% specificity. Spearman correlation analysis revealed that 5-aminolevulinic acid was significantly positively correlated with both serum IgE (r = 0.469, p = 0.009) and eosinophil counts (r = 0.506, p = 0.004), while no significant correlations were observed with pulmonary function parameters.ConclusionsThis preliminary multi-omics integration study identified concurrent BPGM downregulation and altered glycine-serine-threonine metabolism in childhood asthma. While these findings suggest a potential association between BPGM expression changes and metabolic alterations in this pathway, the proposed mechanistic link remains hypothetical and requires direct experimental validation.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fped.2026.1820131</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fped.2026.1820131</link>
        <title><![CDATA[Sense of coherence in family caregivers of children with chronic diseases: a narrative review]]></title>
        <pubdate>2026-05-07T00:00:00Z</pubdate>
        <category>Mini Review</category>
        <author>Fangyu Shi</author><author>Junjie Zhao</author><author>Xin Zhang</author>
        <description><![CDATA[In recent years, as the prevalence of chronic diseases in children continues to increase significantly in the world, family caregivers who undertake long-term care responsibilities are increasingly facing a huge psychological burden. As the core theoretical construction of positive psychology, Antonovsky's Sense of Coherence (SOC) has become an important psychological resource that enables caregivers to actively cope with the multiple stressors inherent in the care process and maintain their physical and mental balance. This article reviews the research status of sense of coherence in family caregivers of children with chronic diseases, including the theoretical connotation and evolution of sense of coherence, the psychometric characteristics of existing measurement tools, a variety of influencing factors, and the current mainstream intervention strategies. In addition, the review critically dissects controversies, methodological flaws, and inherent gaps in the current body of literature and suggests targeted directions for future research. This study aims to provide a solid theoretical and empirical basis for clinicians to formulate targeted intervention programs, so as to improve the mental health status of family caregivers and optimize the overall care system for children with chronic diseases.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fped.2026.1732453</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fped.2026.1732453</link>
        <title><![CDATA[Case Report: BKV-specific T cells: a fast, safe and potentially effective treatment option for refractory BKV infections in pediatric patients after allogeneic stem cell transplantation]]></title>
        <pubdate>2026-05-07T00:00:00Z</pubdate>
        <category>Case Report</category>
        <author>Sven Oberwegner</author><author>Steffen A. Hettler</author><author>Luca Hensen</author><author>Amadeus T. Heinz</author><author>Christiane Braun</author><author>Michaela Döring</author><author>Peter Lang</author>
        <description><![CDATA[BK virus reactivation is frequently observed in patients following allogeneic stem cell transplantation and can cause nephropathy and hemorrhagic cystitis. Current treatments are mainly supportive, and antiviral therapy with cidofovir lacks clear evidence of efficacy. Therefore, novel therapeutic strategies are needed. Since adoptive transfer of virus-specific T cells has proven effective for other viral infections, this case series with four cases of post-transplant severe BKV infections evaluated the feasibility, safety, and efficacy of BKV-specific T cells in patients with refractory BKV infection using the CliniMACS Prodigy system. Three of the four patients demonstrated a reduction in BKV viral load following adoptive T-cell transfer, with detectable in vivo expansion of BKV-specific T cells in these individuals. However, complete viral clearance was not achieved in all cases. One patient with extensive immunosuppression showed minimal viral response and no detectable BKV-specific T cells after infusion. Treatment was well tolerated, with no infusion-related toxicities and no severe de novo graft-versus-host disease observed. Overall, this case series suggests that rapidly manufactured BKV-specific T cells produced via the CliniMACS Prodigy system represent a feasible, safe, and potentially effective treatment option for refractory BKV viremia after stem cell transplantation. Early administration and limited concurrent immunosuppression may improve therapeutic outcomes. Further studies are needed to confirm these findings.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fped.2026.1805856</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fped.2026.1805856</link>
        <title><![CDATA[Prenatal ultrasound diagnosis, intrauterine monitoring and postnatal management of a giant fetal abdominopelvic lymphangioma: a case report and scoping review]]></title>
        <pubdate>2026-05-07T00:00:00Z</pubdate>
        <category>Case Report</category>
        <author>Matteo Giudice</author><author>Milena Viggiano</author><author>Chiara Vassallo</author><author>Alice Novak</author><author>Laura Valfrè</author><author>Irma Capolupo</author><author>Andrea Dotta</author><author>Andrea Conforti</author><author>Marco Bonito</author><author>Maurizio Guida</author><author>Leonardo Caforio</author><author>Isabella Fabietti</author>
        <description><![CDATA[BackgroundFetal lymphangioma is a rare congenital malformation, generally isolated and clinically asymptomatic, except when it invades adjacent tissues, causing compression-related symptoms.ObjectivesTo present a rare case of a giant fetal abdominopelvic lymphangioma and to perform, to our knowledge, the first scoping review of the literature specifically addressing prenatal diagnosis, intrauterine monitoring and postnatal management of this condition.MethodsThe PubMed, Scopus and Embase databases were searched up to September 2025. No limitations on the country were made.ResultsWe present the case of a 38-year-old primigravida with gestational diabetes, hypothyroidism and severe obesity referred to our institute for a second opinion after prenatal detection of a large multiloculated cystic abdominal mass in the fetus, extending to the pelvis, without vascularization. Follow-up imaging, including a fetal magnetic resonance imaging (MRI), confirmed the suspicion of a giant lymphatic malformation with progressive fetal ascites and associated symptomatic polyhydramnios requiring amnioreduction. A male infant was delivered via emergency cesarean section at 34 + 3 weeks and admitted to neonatal intensive care unit (NICU) with respiratory distress. Due to progressive clinical worsening and persistent fluid accumulation, an abdominal drain was placed, followed by debulking surgery at four months, which confirmed the diagnosis of lymphangioma. Gradual clinical improvement enabled the patient's transfer to the Nutritional Rehabilitation Unit and subsequent discharge. Regarding the scoping review, 20 case reports fulfilled the inclusion criteria. Patients were analyzed concerning the prenatal ultrasound diagnosis of a fetal abdominal lymphangioma, pregnancy outcomes, intrauterine and postnatal treatment of the mass.ConclusionClinical presentation and outcomes of fetal abdominal and abdominopelvic lymphangiomas are highly heterogeneous and strongly influenced by lesion extent and intra-abdominal involvement. Our case, characterized by diffuse intestinal and mesenteric disease, highlights the limitations of curative surgical strategies and underscores the need for early recognition of patients who may require prolonged supportive management rather than a complete excision. The scoping review suggests that while focal lesions are often amenable to surgery with favorable outcomes, diffuse forms often require a multidisciplinary, staged approach, with realistic prognostic counseling and long-term follow-up.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fped.2026.1834587</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fped.2026.1834587</link>
        <title><![CDATA[Commentary: A rare case report of Salmonella infection: severe necrotizing pneumonia with empyema in an immunocompetent child]]></title>
        <pubdate>2026-05-04T00:00:00Z</pubdate>
        <category>General Commentary</category>
        <author>Regina Célia de Souza Campos Fernandes</author><author>Enrique Medina-Acosta</author>
        <description></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fped.2026.1812750</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fped.2026.1812750</link>
        <title><![CDATA[Gastroenterologically relevant high alert medications prescribed to children with chronic diseases—a consensus-driven single-center pilot study]]></title>
        <pubdate>2026-05-04T00:00:00Z</pubdate>
        <category>Brief Research Report</category>
        <author>Judith Hochrainer</author><author>Rebecca Einspieler</author><author>Andreas Heilos</author><author>Judith Pichler</author><author>Michael Boehm</author>
        <description><![CDATA[IntroductionChildren with chronic diseases, including complex gastroenterological patients, often manage complex home medication regimens, where errors pose significant patient- and medication-related risks. High Alert Medications (HAMs) are those with a particularly high potential for adverse consequences if administered incorrectly.AimThis study used a consensus approach to identify HAMs in the pediatric gastroenterological population, using a new scale to measure medication risk and potential patient harms.MethodsThis secondary analysis included 106 children with chronic diseases discharged from the Medical University of Vienna. Interdisciplinary teams identified relevant medications through a consensus approach and separately evaluated the inherent risk of each medication and the potential harm of its use at the individual patient level using five-level scales. Substances were coded via the Anatomical Therapeutic Chemical classification system (ATC system), ranked, and compared with existing HAM lists.ResultsThirty-two medications were categorized into the highest medication risk categories, and 16 into the highest potential patient harm group. The intersection of these categories identified 12 medications defined as HAMs, with immunosuppressants forming the largest therapeutic class. Notably, 50% of the identified HAMs appeared in only one other published list, and one-third were not previously classified as High Alert.DiscussionImmunosuppressants carry elevated risk due to narrow therapeutic windows, complex drug interactions, and potential for severe organ dysfunction. Discrepancies between HAM lists stem from varied methodologies and local clinical characteristics. This study distinguishes itself by focusing specifically on home care and by including off-label medications. The findings underscore the need for localized HAM lists to address specific risks within the target population. Validation studies and consideration of empirical data are needed to further generalize our findings.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fped.2026.1784387</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fped.2026.1784387</link>
        <title><![CDATA[Merging evans syndrome with mucopolysaccharidosis type II: a case report]]></title>
        <pubdate>2026-05-04T00:00:00Z</pubdate>
        <category>Case Report</category>
        <author>Xinrui Wang</author><author>Jing Zhang</author><author>Yanhui Tang</author><author>Chunyan Liu</author><author>Peng Hu</author><author>You Yang</author><author>Hongying Chen</author>
        <description><![CDATA[Mucopolysaccharidosis type II (MPS II) is an X-linked recessive lysosomal storage metabolic disorder caused by pathogenic mutations in the iduronate-2-sulfatase (IDS) gene. Herein, we report the case of a 2-year-old male patient diagnosed with concurrent Evans syndrome (ES) and MPS II, who presented with severe anemia, thrombocytopenia, recurrent respiratory tract infections, and typical clinical manifestations of MPS II. Laboratory examinations showed decreased hemoglobin (Hb) and platelet (PLT) counts, a positive direct Coombs test, presence of anti-platelet antibodies, elevated urinary glycosaminoglycan levels, and complete absence of IDS enzyme activity. Whole exome sequencing identified a novel compound heterozygous nonsense mutation in the IDS gene: c.380_383dup GCTA, p.Y128X. The patient received hematopoietic stem cell transplantation (HSCT) and underwent long-term follow-up. During the follow-up period, the patient's IDS enzyme activity returned to normal levels, and no further recurrence of ES was observed. This study reports a novel pathogenic mutation of the IDS gene, and represents the first documented case of concurrent ES and MPS II in a toddler. HSCT has been confirmed to be an effective therapeutic strategy for this extremely rare comorbid condition. Additionally, we discuss the potential pathogenic association between mucopolysaccharidosis (MPS) and ES, and present a systematic summary of the clinical management of this patient, to provide a reference for improved identification and treatment of similar clinical cases in the future.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fped.2026.1759935</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fped.2026.1759935</link>
        <title><![CDATA[A literature review: progress in the study of plastic bronchitis]]></title>
        <pubdate>2026-05-04T00:00:00Z</pubdate>
        <category>Review</category>
        <author>Huihan Li</author><author>Chi Han</author><author>Danchen Wu</author><author>Yuanyuan Zhang</author>
        <description><![CDATA[This literature review aims to synthesize current evidence on plastic bronchitis (PB), a disease characterized by varying degrees of branching cast formation in the airways. The rationale for undertaking this review stems from the increasing recognition of PB as a potentially life-threatening condition in pediatric populations, coupled with significant recent advances in diagnostic and therapeutic approaches. By systematically searching and analyzing historical literature related to PB from multiple electronic databases, this review examines the current status of PB studies across five critical domains: risk factors, pathology and pathogenesis, clinical features and diagnosis, treatment, and prognosis. Particular emphasis is placed on recent advances in diagnostic imaging, interventional bronchoscopy techniques, and emerging pharmacological therapies. This review provides clinically relevant guidance to enhance awareness and improve management strategies for this rare but serious condition among pediatric practitioners.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fped.2026.1807879</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fped.2026.1807879</link>
        <title><![CDATA[Intubation in children presenting with seizures to a pediatric emergency department in a safety net hospital]]></title>
        <pubdate>2026-05-04T00:00:00Z</pubdate>
        <category>Original Research</category>
        <author>Mugdha Mohanty</author><author>Zakir Shaikh</author><author>Hovra Zahoor</author><author>Shivangi Kataria</author><author>N. Paul Rosman</author><author>Alcy R. Torres</author>
        <description><![CDATA[ObjectivePatients seen for uncontrolled seizures in a Pediatric Emergency Department (ED) often undergo tracheal intubation (TI). We looked at factors associated with TI in children in a safety net hospital.MethodsThis was a single-center retrospective case series. Fifty-six patients who had ongoing seizures at the time of arrival to the pediatric ED, between ages 0–21 years, were analyzed for demographics, seizure duration, seizure types, indications for TI, antiseizure medication on discharge, and neurological sequelae.ResultsForty-six percent of patients (26/56) underwent TI. The most common type of seizures in the intubated group was a complex febrile seizure (27%). Forty-two percent were intubated for airway protection and 46% were intubated for respiratory failure.ConclusionsIn all patients presenting to a Pediatric ED with uncontrolled seizures, those undergoing TI most often had complex febrile convulsions, seizures longer in duration (p = 0.036), and seizures needing poly-drug therapy for seizure control (p < 0.001).]]></description>
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        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fped.2026.1811557</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fped.2026.1811557</link>
        <title><![CDATA[Case Report: Atypical presentations of neonatal and infantile hemophilia B]]></title>
        <pubdate>2026-05-04T00:00:00Z</pubdate>
        <category>Case Report</category>
        <author>Arielle Locke</author><author>Nasrin Samji</author><author>Mihir Bhatt</author><author>Kay Decker</author><author>Sara J. Israels</author><author>Anthony K. C. Chan</author><author>Kyle Mendonça</author>
        <description><![CDATA[Hemophilia B is an X-linked recessive bleeding disorder caused by deficiency or dysfunction of factor IX. It typically presents with spontaneous or trauma-induced bleeding, hemarthrosis, and soft tissue hematomas. We report three cases—two severe neonatal and one moderate infantile case—with atypical presentations: intra-abdominal hemorrhage with hepatic hematoma, a scrotal mass mimicking testicular torsion, and intracranial hemorrhage. None of the patients had a family history of bleeding disorders, and diagnoses were made after these significant bleeding episodes. These cases underscore the importance of considering congenital bleeding disorders in neonates and infants, especially males, who present with unexplained severe bleeding episodes in the absence of trauma or family history. Early recognition, preconception genetic counseling to identify the risk of bleeding disorders in parents, and individualized prophylactic approaches are essential to improve outcomes.]]></description>
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        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fped.2026.1779116</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fped.2026.1779116</link>
        <title><![CDATA[Machine learning-based identification of inflammatory biomarkers for predicting pulmonary consolidation in children with Chlamydia pneumoniae infection]]></title>
        <pubdate>2026-05-04T00:00:00Z</pubdate>
        <category>Original Research</category>
        <author>Qianqian Dai</author><author>Zhiyuan Wang</author><author>Junlin Zhao</author><author>Yanan Wang</author><author>Menghua Li</author><author>Aliya Maimaitiniyazi</author><author>Xueli Wang</author><author>Jianjiang Cui</author><author>Zhenzhen Guo</author><author>Shengmeng Qu</author><author>Wen Zhao</author><author>Liang Ru</author>
        <description><![CDATA[ObjectiveThis study aimed to identify core inflammatory biomarkers through machine learning approaches and develop an accessible online risk calculator to predict pulmonary consolidation in children with Chlamydia pneumoniae infection, addressing the current lack of effective early warning tools.MethodsThis retrospective case-control study enrolled 42 children with C. pneumoniae infection (consolidation group: 26 cases; non-consolidation group: 16 cases) between January 2020 and December 2024. Five machine learning algorithms, including least absolute shrinkage and selection operator (LASSO) regression, support vector machine-recursive feature elimination (SVM-RFE), Random Forest, XGBoost, and LightGBM, were employed for feature selection, and core predictive factors were identified through consensus validation across these algorithms. K-means clustering analysis was performed on the key inflammatory markers, and an online risk assessment system based on HTML5 technology was developed.ResultsThe five machine learning algorithms consistently identified lactate dehydrogenase (LDH), C-reactive protein (CRP), and erythrocyte sedimentation rate (ESR) as core inflammatory markers for predicting pulmonary consolidation. All three indicators were significantly higher in the consolidation group compared with the non-consolidation group (P < 0.001). K-means clustering analysis stratified patients into a high-inflammation group (9 cases, 21.4%) and a low-inflammation group (33 cases, 78.6%), with a significant difference in consolidation rates between the two groups (100% vs. 51.5%, P = 0.008). The risk assessment system, constructed based on clustering results, demonstrated excellent predictive performance [area under the curve (AUC) = 0.993, 95% confidence interval (CI): 0.966–1.000], with a sensitivity of 88.9% and specificity of 93.9%. Bootstrap resampling validation (1,000 iterations) confirmed the robustness of the clustering solution (stability: 91.2%) and the risk assessment system (bootstrap AUC: 0.949, 95% CI: 0.881–0.995).ConclusionLDH, CRP, and ESR are key indicators for predicting pulmonary consolidation in children with C. pneumoniae infection. The online risk assessment system developed based on these three routine laboratory parameters demonstrates good clinical usability and practicality, enabling early identification of high-risk patients to guide individualized treatment decisions.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fped.2026.1752616</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fped.2026.1752616</link>
        <title><![CDATA[Systemic propranolol and topical moist wound dressings for ulcerated infantile hemangioma of the scrotum: a case report]]></title>
        <pubdate>2026-05-04T00:00:00Z</pubdate>
        <category>Case Report</category>
        <author>Jiejun Xia</author><author>Kunshan Chen</author><author>Zhenyin Liu</author><author>Xiaoyun Tan</author><author>Shifeng Xie</author><author>Haibo Li</author>
        <description><![CDATA[BackgroundUlceration is a common complication of infantile hemangioma, and its management poses unique difficulties when the lesion is located in high-risk areas like the scrotum. This case report details the successful management of this condition using topical moist wound dressings combined with propranolol.Case presentationA 5-month-old male presented with a rapidly progressing, ulcerated scrotal infantile hemangioma characterized by purulent exudate. Systemic treatment involved oral propranolol solution (maintenance dose of 2 mg/kg/d). Local wound care was managed using a tailored moist wound healing strategy: alginate dressing combined with recombinant human epidermal growth factor gel, secured with a transparent film dressing. The patient was treated successfully; localized infection was controlled within 3 days. The wound achieved complete epithelialization after a total of 12 days of consistent combined treatment, accompanied by simultaneous regression of the hemangioma volume. Three-month Follow-up confirmed favorable cosmetic results with no significant hypertrophic scarring.ConclusionThis case underscores that a synergistic regimen of systemic propranolol and a customized moist wound healing strategy can significantly accelerate healing timelines and improve the quality of tissue repair in ulcerated infantile hemangiomas.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fped.2026.1799724</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fped.2026.1799724</link>
        <title><![CDATA[RSV-infected children with mixed infections: clinical features and early predictive indicators of codetection with Streptococcus pneumoniae and Haemophilus influenzae]]></title>
        <pubdate>2026-05-04T00:00:00Z</pubdate>
        <category>Original Research</category>
        <author>Jingwen Ni</author><author>Junyu Dong</author><author>Lele Li</author><author>Mengxin Zhao</author><author>Zhihui Du</author><author>Jie Li</author><author>Kenan Fang</author><author>Kai-Sheng Hsieh</author>
        <description><![CDATA[BackgroundSince the COVID-19 pandemic, the incidence of respiratory syncytial virus (RSV) infections has significantly increased, and bacterial codetection further exacerbates the disease burden. This study aims to compare the clinical characteristics, laboratory results, and prognostic differences in children with RSV infection who are codetected with Streptococcus pneumoniae and Haemophilus influenzae, and to identify early predictive markers for such codetections.MethodsIn this single-center retrospective study, we collected data from 1,601 children hospitalized with RSV infection at Luoyang Maternal and Child Health Hospital, Henan Province, between January 2023 and March 2025. Children were divided into three groups: non-bacterial codetection, S. pneumoniae codetection, and H. influenzae codetection. We compared demographic characteristics, clinical features, laboratory findings, and prognosis. Logistic regression identified risk factors for codetection of S. pneumoniae and H. influenzae.ResultsA history of wheezing increased the likelihood of codetection with both bacteria. Children with S. pneumoniae codetection were more likely to present with fever, whereas those with H. influenzae codetection were more prone to wheezing and respiratory distress. The presence of extrapulmonary manifestations was a significant common factor for both codetections. Regarding laboratory markers, children with codetection of S. pneumoniae showed significantly elevated levels of WBC, NLR, CRP, PCT, and IL-6. For those codetected with H. influenzae, WBC, NLR, CRP, PCT, IL-6, PLT, and D-dimer levels were all significantly increased. Children with either bacterial codetection required significantly more respiratory support, had higher PICU admission rates, and experienced longer hospital stays. A history of wheezing and elevated IL-6 levels were associated with a higher likelihood of S. pneumoniae codetection, while younger age and higher levels of WBC, CRP, and IL-6 were predictive of H. influenzae codetection.ConclusionsCompared with children with RSV infection alone, those with codetection of S. pneumoniae or H. influenzae exhibit significantly elevated inflammatory markers, especially IL-6. These children are more likely to require PICU admission and respiratory support, and to experience longer hospital stays.]]></description>
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