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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>2026-04-16T12:44:47.814+00:00</pubDate>
        <ttl>60</ttl>
        <item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fped.2026.1739376</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fped.2026.1739376</link>
        <title><![CDATA[Advances in multi-omics research on neuroblastoma]]></title>
        <pubdate>2026-04-16T00:00:00Z</pubdate>
        <category>Review</category>
        <author>Yubing Wang</author><author>Zhifei Zhao</author><author>Jinbin Wang</author><author>Shujie Song</author><author>Chengmin Zhao</author><author>Chao Qv</author><author>Hongting Lu</author>
        <description><![CDATA[Neuroblastoma is the most common extracranial solid tumor in children, presenting significant challenges in diagnosis and treatment due to its highly heterogeneous clinical manifestations and complex genetic background. In recent years, advances in transcriptomics have played a pivotal role in this field, not only aiding in the identification of molecular subtypes of tumors but also revealing potential mechanisms of drug resistance. Through comprehensive gene expression profiling and single-cell sequencing technology, researchers have deeply analyzed key interaction nodes within the metabolic-immune microenvironment, providing a theoretical basis for developing targeted therapeutic strategies. Concurrently, radiomics, leveraging imaging techniques such as MRI, PET-CT, and CT, quantitatively assesses the morphological and metabolic characteristics of tumors. This enables non-invasive prediction of MYCN amplification status, evaluation of bone marrow metastasis risk, and prognostic stratification, thereby supporting dynamic disease monitoring. In pathology, artificial intelligence technology is widely applied in the analysis of digital pathology images. It effectively identifies cellular diversity and immune microenvironment features in tissues, enhancing diagnostic accuracy and assisting in predicting potential gene mutations. More importantly, integrating transcriptomics, radiology, and pathology data through multi-omics approaches overcomes the limitations of single data types. This integration constructs more precise disease classification models and facilitates the development of personalized treatment plans. This review emphasizes the critical roles of transcriptomics, radiomics, digital pathology analysis, and multi-omics fusion strategies in enhancing diagnostic precision for neuroblastoma and optimizing treatment decisions.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fped.2026.1809311</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fped.2026.1809311</link>
        <title><![CDATA[Case Report: Washed microbiota transplantation for the treatment of malnutrition with multidrug-resistant Klebsiella pneumoniae and Candida tropicalis coinfection in a child]]></title>
        <pubdate>2026-04-16T00:00:00Z</pubdate>
        <category>Case Report</category>
        <author>Wenkai Yang</author><author>Qian Ren</author><author>Bowen Li</author>
        <description><![CDATA[BackgroundMultidrug-resistant (MDR) Klebsiella pneumoniae and fungal coinfection in children with severe malnutrition are difficult to control with antibiotics alone. This report describes an 8-year-old boy whose pulmonary infection remained uncontrolled and whose nutritional status progressively deteriorated. Washed microbiota transplantation (WMT) was introduced as part of a multimodal salvage treatment strategy, after which the patient showed gradual improvement during continued antimicrobial therapy, respiratory support, and nutritional rehabilitation.Case presentationWe report the case of an 8-year-old boy with chronic malnutrition and recurrent severe pneumonia associated with an underlying central nervous system disorder. He developed recurrent respiratory failure and a persistent pulmonary infection caused by ESBL-producing MDR K. pneumoniae and Candida tropicalis. Despite broad-spectrum antimicrobial therapy, respiratory support, bronchoscopy/bronchoalveolar lavage, and enteral nutrition through a nasojejunal tube, infection control remained poor and nutritional status continued to deteriorate, complicated by sepsis and antibiotic-associated diarrhea. In this context, WMT was introduced through a nasojejunal tube as part of a multimodal salvage treatment strategy and was administered in two treatment courses. Thereafter, during continued antimicrobial treatment, respiratory support, and nutritional rehabilitation, the patient showed progressive clinical improvement, with subsequent negative sputum culture results, gradual radiographic resolution of pulmonary inflammation, weight gain from 14.0 to 22.5 kg, and marked functional recovery.ConclusionThis case suggests that, in severely malnourished children with refractory multidrug-resistant pulmonary bacterial and fungal infections, WMT may have potential adjunctive value as part of comprehensive management. However, because multiple interventions were implemented concurrently and no pre- and post-WMT microbiome sequencing was performed, the observed clinical improvement could not be attributed exclusively to WMT. Therefore, this case should be interpreted only as an exploratory clinical observation rather than confirmatory evidence, and future prospective studies under strict ethical oversight need to be conducted.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fped.2026.1774350</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fped.2026.1774350</link>
        <title><![CDATA[Comparative efficacy of quarterly vs. monthly triptorelin in Chinese girls with central precocious puberty: a 12-month observational study]]></title>
        <pubdate>2026-04-16T00:00:00Z</pubdate>
        <category>Original Research</category>
        <author>Hongyi Cai</author><author>Wenyong Wu</author><author>Xin Yuan</author><author>Ying Zhang</author><author>Xiaohong Yang</author><author>Xiaozhen Huang</author><author>Zhuanzhuan Ai</author><author>Dandan Li</author><author>Ruimin Chen</author>
        <description><![CDATA[BackgroundThis study aimed to compare the clinical efficacy of quarterly (15 mg/90 days) versus monthly (3.75 mg/28 days) triptorelin formulations with respect to bone maturation, predicted adult height (PAH), and hormonal suppression in Chinese girls with central precocious puberty (CPP).MethodsThis retrospective cohort study included 70 girls diagnosed with CPP at Fuzhou First General Hospital from March 2023 to 2025. Participants were assigned to either a quarterly regimen (triptorelin 15 mg every 90 days, n = 32) or a monthly regimen (triptorelin 3.75 mg every 28 days, n = 38). The evaluated outcomes included bone age (BA; TW3 method), PAH, serum luteinizing hormone (LH) and follicle-stimulating hormone (FSH) concentrations, uterine and ovarian volumes, body mass index (BMI), and adverse events, assessed at baseline, 6 months, and 12 months.ResultsAfter 12 months of treatment, both regimens achieved effective and comparable suppression of LH (quarterly: 0.30 ± 0.19 IU/L; monthly: 0.30 ± 0.26 IU/L; both P < 0.001 vs. baseline) and FSH (quarterly:1.22 ± 0.91 IU/L; monthly: 1.31 ± 0.65 IU/L; P < 0.05 vs. baseline). Improvements in PAH were also comparable between groups (quarterly: 3.95 ± 2.97 cm; monthly: 2.91 ± 2.70 cm; P = 0.790). No significant between-group differences were observed in BA maturation, growth velocity, or uterine and ovarian volumes (P > 0.05). BMI increased significantly in both groups (quarterly: from 16.96 ± 2.10 to 17.89 ± 2.53 kg/m2, P = 0.01; monthly: from 16.89 ± 2.06 to 17.50 ± 2.03 kg/m2, P = 0.008), with no significant differences between regimens. Three patients experiencing a “flare-up” had a larger mean baseline uterine volume (6.95 mL) compared with the remaining 67 patients (2.38 mL).ConclusionQuarterly triptorelin demonstrated efficacy comparable to that of monthly administration in suppressing puberty and improving PAH in Chinese girls with CPP.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fped.2026.1761634</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fped.2026.1761634</link>
        <title><![CDATA[Parental knowledge and awareness of complications of recurrent adenotonsillitis and its surgical management in children in the Jazan region, Saudi Arabia: a cross-sectional study]]></title>
        <pubdate>2026-04-15T00:00:00Z</pubdate>
        <category>Original Research</category>
        <author>Abdulelah A. Otaif</author><author>Ramzi M. Dighriri</author><author>Abdulrahman A. Otaif</author><author>Riyadh A. Jahlan</author><author>Osama A. Alotayf</author><author>Ali Y. Shaikh</author><author>Saud N. Alwadani</author><author>Raghad M. Alnami</author><author>Asma M. Soweedi</author>
        <description><![CDATA[BackgroundRecurrent adenotonsillitis is a frequent pediatric condition with complications affecting sleep, growth, hearing, and behavior. Parental awareness is essential for early identification and timely intervention.AimThis study aimed to assess parental knowledge and awareness of recurrent adenotonsillitis complications and its surgical management among parents in the Jazan region, Saudi Arabia.MethodsA cross-sectional survey was conducted among parents residing in the Jazan region who had at least one child aged 1–14 years. A validated self-administered questionnaire assessed sociodemographic characteristics and knowledge of adenotonsillar disease and surgery. Descriptive and inferential statistical analyses were performed using SPSS version 26, with significance set at p < 0.05.ResultsOut of 448 respondents, 311 met inclusion criteria. Most were female (59%), Saudi (97%), and had university-level education (72%). About 57% of parents showed good knowledge based on scoring above the mean. Awareness was higher regarding symptoms like snoring (66%), sleep apnea (67%), and voice changes (75%). However, fewer parents recognized complications such as pulmonary hypertension (28%), GERD (32%), or dental issues (31%). Nearly half (49%) acknowledged weight loss as a possible consequence of chronic infections, and 58% agreed neck swelling could be a sign. Regarding surgery, 44% believed immunity might weaken post-adenotonsillectomy, and 47% identified bleeding as the most common complication. Only 40% were aware of adenoid regrowth. Age over 40 (p < 0.001) and positive family history (p = 0.001) were significantly associated with higher knowledge.ConclusionWhile parental awareness of some aspects of adenotonsillar complications is adequate, notable gaps remain, particularly concerning long-term and systemic effects. Targeted health education campaigns are essential to bridge these gaps and support better pediatric health outcomes.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fped.2026.1774544</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fped.2026.1774544</link>
        <title><![CDATA[Clinical features and outcomes of herpes simplex viral infections with co-infection in 100 children]]></title>
        <pubdate>2026-04-15T00:00:00Z</pubdate>
        <category>Original Research</category>
        <author>Ping Wang</author><author>Jian Li</author>
        <description><![CDATA[ObjectiveTo analyze the clinical features, laboratory findings, and treatment outcomes of febrile hospitalized children with herpes simplex virus (HSV) detected by serological and/or molecular biological tests, and to provide an evidence-based basis for the early clinical screening, differential diagnosis and targeted intervention of HSV in pediatric febrile cases.MethodsA retrospective analysis was performed on the clinical data of 100 febrile children with positive HSV test results who were admitted to Jinan Children's Hospital from January 2018 to October 2024. The collected data included demographic characteristics, clinical manifestations, confirmed clinical diagnoses, co-detected pathogen status(diagnosed by a combination of serology, PCR and microbial culture), laboratory examination indicators, treatment regimens(including individualized acyclovir course), and prognostic outcomes. HSV detection was conducted by serum HSV-IgM antibody assay and/or HSV-DNA detection in pharyngeal swab/blood samples, and the number of cases with single positive and double positive results of the two tests was statistically analyzed separately. All statistical analyses were performed using SPSS 26.0 software, with measurement data described as median [interquartile range (IQR)] and compared by Mann–Whitney U test. A two-sided P < 0.05 was considered statistically significant.ResultsAmong the 100 children, 62 were male and 38 were female, with a male-to-female ratio of 1.6:1. The age ranged from 1 month to 8 years, with a median age of 2.1 years, and the 1 to <3 years age group accounted for the highest proportion (56.0%, 56/100). Fever was the primary admission symptom in all cases, with 72.0% (72/100) presenting with high fever (≥39 °C). The most common local manifestation was oral mucosal lesions (19.0%, 19/100). Physical examination showed cervical lymphadenopathy in 85.0% (85/100) and pharyngeal mucosal congestion/redness in 92.0% (92/100) of the children. Of the 100 HSV-positive cases, 65 (65.0%) were double positive for HSV-IgM and HSV-DNA, 23 (23.0%) were single positive for HSV-IgM, and 12 (12.0%) were single positive for HSV-DNA. Other pathogens were co-detected in 52.0% (52/100) of the cases, with Epstein–Barr virus (EBV) being the most common (27.0%, 27/100). Abnormal liver function (elevated alanine aminotransferase [ALT] and/or aspartate aminotransferase [AST]) was found in 30.0% (30/100) of the children. Ninety-two children received intravenous acyclovir for antiviral treatment, with a median time to defervescence of 2.5 days (IQR: 2.0–3.0) and a median hospital stay of 7.0 days (IQR: 6.0–8.0). All children were cured and discharged. Statistical analysis showed that children who received early acyclovir treatment (within 24 h of admission) had significantly shorter time to defervescence and hospital stay compared with those in the delayed treatment group (>24 h) (Z = −3.874 and −4.125, respectively, both P < 0.001). Co-detection of EBV and abnormal liver function were associated with a significant prolongation of hospital stay (Z = −3.987 and −4.563, respectively, both P < 0.001).ConclusionHSV is a frequently isolated pathogen in febrile infants and young children with herpetic gingivostomatitis as the core clinical diagnosis and diverse clinical manifestations dominated by non-specific systemic and oropharyngeal symptoms (cutaneous herpes with low incidence). HSV infection is often accompanied by co-detection of other pathogens such as EBV and Bordetella pertussis (diagnosed by standardized serological, PCR and microbial culture methods) and abnormal liver function in some cases. Early HSV-PCR detection combined with serological testing, timely and individualized acyclovir treatment (with clear course standards) based on comprehensive clinical judgment can significantly improve the clinical outcomes of febrile children with HSV detected. Comprehensive intervention targeting co-detected pathogens and complications is equally important for the clinical management of such cases.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fped.2026.1727430</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fped.2026.1727430</link>
        <title><![CDATA[TIBC, PLR, and EBV DNA load correlate with hepatic injury in EBV-associated infectious mononucleosis]]></title>
        <pubdate>2026-04-15T00:00:00Z</pubdate>
        <category>Original Research</category>
        <author>Shengfeng Sun</author><author>Mingqi Wang</author><author>Shuyan Yang</author><author>Yuanyuan Huang</author>
        <description><![CDATA[ObjectiveTo analyze clinical features of hepatic injury in children with EBV-associated infectious mononucleosis (EBV-IM) and identify its risk factors.MethodsA retrospective analysis of the clinical data of children with EBV-IM admitted to the First Hospital of Jilin University from March 2023 to March 2025 was conducted. Confounding factors were balanced by propensity score matching (PSM). The children were divided into a hepatic injury group and a non-hepatic injury group. The risk factors were examined using binary logistic regression. Furthermore, the diagnostic performance of these risk factors was assessed and presented using receiver operating characteristic (ROC) curves.ResultsAfter PSM, 52 pairs of patients were matched. Statistically significant differences in white blood cell count, the proportion of neutrophils, the proportion and absolute value of lymphocytes, the platelet–to-lymphocyte ratio (PLR), hepatosplenomegaly, whole blood EBV DNA load >1 × 105 copies/mL, and total iron-binding capacity(TIBC) were detected(all P < 0.05). Multivariate logistic regression analysis revealed that TIBC and whole blood EBV DNA load >1 × 105 copies/mL were risk factors, whereas the PLR was a protective factor. ROC curve analysis showed that the cutoff values of TIBC and reciprocal platelet-to-lymphocyte ratio (rPLR) for the diagnosis of EBV-IM-related hepatic injury were 53.250 μmol/L and 0.052, with areas under the curve of 0.652 and 0.713, sensitivities of 69.2% and 53.8%, and specificities of 62.7% and 88.2%, and these two indicators could be used as diagnostic markers for hepatic injury in children with EBV-IM.ConclusionEBV-IM-related hepatic injury in children correlates with iron metabolism. TIBC and whole blood EBV DNA load (>1 × 105 copies/mL) are independent risk factors, whereas the PLR is a protective factor.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fped.2026.1838282</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fped.2026.1838282</link>
        <title><![CDATA[Correction: Acute cyclosporine overdose in a child with nephrotic syndrome: a case report and literature review]]></title>
        <pubdate>2026-04-15T00:00:00Z</pubdate>
        <category>Correction</category>
        <author>Eun Song Song</author><author>Eun Mi Yang</author>
        <description></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fped.2026.1809021</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fped.2026.1809021</link>
        <title><![CDATA[A case report of acute liver failure caused by biliary ascariasis in children]]></title>
        <pubdate>2026-04-15T00:00:00Z</pubdate>
        <category>Case Report</category>
        <author>Jiaqi Li</author><author>Liting Hou</author><author>Qianqian Liu</author><author>Bin Yan</author><author>Weikai Wang</author><author>Hongxia Gao</author>
        <description><![CDATA[Most patients with biliary ascariasis present with acute abdominal pain and biliary colic. Typically, conservative treatment involving deworming agents is employed. However, for those who do not respond to pharmacological therapy, endoscopic or surgical intervention becomes necessary. Generally, the mortality rate is low, and the prognosis is favorable. This case describes a pediatric patient exhibiting symptoms of intestinal disease, including upper abdominal pain and jaundice, resulting from extrahepatic biliary tract obstruction caused by roundworms. This condition subsequently led to complications such as obstructive jaundice and acute liver failure. Abnormal signals within the gallbladder cavity were detected through imaging techniques, including abdominal magnetic resonance cholangiopancreatography (MRCP) and enhanced abdominal computed tomography (CT). These abnormalities typically manifest as strip-shaped, tortuous, and tubular filling defects, thereby confirming the diagnosis of biliary ascariasis. Following the oral administration of albendazole for deworming and DPMAS treatment for acute liver failure, the child's condition improved, and he was discharged from the hospital. Subsequent follow-up indicated no recurrence of the disease. The objective of this study is to facilitate the early identification of biliary ascariasis in children, actively manage associated complications, and prevent the development of severe conditions.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fped.2026.1785969</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fped.2026.1785969</link>
        <title><![CDATA[The role of systemic immune-inflammation Index in predicting the diagnosis of severe pneumonia in children]]></title>
        <pubdate>2026-04-15T00:00:00Z</pubdate>
        <category>Original Research</category>
        <author>Qirui Liu</author><author>Mengzhen Zhang</author><author>Hao Wei</author><author>Ailian Wang</author>
        <description><![CDATA[ObjectiveThis study aimed to evaluate the role of Systemic Immune-Inflammation Index (SII) in predicting the diagnosis of severe pneumonia in children.MethodsA retrospective analysis included 595 pediatric community-acquired pneumonia (CAP) patients from the Affiliated Hospital of North Sichuan Medical College (January 2024–July 2025). Patients were randomly divided into development (70%) and validation (30%) sets. General clinical data and SII were collected. Statistical analysis included Mann–Whitney U, chi-square, multivariate logistic regression, and ROC analysis. A predictive nomogram was developed and evaluated for calibration, discrimination, and clinical utility.ResultsSII was an independent risk factor for severe pneumonia. An SII ≥738.0 significantly increased severe pneumonia risk. A combined model including SII, infection status, length of hospital stay, and ICU admission showed higher predictive accuracy than SII alone. Conclusion: SII is a useful biomarker for predicting severe pneumonia in children. The nomogram integrating SII with clinical factors demonstrates good predictive performance.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fped.2026.1803924</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fped.2026.1803924</link>
        <title><![CDATA[Case Report: Diagnostic odyssey in rare diseases: when genetic variants are misinterpreted]]></title>
        <pubdate>2026-04-15T00:00:00Z</pubdate>
        <category>Case Report</category>
        <author>Minerva Montero-Hernández</author><author>Nahuel Pérez-Moix</author><author>María-Carmen Carrascosa-Romero</author><author>María-Pilar López-Garrido</author><author>Francisco Sánchez-Sánchez</author>
        <description><![CDATA[IntroductionThe diagnostic odyssey in rare diseases often involves the misinterpretation of genetic data, particularly when multidisciplinary approaches are lacking. This study illustrates the critical process of interpreting variants from next-generation sequencing (NGS) through a real-life case of a child misdiagnosed with Marfan Syndrome (MFS). The misdiagnosis was maintained for over seven years despite repeated clinical evaluations by different specialists. An initial clinical suspicion of MFS due to joint hypermobility at 3 years of age became a definitive diagnosis after an external laboratory reported a heterozygous variant in the MYH11 gene at age 5, despite the patient never fulfilling the established clinical diagnostic criteria for the disease.MethodsTo provide an accurate diagnosis and end the family's diagnostic odyssey, a complete clinical and genetic reinterpretation was performed when the patient was 7 years old. The proband and 9 asymptomatic relatives were recruited for a functional study of the MYH11 c.5544_5548del, p.(D1848Efs*60) variant.ResultsThe functional analysis demonstrated that the variant operates through a loss-of-function mechanism, leading to nonsense-mediated mRNA decay. While gain-of-function variants in MYH11 are associated with thoracic aortic aneurysms and dissections, loss-of-function variants are linked to autosomal recessive Megacystis-Microcolon-Intestinal Hypoperistalsis Syndrome (MMIHS). As a heterozygous carrier of a loss-of-function variant, the patient is asymptomatic for MMIHS and definitively does not have MFS. Currently, the 11-year-old child is progressing favorably without any notable pathology.ConclusionsThis case exposes the entire diagnostic odyssey suffered by the patient's family and highlights three fundamental systemic errors: the critical delay in genetic counseling, the over-interpretation of NGS data by external laboratories lacking phenotypic context, and the health system's inefficiency in integrating clinical geneticists. Overcoming these barriers is essential for the true implementation of personalized precision medicine.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fped.2026.1799664</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fped.2026.1799664</link>
        <title><![CDATA[Synchronous orbital and intracranial infantile hemangiomas: a case report and literature review]]></title>
        <pubdate>2026-04-15T00:00:00Z</pubdate>
        <category>Case Report</category>
        <author>Shuyu Liu</author><author>Chi Ma</author><author>Cangming Shi</author><author>Dawei Chen</author>
        <description><![CDATA[BackgroundSolitary orbital and parasellar infantile hemangiomas (IHs) without cutaneous manifestations are exceptionally rare, posing significant diagnostic and therapeutic challenges due to the absence of management consensus.Case presentationA 55-day-old female infant presented with progressive left-sided proptosis over the course of one month. Preoperative magnetic resonance imaging (MRI) revealed homogeneously enhancing masses in the left orbit (encasing the optic nerve) and the parasellar region, in which imaging characteristics resembled those of a meningioma. No cutaneous lesions or features of PHACE syndrome were identified. Following multidisciplinary team consultation, a single-stage left pterional approach for the simultaneous resection of both the orbital and parasellar lesions, with the aim of establishing a definitive histopathological diagnosis and relieving mass effect. Histopathological examination confirmed the diagnosis of cellular IH, which could be supported by characteristic morphology and positive immunohistochemical staining for GLUT-1 and CD31. Postoperative recovery was uneventful, with complete resolution of proptosis and no neurological deficits. Imaging confirmed total resection of both lesions.ConclusionsThis case emphasizes that isolated intracranial/orbital IH should be included in the differential diagnosis of pediatric masses, even in the absence of skin involvement. When facing diagnostic uncertainty and significant symptomatology, surgical resection can be a safe and effective primary strategy, providing definitive diagnosis and immediate decompression.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fped.2026.1713890</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fped.2026.1713890</link>
        <title><![CDATA[Case Report: Safety and efficacy of combination therapy with adalimumab and anakinra in two patients with severe inflammatory diseases]]></title>
        <pubdate>2026-04-15T00:00:00Z</pubdate>
        <category>Case Report</category>
        <author>Simone Coslovich</author><author>Matteo Bramuzzo</author><author>Serena Pastore</author><author>Daniela Chicco</author><author>Sara Lega</author><author>Giulia Gortani</author><author>Thomas Caiffa</author><author>Alberto Tommasini</author><author>Andrea Taddio</author>
        <description><![CDATA[BackgroundChronic inflammatory diseases in children can involve distinct immunologic pathways, occasionally necessitating dual biologic therapy when single-agent treatment is insufficient. Evidence on combined IL-1 and TNF-α inhibition remains limited.CasesA 15-year-old girl with ulcerative colitis and recurrent pericarditis received adalimumab and anakinra, achieving clinical remission without infections over eight months. An 11-year-old boy with juvenile idiopathic arthritis, uveitis, and colchicine-resistant familial Mediterranean fever received combined adalimumab and anakinra, achieving low disease activity in both conditions at six months, without adverse events.DiscussionDual blockade of TNF-α and IL-1 may be rational in selected patients due to overlapping and complementary roles of these cytokines in driving inflammation. Our cases illustrate that this combination can be effective and well tolerated with careful monitoring.ConclusionIn carefully selected pediatric patients, simultaneous TNF-α and IL-1 inhibition may provide clinical benefit. Further studies are required to assess long-term safety and efficacy.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fped.2026.1795907</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fped.2026.1795907</link>
        <title><![CDATA[Exploring parental perspectives on the barriers and benefits of pediatric cochlear implantation: a cross-sectional study in Jeddah, Saudi Arabia]]></title>
        <pubdate>2026-04-15T00:00:00Z</pubdate>
        <category>Original Research</category>
        <author>Aya M. Baageel</author><author>Shahad M. Aldini</author><author>Tuleen J. Abudawood</author><author>Hanin H. Rayes</author>
        <description><![CDATA[BackgroundParents of children with severe-to-profound hearing loss face various challenges that can hinder access to timely interventions. Previous literature has studied various factors affecting parental experiences with cochlear implantation, but research remains limited in Saudi Arabia. Therefore, this study aimed to investigate the challenges faced by parents of children who are candidates for cochlear implantation surgery or have already undergone the procedure and to assess children's quality of life (QoL) after cochlear implantation.MethodA cross-sectional study was conducted among 123 parents of children aged 9 months to 18 years in Saudi Arabia, including cochlear implant (CI) recipients (n = 104) and candidates (n = 19). Participants were recruited from CI clinics in Jeddah and from online platforms across the country. Data were collected using two questionnaires: a structured tool titled Parental Barriers to Pediatric Cochlear Implantation, which was reviewed by an expert panel to assess perceived barriers, and the validated Arabic version of the 24-item Glasgow Children's Benefit Inventory (GCBI) to evaluate post-implantation QoL. Descriptive and inferential statistics were utilized.ResultsThe results revealed that most parents expressed concerns about the surgical procedure (60.1%), including potential risks and outcomes. A substantial proportion reported concerns regarding post-implantation expenses such as the cost of device maintenance (49.6% strongly agreed) and rehabilitation sessions (48.8% strongly agreed). Additionally, 69.1% of the parents reported difficulties accessing rehabilitation services due to the lack of rehabilitation centers in their area. The GCBI questionnaire showed positive outcomes for children's overall QoL (88.1%). Significant improvements were observed in the functional, developmental, cognitive, and social-emotional domains of children's QoL, rather than in the health or medical need domains.ConclusionKey parental barriers to pediatric cochlear implantation include financial concerns, limited access to rehabilitation, and post-surgical challenges. Despite this, parents reported positive outcomes, particularly in the functional, cognitive, and social-emotional domains.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fped.2026.1631683</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fped.2026.1631683</link>
        <title><![CDATA[Case Report: Beyond commensal: Staphylococcus epidermidis as a novel cause of NARDS]]></title>
        <pubdate>2026-04-15T00:00:00Z</pubdate>
        <category>Case Report</category>
        <author>Linlin Chen</author><author>Jie Li</author><author>Xixi Liu</author><author>Xiyang Chen</author><author>Haiting Li</author><author>Dengpan Xie</author><author>Yunqin Chen</author><author>Junhui Yuan</author><author>Enfu Tao</author>
        <description><![CDATA[Staphylococcus epidermidis (S. epidermidis), usually a harmless skin bacterium, can become an opportunistic pathogen in newborns, particularly those with risk factors like premature membrane rupture. Although it commonly causes late-onset sepsis, its association with neonatal acute respiratory distress syndrome (NARDS) is rare. This report describes a unique case of NARDS in a full-term newborn caused by S. epidermidis. The infant, born via cesarean at 40 2/7 weeks with a 30.5-hour membrane rupture, developed severe respiratory failure shortly after birth, necessitating mechanical ventilation. Initial treatment with penicillin and cefotaxime was ineffective, and by day 3, the infant's condition worsened, showing respiratory distress, petechial rashes, and high inflammatory markers. Treatment was changed to vancomycin and meropenem, with the addition of intravenous immunoglobulin and two doses of pulmonary surfactant. Metagenomic next-generation sequencing (mNGS) confirmed S. epidermidis in the airway secretions. The patient was discharged after 19 days with a diagnosis of NARDS, intrauterine infectious pneumonia, neonatal air leak syndrome, type II respiratory failure, neonatal sepsis, and congenital heart defects. In conclusion, S. epidermidis is a novel pathogen capable of causing NARDS in high-risk infants with prolonged membrane rupture. The proposed mechanisms—including surfactant dysfunction and biofilm-associated virulence—are supported by experimental literature and are consistent with the clinical phenotype observed in our patient, though direct confirmation requires further study. Notably, skin symptoms like erythematous rash and petechiae may indicate invasive S. epidermidis infection, especially in cases of respiratory distress with skin symptoms following premature rupture of membranes. Moreover, mNGS is vital for pathogen identification when traditional cultures fail.]]></description>
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        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fped.2026.1794686</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fped.2026.1794686</link>
        <title><![CDATA[Infliximab for intravenous immunoglobulin-resistant Kawasaki disease complicated with cholestatic hepatitis: a case report and discussion on coronary artery aneurysm prevention]]></title>
        <pubdate>2026-04-15T00:00:00Z</pubdate>
        <category>Case Report</category>
        <author>Zhong Yongxing</author><author>Zhang Zheng</author><author>Zheng Qi</author><author>Yang Fangyan</author>
        <description><![CDATA[BackgroundKawasaki disease (KD) is the leading cause of acquired heart disease in children under 5 years of age worldwide. Approximately 15%–20% of KD patients are resistant to intravenous immunoglobulin (IVIG), and these patients have a significantly higher risk of developing coronary artery aneurysms (CAAs), a severe complication leading to long-term cardiovascular morbidity. Cholestatic hepatitis is a rare manifestation of KD, which further increases the difficulty of clinical treatment. This study reports a case of IVIG-resistant KD complicated with cholestatic hepatitis treated with infliximab, and explores the clinical challenges in preventing CAA progression.Case reportA 2-year-old Han Chinese male presented with persistent fever as the initial symptom, followed by typical clinical manifestations of KD and cholestatic hepatitis. Initial treatment with high-dose IVIG (2 g/kg) combined with clopidogrel (1 mg/kg/day) was ineffective. A second dose of IVIG (1 g/kg) combined with high-dose methylprednisolone pulse therapy also failed to control the disease. On the ninth day of illness, salvage therapy with the tumor necrosis factor-alpha (TNF-α) inhibitor infliximab (5 mg/kg) was administered, and the child's fever subsided rapidly within 24 h. Subsequent laboratory examinations showed that inflammatory indicators [C-reactive protein (CRP), erythrocyte sedimentation rate (ESR)] and liver function indicators [alanine aminotransferase (ALT), aspartate aminotransferase (AST), bilirubin, total bile acids (TBA)] improved significantly. However, despite effective inflammation control, echocardiographic follow-up revealed progressive development of CAAs, eventually forming giant CAAs.ConclusionInfliximab can effectively suppress systemic inflammation and improve liver function in patients with IVIG-resistant KD complicated with cholestatic hepatitis. However, the development of giant CAAs in this case underscores the dissociation between systemic inflammation control and coronary protection, highlighting the critical importance of optimizing the timing of infliximab administration. Further randomized controlled trials are needed to clarify the optimal timing, dose, and patient selection criteria for infliximab in the treatment of IVIG-resistant KD.]]></description>
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        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fped.2026.1739614</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fped.2026.1739614</link>
        <title><![CDATA[Healthcare with unconditional positive regard: the KICS clinic medical home model for children in out-of-home care]]></title>
        <pubdate>2026-04-15T00:00:00Z</pubdate>
        <category>Original Research</category>
        <author>Rebecca Orsi-Hunt</author><author>Heather Allan</author><author>Rachel A. Wilson</author><author>Gretchen Domek</author><author>Brooks R. Keeshin</author><author>Amanda Bird Hoffert Gilmartin</author>
        <description><![CDATA[BackgroundOn any given day in the United States over the past five years 300,000–400,000 children and youth have been in an out-of-home (OOH) placement, typically kinship or foster care. Children living in an OOH setting commonly have health issues beyond those of a general pediatric population. To address the needs of this special population, the Kids in Care Settings (KICS) Clinic was established at Children's Hospital Colorado in May 2023.MethodsThis study provides a comprehensive and descriptive summary of the novel specialty primary care medical home model used at KICS. We use early data from electronic health records to describe the patient population over the clinic's first two years (May 2023 through June 2025), including demographics, placement characteristics and foster and kinship family needs.ResultsData show that care at KICS is accessible to both foster and kin families, and barriers to keeping appointments are low. KICS provides care across a wide age range and continuous care across placement changes. Care is comprehensive, provided by a multidisciplinary team, and incorporates screening for broader concerns such as educational challenges and substance use. Data show that kinship caregivers have a substantially higher level of psychosocial need and are deeply affected by social determinants of health.ConclusionsThe KICS clinic offers a novel and promising specialty primary care medical home model to deliver care for a diverse population of children and youth living in varying forms of OOH placement.]]></description>
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        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fped.2026.1785074</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fped.2026.1785074</link>
        <title><![CDATA[Childhood cancer care in Northern Tanzania: hospital infrastructure and provision of services]]></title>
        <pubdate>2026-04-15T00:00:00Z</pubdate>
        <category>Original Research</category>
        <author>Lexi Nussbaum</author><author>Yotham A. Gwanika</author><author>Prisca Joseph Stephano</author><author>Happiness D. Kajoka</author><author>Catherine Staton</author><author>Henry E. Rice</author><author>Blandina T. Mmbaga</author><author>Emily R. Smith</author><author>Pamela Espinoza</author><author>Esther Majaliwa</author>
        <description><![CDATA[IntroductionSurvival rates for childhood cancer remain far lower in low- and middle-income countries (LMICs) compared to high-income countries (HICs). In Tanzania, challenges in cancer care for children are driven by shortages of trained providers, limited infrastructure, and constrained access to essential medications. This study evaluates pediatric oncology capacity and infrastructure in Northern Tanzania to identify system gaps and opportunities for improvement.MethodsA cross-sectional survey of capacity for pediatric cancer care was conducted at 25 hospitals across the Kilimanjaro, Arusha, Manyara, and Tanga regions in Tanzania. Facilities included health centers, district hospitals, regional hospitals, and one zonal referral hospital. Using a tool adapted from the International Society of Paediatric Oncology (SIOP) Global Mapping Survey, the World Health Organization Essential Medicines List, and the Global Initiative for Childhood Cancer, we collected data on hospital infrastructure from hospital leaders and staff. Key indicators included diagnostic imaging, pathology services, oncology workforce, medicine availability, treatment modalities, and cancer case volumes. Descriptive statistics were summarized using R.ResultsOf the facilities surveyed, only one hospital (Kilimanjaro Christian Medical Centre) had a dedicated pediatric oncology ward and subspecialized staff. Although all facilities reported access to basic imaging such as x-ray and ultrasound, advanced imaging modalities (CT, MRI, specialized imaging) were confined to higher-level hospitals. Only 1 out of 25 hospitals offered pathology and pediatric surgical services. Among 20 essential pediatric oncology medicines assessed, only dexamethasone was universally available. District hospitals, despite serving the largest pediatric catchment areas and recording the highest admissions for children, lacked dedicated pediatric oncology wards.DiscussionPediatric oncology services in Northern Tanzania are constrained by shortages in infrastructure, personnel, diagnostics, and medications. District hospitals have limited capacity to treat childhood cancer, resulting in critical delays in diagnosis and treatment. Strengthening infrastructure at the district level, creating efficient referral systems, and embedding pediatric oncology care into broader health systems may improve survival outcomes for children with cancer.]]></description>
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        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fped.2026.1758972</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fped.2026.1758972</link>
        <title><![CDATA[Identification of risk factors of cystic periventricular leukomalacia in preterm infants]]></title>
        <pubdate>2026-04-15T00:00:00Z</pubdate>
        <category>Original Research</category>
        <author>Renée Lampe</author><author>Irina Sidorenko</author><author>Eva Lück</author><author>Andrey Kovtanyuk</author><author>Ursula Felderhoff-Müser</author><author>Marcus Krüger</author><author>Christian Brickmann</author>
        <description><![CDATA[IntroductionThe neonatal period in very preterm born infants is characterized by high vulnerability of the developing brain. Diffuse or cystic white matter injury—cystic periventricular leukomalacia (cPVL)—is one of the most serious complications leading to brain injury in preterm infants, associated with an increased risk of neurological impairments such as cerebral palsy.MethodsIn the present study, parameters that may potentially influence the occurrence of cPVL are analyzed. The study is based on retrospective clinical data of 46 preterm infants with and without cPVL, including prenatal factors, birth-related information, neonatal diagnoses and routinely measured clinical monitoring data. The novelty of this work lies in the inclusion in analyses of cerebral blood flow (CBF), CBF fluctuations and partial pressure of oxygen in brain tissue (PtO2), calculated from routinely measured parameters using a mathematical model.ResultsStatistical analyses revealed significant association between cPVL and a group of 5 clinical and 23 regularly measured parameters including mathematically calculated CBF, CBF fluctuations and PtO2. The obtained results may be useful for future risk assessment of cPVL at an early stage.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fped.2026.1774627</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fped.2026.1774627</link>
        <title><![CDATA[Prolonged anesthesia duration is associated with postoperative thyroid hormone reduction in pediatric surgical patients: a retrospective cohort study]]></title>
        <pubdate>2026-04-15T00:00:00Z</pubdate>
        <category>Original Research</category>
        <author>Mengqin Shan</author><author>Chaoyang Tong</author><author>Xin Fu</author><author>Yuxin Zhang</author><author>Liping Sun</author><author>Kan Zhang</author><author>Jijian Zheng</author>
        <description><![CDATA[BackgroundPostoperative reduction of thyroid hormones (TH), particularly triiodothyronine (T3), is frequently observed but poorly characterized in pediatric surgical patients. This study aimed to identify risk factors for postoperative TH reduction in pediatric patients, analyze the association between anesthetic factors and perioperative TH changes, and explore the relationship between postoperative TH reduction and clinical outcomes in pediatric cardiac surgery patients.MethodsWe conducted a retrospective analysis of 233 pediatric patients (ages 0–18) undergoing surgery and anesthesia at Shanghai Children's Medical Center between 2014 and 2023. Patients were categorized into low thyroid hormone (LTH) and non-LTH groups based on postoperative free T3 (FT3) and/or free thyroxine (FT4) levels below the lower reference limits. Multivariable logistic and ridge regression were used to identify independent predictors. Clinical outcomes were analyzed in a sub-cohort of cardiac surgery patients.ResultsPostoperative LTH occurred in 78 patients (33.5%). Longer anesthesia duration, surgical duration, higher ASAphysical status (III-V), cardiac surgery, and cardiopulmonary bypass (CPB) use were associated with LTH in univariate analysis (P < 0.05). Multivariable regression identified anesthesia duration as a significant independent risk factor (OR = 1.335, 95% CI: 1.144–1.557, P < 0.001), a finding confirmed by ridge regression. This risk remained consistent regardless of surgery type (P for interaction = 0.747) or CPB use (P for interaction = 0.826). In an exploratory analysis of cardiac surgery patient, severe TH reduction (low both FT3 and FT4) was significantly associated with longer postoperative hospital stays (P = 0.035).ConclusionLonger anesthesia duration is independently associated with postoperative TH reduction in children. In cardiac surgery, the degree of this reduction correlates with prolonged hospitalization. These findings highlight anesthesia duration as a potentially risk factor for postoperative thyroid hormone reduction, which may inform perioperative management and warrant further investigation into underlying mechanisms.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fped.2026.1767283</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fped.2026.1767283</link>
        <title><![CDATA[Repeat kidney biopsy in pediatric lupus nephritis: an analysis of associated clinical-pathological features and outcomes]]></title>
        <pubdate>2026-04-15T00:00:00Z</pubdate>
        <category>Original Research</category>
        <author>Wenyan Wang</author><author>Fei Zhao</author><author>Guixia Ding</author><author>Sanlong Zhao</author><author>Guoliang Ma</author><author>Xueqin Cheng</author>
        <description><![CDATA[BackgroundThe utility of repeat kidney biopsy in pediatric lupus nephritis (LN) remains debated. This study aims to evaluate pathological evolution, therapeutic implications, and prognostic impact of repeat biopsies in children with LN.MethodsWe conducted a retrospective analysis of 19 pediatric LN patients (aged 5–18 years) who underwent ≥2 kidney biopsies at Nanjing Children's Hospital (2009–2022). Pathological classification (ISN/RPS criteria), activity/chronicity indices, and treatment responses were compared between biopsies. Statistical analyses were performed using SPSS 21.0, with P < 0.05 considered significant.ResultsThe primary indication for repeat biopsy was proteinuria recurrence (73.7%, 14/19). Pathological class transformation occurred in 47.4% (9/19) of cases (e.g., class III to IV), with a higher proportion of non-nephrotic type presentation in the transformation group (77.8% vs. 20.0%, P < 0.05). Treatment regimens were adjusted in 63.2% (12/19) of patients post-biopsy (e.g., cyclophosphamide to mycophenolate mofetil). Although chronicity scores increased significantly (e.g., glomerulosclerosis: 57.9% to 89.5%, P < 0.05), short-term kidney remission rates did not differ between groups with and without pathological transformation (77.8% vs. 80.0%, P > 0.05).ConclusionRepeat kidney biopsy detects pathological progression (e.g., increased chronicity) and guides treatment modifications in over 60% of pediatric LN cases. However, pathological class change alone does not dictate short-term outcomes, highlighting initial treatment response as a stronger prognostic indicator. Individualized use of repeat biopsies is recommended for children with proteinuria relapse to optimize management while mitigating procedural invasiveness.]]></description>
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