The Turkish Journal of Pediatrics
type: channel
publisher: Hacettepe University Institute of Child Health
language: en
publication name: The Turkish Journal of Pediatrics
issn: 0041-4301
copyright: This is an open access article distributed under the Creative Commons Attribution License (CC BY), which permits unrestricted use, distribution, and reproduction in any medium or format, provided the original work is properly cited.
items: Semiological seizure classification of epileptic seizures in children admitted to video-EEG monitoring unit
items: Factors for poor outcomes of neonatal bacterial meningitis: a retrospective multicenter study
items: Should we prioritize proton beam therapy before making a decision on orthotopic liver transplantation for unresectable hepatoblastoma?
items: Leber hereditary optic neuropathy (LHON) in a 6-year-old boy with a transient spinal cord lesion
items: Full-text publication outcomes of oral abstracts presented at the Turkish National Pediatric Congresses
items: Predictive value of serum hsa_circ_0061346, hsa_circ_0000095, and hsa_circ_0068606 expression levels on the severity of retinopathy of prematurity
items: Perspectives on “Assessment of hormone measurement methods in girls with premature adrenarche, polycystic ovary syndrome, and non-classical congenital adrenal hyperplasia”
items: Response to “Perspectives on ‘Assessment of hormone measurement methods in girls with premature adrenarche, polycystic ovary syndrome, and non-classical congenital adrenal hyperplasia’”
items: Perianal and gluteal parasitic abscess of Enterobius vermicularis: case report and review of the literature
items: Pediatric cervicofacial actinomycosis presenting with mandibular osteomyelitis: a diagnostic and therapeutic challenge and literature review
items: Clinical and economic burden of preseptal cellulitis in children: a 6-year review
items: Dose-specific childhood vaccine refusal in Balıkesir, Türkiye (2024): a population-based surveillance analysis
items: Comparative analysis of surgical costs vs. theoretical tiopronin therapy in pediatric cystinuria: a single-center experience from Türkiye
items: Chronic nonbacterial osteomyelitis: current perspectives in pediatric practice
items: Beyond contamination rates: a broader lens on diagnosing neonatal sepsis
items: Decoding joint complaints in children: a diagnostic approach to rheumatic and non-rheumatic disorders
items: The relationship between early feeding skills and general movements of preterm infants in the neonatal intensive care unit
items: Impact of a structured influenza seminar on pediatric residents’ knowledge and attitudes: a pre-post single-group study
items: Prognostic significance of serum apelin-13 and galectin-3 concentrations as potential indicators of severity and mortality in pediatric acute respiratory distress syndrome
items: The impact of hematocrit, punch location, and cellular interference on neonatal screening for biotinidase deficiency
items: Problematic social media use and eating behaviors in adolescence: gender-based differences
items: Authors’ reply to the letter “Beyond contamination rates: a broader lens on diagnosing neonatal sepsis”
items: Assessment of hormone measurement methods in girls with premature adrenarche, polycystic ovary syndrome, and non-classical congenital adrenal hyperplasia
items: Response to modulator therapy in a cystic fibrosis patient with a single identified CFTR variant not eligible for modulator treatment
items: Exploring the link between adenovirus infection and Guillain-Barré syndrome in children: a case-based analysis
items: Neuroblastoma-associated opsoclonus-myoclonus-ataxia syndrome: an important yet overlooked diagnosis in pediatric ataxia
items: Turkish pediatricians’ knowledge, attitudes, and awareness of respiratory syncytial virus (RSV) infection and immunization strategies: a cross-sectional study
items: https://turkjpediatr.org/article/view/8115
items: https://turkjpediatr.org/article/view/8020
items: Clinical significance of human herpesvirus 6 detected in cerebrospinal fluid: a 10-year retrospective study in children

Semiological seizure classification of epileptic seizures in children admitted to video-EEG monitoring unit
type: item
description: We aimed to determine seizure characteristics of pediatric patients with epilepsy, and evaluate if Semiological Seizure Classification (SSC) system is applicable in this cohort. We retrospectively studied 183 patients, aged between 3 months-18 years, admitted to the video-EEG monitoring unit (VEMU). Most patients suffered from intractable epilepsy with comorbidities, and had structural lesions. Seizures were classified based on ictal video-EEG recordings by using SSC system; 157 patients had only one seizure type, 26 had more than one seizure types. Overall 211 seizures and 373 semiologies were analyzed; 114 seizures (54%) had more than one semiological subtype. The most frequent semiology was motor seizures (78%), followed by dialeptic seizures (12%). The most common subtypes were simple motor seizures (49%); tonic seizures constituted (28.4%) of all semiologies. We conclude that SSC system is applicable for children with epilepsy admitted to VEMU; complementary EEG and imaging data are required for evaluation of patients with epilepsy.
subject: Original Article
  topic: section
subject: semiologic seizure classification
  topic: keywords
subject: epilepsy
  topic: keywords
subject: children
  topic: keywords
subject: video-EEG monitoring
  topic: keywords
creator: Serdar Alan
creator: Dilek Yalnızoğlu
creator: Güzide Turanlı
creator: Kader Karlı-Oğuz
creator: Eser Lay-Ergun
creator: Figen Söylemezoğlu
creator: Nejat Akalan
creator: Meral Topçu
rights: Copyright (c) 2015 The Author(s) https://creativecommons.org/licenses/by/4.0
date: 2015-08-28
publication date: 2015-08-28
starting page: 317
ending page: 323
doi: 10.24953/turkjpediatr.2015.8457

Factors for poor outcomes of neonatal bacterial meningitis: a retrospective multicenter study
type: item
description: Background. Neonatal bacterial meningitis remains a severe infectious disease associated with substantial mortality and long-term neurological sequelae. This study aimed to identify factors associated with poor outcomes and to determine independent prognostic predictors in neonates with bacterial meningitis. Methods. This retrospective multicenter cohort study included neonates diagnosed with bacterial meningitis. Clinical characteristics, laboratory findings, microbiological data, treatment responses, and outcomes were analyzed. Univariate and multivariable logistic regression analyses were performed to identify factors associated with poor outcomes. Results. A total of 85 neonates were included in the final analysis. 31 neonates (36.5%) experienced poor outcomes, including death or long-term neurological sequelae. In multivariable analysis, the presence of neurological signs at admission (odds ratio [OR]: 7.315; 95% confidence interval [CI]: 1.875–28.535) and the development of acute neurological complications during hospitalization (OR: 7.541; 95% CI: 2.045–27.807) were the only factors independently associated with poor outcomes. Several variables, including elevated cerebrospinal fluid protein levels, early administration of blood-brain barrier (BBB)-permeable antibiotics prior to lumbar puncture, and adequate response to initial antimicrobial therapy, were significantly associated with outcomes in univariate analyses but did not retain statistical significance after multivariable adjustment. Conclusions. Neurological involvement at presentation and acute neurological complications are key independent predictors of poor outcomes in neonatal bacterial meningitis. Other clinical and laboratory variables may reflect disease severity or early clinical course and may assist in early risk stratification.
subject: Original Article
  topic: section
subject: neonatal bacterial meningitis
  topic: keywords
subject: prognosis
  topic: keywords
subject: neurological complications
  topic: keywords
subject: cerebrospinal fluid
  topic: keywords
subject: outcomes
  topic: keywords
creator: Lan Shao
creator: Dongdong You
creator: Yunpeng Shao
creator: Huanhuan Xu
creator: Feng Li
rights: Copyright (c) 2026 The Author(s) https://creativecommons.org/licenses/by/4.0
date: 2026-03-11
publication date: 2026-03-11
starting page: 1
ending page: 11
doi: 10.24953/turkjpediatr.2026.6678

Should we prioritize proton beam therapy before making a decision on orthotopic liver transplantation for unresectable hepatoblastoma?
type: item
description: Background. In unresectable hepatoblastoma (HB), particularly “pre-treatment extent of tumor” (PRETEXT) IV tumors or those with positive annotation factors, standard management consists of intensive chemotherapy followed by surgical resection or orthotopic liver transplantation (OLT). Radiotherapy has traditionally been avoided because of the liver’s radiosensitivity and the risk of radiation-induced liver disease. Proton beam therapy (PBT), owing to its dosimetric advantage and ability to spare uninvolved liver parenchyma, may represent a potential local control strategy in selected pediatric patients for whom curative surgery or OLT is not feasible. Case Presentation. We describe five pediatric patients with advanced hepatoblastoma treated with proton beam therapy at our institution between February 2022 and January 2024. The cohort included three girls and two boys, with a median age of 3.0 years (interquartile range [IQR], 1.6–4.0) and a median alpha-fetoprotein level of 435,453 ng/mL (IQR: 7,668–1,276,681) at diagnosis. All patients were initially considered inoperable because of extensive hepatic involvement, inadequate future liver remnant, or multifocal disease, and OLT was not feasible owing to donor limitations or medical comorbidities. All received neoadjuvant chemotherapy using SIOPEL-based regimens, achieving partial tumor response. Tumors ranged from 5 to 12 cm and involved central hepatic segments, the portal region, or both lobes. PBT was delivered at a total dose of 50 GyE in 10–25 fractions as definitive or consolidative therapy, followed by surgical resection in three patients. Two patients additionally received targeted therapy and immunotherapy. At last follow-up, four patients were alive with no evidence of disease, while one patient died from tumor progression. Conclusions. These cases suggest that proton beam therapy may serve as a feasible liver-sparing local treatment option for selected pediatric patients with unresectable or residual hepa…
subject: Case Report
  topic: section
subject: hepatoblastoma
  topic: keywords
subject: proton beam therapy
  topic: keywords
subject: pediatric liver tumor
  topic: keywords
subject: unresectable cancer
  topic: keywords
subject: radiotherapy
  topic: keywords
subject: PRETEXT
  topic: keywords
creator: Yi-Wen Hsiao
creator: Yi-Lun Wang
creator: Chen-Kan Tseng
creator: Tsung-Yen Chang
creator: Shih-Hsiang Chen
creator: Tang-Her Jaing
rights: Copyright (c) 2026 The Author(s) https://creativecommons.org/licenses/by/4.0
date: 2026-03-11
publication date: 2026-03-11
starting page: 1
ending page: 6
doi: 10.24953/turkjpediatr.2026.6426

Leber hereditary optic neuropathy (LHON) in a 6-year-old boy with a transient spinal cord lesion
type: item
description: Background. Leber hereditary optic neuropathy (LHON) is a maternally inherited mitochondrial disorder that predominantly manifests as bilateral, painless vision loss in young males. While traditionally associated with the optic nerves, a subset of patients exhibits additional neurological symptoms, referred to as LHON-plus syndrome. Involvement of the spinal cord is uncommon, particularly among the pediatric population, and may result in diagnostic challenges, potentially leading to confusion regarding acquired demyelinating diseases. Case Presentation. We report a 6-year-old boy with near-complete vision loss in the right eye and blurred vision in the left eye. Demyelinating diseases were suspected in the case of acute bilateral optic neuropathy. Cranial and orbital magnetic resonance imaging (MRI) showed no demyelinating lesions, whereas spinal MRI revealed a T2-hyperintense lesion at the C3–C6 levels. Due to unresponsiveness to conventional treatment for demyelinating diseases, genetic testing confirmed the homoplasmic m.11778G>A variant in NADH dehydrogenase subunit 4 (MT-ND4), establishing an LHON diagnosis. Spinal cord involvement supported the LHON-plus syndrome classification. Idebenone therapy was initiated, and follow-up was scheduled. During the 1.5-year follow-up, right eye visual loss persisted, while the left eye showed gradual vision decline. A second spinal MRI performed at 6 months showed complete resolution of the previous lesion without new lesions. Conclusion. Since optic neuropathy and spinal cord involvement typically indicate demyelinating diseases, these should be prioritized in initial evaluation due to their frequency and need for early immunomodulatory treatment. However, spinal cord involvement can occur in mitochondrial diseases, as demonstrated in this case. The presence of a transient and asymptomatic spinal cord lesion in this patient expands the recognized spectrum of central nervous system involvement in LHON. Therefore, LHON-plus s…
subject: Case Report
  topic: section
subject: Leber hereditary optic neuropathy
  topic: keywords
subject: LHON-plus syndrome
  topic: keywords
subject: optic neuropathy
  topic: keywords
subject: mitochondrial disease
  topic: keywords
subject: MT-ND4 m.11778G>A mutation
  topic: keywords
creator: Anıl Gök
creator: Gökçe Cırdı
creator: Adnan Deniz
creator: Ayfer Sakarya Güneş
creator: Leman Tekin Orgun
creator: Bülent Kara
rights: Copyright (c) 2026 The Author(s) https://creativecommons.org/licenses/by/4.0
date: 2026-03-11
publication date: 2026-03-11
starting page: 1
ending page: 7
doi: 10.24953/turkjpediatr.2026.6882

Full-text publication outcomes of oral abstracts presented at the Turkish National Pediatric Congresses
type: item
description: Background. Scientific congresses are critical platforms for knowledge dissemination and collaboration. The scientific value of presented abstracts is best demonstrated through their subsequent publication as full-text articles in peer-reviewed journals. This study aimed to evaluate the publication rate and characteristics of oral abstracts presented at the Turkish National Pediatric Congresses (TNPC) between 2019 and 2023. Methods. Abstract books of five consecutive congresses were reviewed. The publication status of each abstract was determined through systematic searches in Web of Science, PubMed, Scopus, Google Scholar and the TR Index utilizing the title, keywords from the title and author names. Parameters such as study design, collaboration type, index status and the impact factor of the journal, the year it was published, and time to publication were analyzed. Additionally, the subspecialty of each abstract and the publication rate for each subspecialty were evaluated. Results. Among 268 oral abstracts, 111 (41.8%) were published as full-text articles. Of these, 66 (59.5%) were published in journals indexed in the Science Citation Index Expanded. Approximately one-third (32.4%) of the articles were published in Q1 or Q2 ranked journals. The average impact factor was 1.72 ± 1.26 and the mean time to publication was 1.6 ± 1.17 years. The most common study design published was retrospective (51.3%), and the majority were single-center studies (88.3%). The highest publication rates were observed in the fields of rheumatology, adolescent medicine, and infectious diseases. Conclusion. A significant portion of the papers presented at TNPC congresses are published in peer-reviewed scientific journals. The fact that more than one-third of the published studies appear in high-impact journals demonstrates the academic quality of the papers presented at the congresses and the effectiveness of the selective evaluation process. The findings provide valuable contributions …
subject: Original Article
  topic: section
subject: Publication rate
  topic: keywords
subject: scientific congress
  topic: keywords
subject: pediatric abstracts
  topic: keywords
subject: Türkiye
  topic: keywords
subject: bibliometric analysis
  topic: keywords
creator: Sinem Akgül
creator: Özge Başaran
creator: Melis Pehlivantürk Kızılkan
creator: Gülen Eda Ütine
creator: Leman Akcan Yıldız
creator: Yılmaz Yıldız
creator: Ali Düzova
creator: Enver Hasanoğlu
rights: Copyright (c) 2026 The Author(s) https://creativecommons.org/licenses/by/4.0
date: 2026-02-27
publication date: 2026-02-27
starting page: 18
ending page: 24
doi: 10.24953/turkjpediatr.2026.7526

Predictive value of serum hsa_circ_0061346, hsa_circ_0000095, and hsa_circ_0068606 expression levels on the severity of retinopathy of prematurity
type: item
description: Background. To investigate the diagnostic and pathological staging value of serum hsa_circ_0061346, hsa_circ_0000095, and hsa_circ_0068606 levels in retinopathy of prematurity (ROP). Methods. A total of 70 infants with ROP (140 eyes) treated at our hospital from October 2018 to October 2023 were enrolled as the ROP group, while 70 healthy preterm infants (140 eyes) of the same gestational age without ROP were selected as the control group. The relative expression levels of serum hsa_circ_0061346, hsa_circ_0000095, and hsa_circ_0068606 were detected by quantitative real-time PCR. Logistic regression analysis was used to identify factors influencing ROP occurrence. The diagnostic efficacy of the three circular RNAs (circRNAs) was evaluated using receiver operating characteristic (ROC) curve analysis. Results. The relative expression levels of hsa_circ_0061346 in serum were significantly higher in the ROP group than in the control group (6.27 ± 3.60 vs. 0.72 ± 0.31, P < 0.05), whereas the levels of hsa_circ_0000095 (1.98 ± 1.38 vs. 3.90 ± 1.75) and hsa_circ_0068606 (1.18 ± 0.51 vs. 7.71 ± 4.45) were significantly lower (all p < 0.05). Multivariate logistic regression showed that abnormal expression of these circRNAs was an independent risk factor for ROP. Notably, the combined diagnostic performance of the three circRNAs yielded an area under the ROC curve of 0.983, with a sensitivity of 100% and a specificity of 97.14%. Conclusion. The combined detection of serum hsa_circ_0061346, hsa_circ_0000095, and hsa_circ_0068606 may provide a novel approach for the early diagnosis and severity assessment of ROP.
subject: Original Article
  topic: section
subject: circular RNA
  topic: keywords
subject: retinopathy of prematurity
  topic: keywords
subject: biomarker
  topic: keywords
creator: Chenglv Liu
creator: Lijie Dong
creator: Qiaoling Yang
creator: Lang Bai
rights: Copyright (c) 2025 The Author(s) https://creativecommons.org/licenses/by/4.0
date: 2025-12-30
publication date: 2025-12-30
starting page: 798
ending page: 807
doi: 10.24953/turkjpediatr.2025.6725

Perspectives on “Assessment of hormone measurement methods in girls with premature adrenarche, polycystic ovary syndrome, and non-classical congenital adrenal hyperplasia”
type: item
subject: Letter to the Editor
  topic: section
creator: Rabia Raheem
creator: Munazza Raheem
rights: Copyright (c) 2026 The Author(s) https://creativecommons.org/licenses/by/4.0
date: 2026-02-27
publication date: 2026-02-27
starting page: 168
ending page: 169
doi: 10.24953/turkjpediatr.2026.7402

Response to “Perspectives on ‘Assessment of hormone measurement methods in girls with premature adrenarche, polycystic ovary syndrome, and non-classical congenital adrenal hyperplasia’”
type: item
subject: Letter to the Editor
  topic: section
creator: Mert Uçar
creator: Aysun Ata
creator: Burcu Barutçuoğlu
creator: Güneş Ak
creator: Sara Habif
creator: Zühal Parıldar
creator: Damla Gökşen
creator: Şükran Darcan
creator: Samim Özen
rights: Copyright (c) 2026 The Author(s) https://creativecommons.org/licenses/by/4.0
date: 2026-02-27
publication date: 2026-02-27
starting page: 170
ending page: 171
doi: 10.24953/turkjpediatr.2026.7475

Perianal and gluteal parasitic abscess of Enterobius vermicularis: case report and review of the literature
type: item
description: Background. Enterobius vermicularis is a nematode that predominantly affects the pediatric population, particularly in families with school-aged children. While it typically causes intestinal symptoms, rare cases of extraintestinal involvement have been reported, including female genital tract involvement and complications such as appendicitis or enterocolitis. Perianal parasitic abscesses are also rare, with only a few cases reported in the literature. Case Presentation. A 17-year-old female presented with abdominal pain during menstruation. Pelvic ultrasound revealed a septated cystic lesion located posterior to the uterus. Magnetic resonance imaging (MRI) demonstrated a perianal lesion with thick material, appearing iso- to hyperintense on both T1- and T2-weighted images. The lesion extended into the left gluteal muscles and showed peripheral contrast enhancement and diffusion restriction. Notably, there were no surrounding inflammatory changes, making an abscess diagnosis less likely. Surgical drainage revealed pus, and cytological analysis identified abundant parasitic oocytes consistent with E. vermicularis. The patient was treated with surgical drainage followed by pyrantel pamoate, resulting in near-complete resolution of the lesion at the one-month follow-up MRI. A literature review was also conducted to identify previously reported cases of parasitic abscesses and to explore the differential diagnoses of perianal cystic lesions. Conclusions. Perianal abscesses due to parasitic infections are rare, particularly those caused solely by E. vermicularis. Given the high prevalence in childhood infestations, parasitic abscesses should be considered in the differential diagnosis of perianal collections in pediatric patients, especially in the absence of peripheral inflammatory signs.
subject: Case Report
  topic: section
subject: Enterobius vermicularis
  topic: keywords
subject: parasitic abscess
  topic: keywords
subject: perianal abscess
  topic: keywords
subject: enterobiasis
  topic: keywords
subject: oxyuriasis
  topic: keywords
subject: pinworm
  topic: keywords
creator: Nazlı Gülsüm Akyel
creator: Tuba Banaz
creator: Burcu Arı Gökhan
rights: Copyright (c) 2025 The Author(s) https://creativecommons.org/licenses/by/4.0
date: 2026-02-27
publication date: 2026-02-27
starting page: 143
ending page: 149
doi: 10.24953/turkjpediatr.2025.6155

Pediatric cervicofacial actinomycosis presenting with mandibular osteomyelitis: a diagnostic and therapeutic challenge and literature review
type: item
description: Background. Actinomycotic osteomyelitis is a rare, chronic infection caused by Actinomyces species, anaerobic bacteria normally found in the oral flora. Mandibular involvement is uncommon and may mimic malignancies, complicating diagnosis. Case Presentation. A 15-year-old previously healthy male presented with painful neck swelling and trismus. Examination revealed a firm mass at the angle of the mandible. Imaging suggested osteomyelitis but raised concern for malignancy. Surgical drainage was performed, and histopathology confirmed actinomycotic infection. The patient initially received empirical intravenous vancomycin, cefotaxime, and metronidazole. Due to persistent fever and elevated inflammatory markers, the regimen was switched to teicoplanin plus piperacillin/tazobactam. Therapy was subsequently escalated to meropenem due to recurrent fever and based on magnetic resonance imaging findings suggestive of osteomyelitis, then vancomycin was replaced with teicoplanin because of vancomycin-associated nephrotoxicity. Following clinical improvement, the patient was discharged on oral amoxicillin/clavulanate to complete a total of six weeks of therapy. Discussion. Pediatric mandibular actinomycotic osteomyelitis is extremely rare. Its indolent course often mimics tumors or granulomatous disease. In this case, delayed diagnosis and nonspecific imaging findings led to initial misinterpretation. Surgical intervention played a key role in diagnosis and treatment. Early recognition and combined medical-surgical management are crucial to avoid complications. This case highlights the importance of considering infectious causes in mandibular masses and underscores the diagnostic challenges associated with them.
subject: Case Report
  topic: section
subject: actinomycosis
  topic: keywords
subject: Actinomyces
  topic: keywords
subject: mandibular osteomyelitis
  topic: keywords
subject: pediatric
  topic: keywords
creator: Sema Yildirim Arslan
creator: Sefa Tigrak
creator: Emrah Yucel
creator: Mahmut Demirci
creator: Ozlem Ekici
rights: Copyright (c) 2026 The Author(s) https://creativecommons.org/licenses/by/4.0
date: 2026-02-27
publication date: 2026-02-27
starting page: 156
ending page: 163
doi: 10.24953/turkjpediatr.2026.6451

Clinical and economic burden of preseptal cellulitis in children: a 6-year review
type: item
description: Background. Children diagnosed with preseptal cellulitis frequently require hospitalization, leading to both clinical management challenges and substantial healthcare-related costs. The condition often necessitates intravenous antibiotic therapy, radiological imaging, laboratory tests, consultations, and inpatient care, which collectively contribute to the overall economic burden. However, data on the clinical characteristics and cost distribution among pediatric patients remain limited. This study aimed to evaluate both the clinical and economic burden of preseptal cellulitis in hospitalized children and to identify the clinical factors influencing healthcare costs. Methods. This retrospective study included children aged 1 month to 18 years who were hospitalized with a diagnosis of preseptal cellulitis between January 2019 and December 2024. Patients were grouped according to age and presence of predisposing factors. Length of stay, total hospital costs, and cost components were analyzed based on clinical characteristics. Results. A total of 166 patients were included (mean age: 70.1 ± 46.9 months; 62% male). The most common findings were periorbital swelling (96.4%) and erythema (75.3%). Median length of stay was 5 days, with no significant differences by age, sex, or predisposing factors (p>0.05). However, a strong positive correlation was found between length of stay and total cost (rho=0.775, p<0.001). The total hospital expenditure was 25,412.95 USD, with antibiotics accounting for the largest share (48.3%). Sinusitis and odontogenic infections were significantly associated with higher costs (p=0.007 and p=0.030). In multivariable analysis, length of stay, age, and odontogenic infection emerged as independent determinants of total cost, with costs increasing by approximately 15% per additional hospital day, 0.2% per month of age, and 25% in the presence of odontogenic infection. Conclusion. Developing standardized treatment protocols and promoting rational an…
subject: Original Article
  topic: section
subject: antibiotic
  topic: keywords
subject: hospital cost
  topic: keywords
subject: sinusitis
  topic: keywords
creator: Çağla Özbakır
creator: Deniz Ergün
creator: Pelin Kaçar
creator: Berna Kahraman Çetin
creator: Hıncal Özbakır
creator: Arife Özer
creator: Gizem Güner Özenen
creator: Aybüke Akaslan Kara
creator: Dilek Orbatu
creator: Nuri Bayram
creator: İlker Devrim
rights: Copyright (c) 2026 The Author(s) https://creativecommons.org/licenses/by/4.0
date: 2026-02-27
publication date: 2026-02-27
starting page: 79
ending page: 86
doi: 10.24953/turkjpediatr.2026.6660

Dose-specific childhood vaccine refusal in Balıkesir, Türkiye (2024): a population-based surveillance analysis
type: item
description: Background. Vaccine hesitancy has intensified since COVID-19. In Türkiye, a performance-based family medicine system provides free vaccines. Before May 2024, physicians could remove refusals from metrics tied to pay deductions, obscuring true rates. A new policy mandating documentation created a natural experiment. We used population-based data to quantify these previously hidden dose-specific refusal rates across the childhood schedule. Methods. We conducted a population-based ecological analysis of monthly dose-specific refusals among children aged 0–59 months in Balıkesir Province, in 2024. Refusals were extracted from Performance Exception Forms. Rates were calculated per 1,000 target children (Wilson 95% confidence intervals [CI]s), using populations derived from Turkish Statistical Institute counts. To quantify the policy’s impact, we fitted an interrupted time-series regression with a fixed breakpoint at May 2024. This model estimated the baseline level and slope (January-April) and compared them to the immediate level shift and new monthly slope post-reform (May–December). Results. Of 3,584 missed-dose exceptions, 3,002 (83.8%) were refusals. The aggregate refusal rate was 3.9 per 1,000 (January-April) versus 21.6 per 1,000 (May–December), while the rate of on-schedule vaccinations decreased from 99.3% to 97.5%. Segmented regression indicated a baseline of 2.6 per 1,000 and a post-policy level increase of 13.7 per 1,000 (p=0.005); pre- and post-policy monthly slopes were not significant. Refusals concentrated in booster and later-scheduled doses (18–48 months), whereas primary-series doses showed lower, comparatively stable rates. Notably, refusal for the second measles-mumps-rubella dose (MMR-II, 48 months) rose toward year-end, reaching 47.4 per 1,000 in December (95% CI, 35.1–63.6). Conclusions. Mandatory documentation exposed substantial under-ascertainment of parental refusal in performance-based records. Refusal is disproportionately clustered at boost…
subject: Original Article
  topic: section
subject: booster doses
  topic: keywords
subject: childhood immunization
  topic: keywords
subject: health policy
  topic: keywords
subject: interrupted time-series
  topic: keywords
subject: surveillance
  topic: keywords
subject: vaccine hesitancy
  topic: keywords
creator: Salih Keskin
creator: Mithat Temizer
rights: Copyright (c) 2026 The Author(s) https://creativecommons.org/licenses/by/4.0
date: 2026-02-27
publication date: 2026-02-27
starting page: 25
ending page: 37
doi: 10.24953/turkjpediatr.2026.6792

Comparative analysis of surgical costs vs. theoretical tiopronin therapy in pediatric cystinuria: a single-center experience from Türkiye
type: item
description: Background. Cystinuria is a rare autosomal recessive disorder leading to recurrent cystine stone formation, often necessitating repeated surgical interventions. In Türkiye, tiopronin—a proven medical therapy—has become inaccessible since 2019, raising concerns about its economic and clinical consequences. This study aimed to compare the annual hospital costs of surgical management with the theoretical cost of tiopronin therapy in pediatric cystinuria patients. Methods. This single-center, retrospective study included 10 consecutive pediatric patients (median age: 12 years; range: 3-17 years) with genetically or biochemically confirmed cystinuria who underwent surgery for cystine stones in 2023. The annual cost of surgical management was calculated by summing all direct medical costs (operating room, anesthesia, devices, hospitalization, and related diagnostics) obtained from the hospital billing database. The theoretical annual cost of tiopronin therapy was calculated based on the last accessible market price of the drug in Türkiye, converted to Turkish Lira at the 2023 average exchange rate, and adjusted per patient using a standard dosing regimen of 15 mg/kg/day. Costs were compared using the Mann-Whitney U test. Results. The median annual surgical cost per patient was 49,936 TL (range: 14,791–84,576 TL), compared to a theoretical tiopronin cost of 27,923 TL (range: 9,307–27,925 TL). Surgical management was significantly more expensive than tiopronin therapy (p=0.001) in 9 of 10 cases. Six patients had a history of tiopronin use, and five of them experienced a surgery-free interval during medication (median duration: 3 years; range: 2-6 years). Preliminary follow-up data for 2024 revealed that 70% of patients required further surgical interventions (median: 2 surgeries per patient), demonstrating the persistent and recurrent nature of the disease when managed solely with surgery. Conclusion. Surgical treatment of cystinuria poses a substantially higher economic bu…
subject: Original Article
  topic: section
subject: cystinuria
  topic: keywords
subject: tiopronin
  topic: keywords
subject: pediatric urolithiasis
  topic: keywords
subject: healthcare costs
  topic: keywords
subject: cost-effectiveness
  topic: keywords
subject: Türkiye
  topic: keywords
creator: Sümeyye Sözduyar
creator: Hilmican Ulman
creator: Ali Tekin
creator: İbrahim Ulman
creator: Sibel Tiryaki
rights: Copyright (c) 2026 The Author(s) https://creativecommons.org/licenses/by/4.0
date: 2026-02-27
publication date: 2026-02-27
starting page: 87
ending page: 93
doi: 10.24953/turkjpediatr.2026.6198

Chronic nonbacterial osteomyelitis: current perspectives in pediatric practice
type: item
description: Chronic nonbacterial osteomyelitis (CNO) is a rare, autoinflammatory bone disorder that predominantly affects children and adolescents. The disease covers a broad clinical spectrum ranging from isolated bone lesions to its severe multifocal form, chronic recurrent multifocal osteomyelitis (CRMO). Although its exact pathogenesis remains elusive, recent advances highlight a pivotal role of innate immune dysregulation, particularly involving imbalanced cytokine signaling. These abnormalities drive sterile bone inflammation and osteoclast activation, leading to bone pain and lytic or sclerotic lesions. CNO remains a diagnosis of exclusion owing to the lack of specific biomarkers or standardized diagnostic criteria; however, the recently developed European Alliance of Associations for Rheumatology/American College of Rheumatology (EULAR/ACR) classification framework represents an important step toward uniformity in research and clinical trials. Whole-body magnetic resonance imaging has emerged as the imaging modality of choice for diagnosis and monitoring, while biopsy is reserved for atypical or unifocal cases. Management is empirical and guided by disease severity, with nonsteroidal anti-inflammatory drugs as first-line therapy, followed by corticosteroids, disease-modifying antirheumatic drugs, bisphosphonates, and biologic agents such as tumor necrosis factor (TNF) inhibitors in refractory cases. New insights into the interleukin (IL)-1, IL-6, and IL-17/23 pathways have opened avenues for targeted therapies, including Janus kinase (JAK) inhibitors, in difficult-to-treat patients. Despite earlier perceptions of a benign course, long-term follow-up indicates a risk of relapses and structural complications, underscoring the need for early recognition and multidisciplinary management. Ongoing international collaborations are expected to refine diagnostic precision and optimize treatment strategies to improve outcomes in pediatric CNO.
subject: Review
  topic: section
subject: autoinflammatory bone disease
  topic: keywords
subject: child
  topic: keywords
subject: chronic nonbacterial osteomyelitis
  topic: keywords
subject: recurrent osteomyelitis
  topic: keywords
subject: pediatric rheumatology
  topic: keywords
creator: Özge Başaran
creator: Adalet Elçin Yıldız
creator: Yelda Bilginer
creator: Seza Özen
rights: Copyright (c) 2026 The Author(s) https://creativecommons.org/licenses/by/4.0
date: 2026-02-27
publication date: 2026-02-27
starting page: 1
ending page: 17
doi: 10.24953/turkjpediatr.2026.7367

Beyond contamination rates: a broader lens on diagnosing neonatal sepsis
type: item
subject: Letter to the Editor
  topic: section
creator: Mishquat Shabbir
creator: Fatima Zahid
creator: Noman Alam
creator: Manahil Bahrawar
rights: Copyright (c) 2026 The Author(s) https://creativecommons.org/licenses/by/4.0
date: 2026-02-27
publication date: 2026-02-27
starting page: 164
ending page: 165
doi: 10.24953/turkjpediatr.2026.6987

Decoding joint complaints in children: a diagnostic approach to rheumatic and non-rheumatic disorders
type: item
description: Introduction. Musculoskeletal (MSK) complaints are common in children, with many cases ranging from benign to serious conditions. While these patients are often referred to pediatric rheumatologists, only about half are diagnosed with rheumatic diseases. The objective of this study is to identify key clues that assist in the differential diagnosis of patients presenting with joint complaints at pediatric rheumatology outpatient clinic. Material Methods. In this one-year study, patients with joint pain were assessed using a standardized form. Demographic, clinical, and examination data were collected and anonymized. Initial assessments were done by pediatric rheumatology fellows or residents, with final diagnoses confirmed by a pediatric rheumatologist. Results. This study included 414 patients aged 0-18 years with joint pain, of whom 273 were diagnosed with rheumatologic conditions and 141 with non-rheumatologic conditions. Patients with rheumatologic conditions had significantly higher laboratory values, including leukocyte counts, neutrophils, platelets, C-reactive protein, and erythrocyte sedimentation rate, all with p < 0.001. Multivariable analysis revealed that arthritis (adjusted odds ratio [aOR] 2.63, 95% confidence interval [CI] 1.09-6.33) and rash (aOR 4.37, 95% CI 1.38-13.86) predicted rheumatic disease in acute presentations, while in chronic complaints arthritis (aOR 2.61, 95% CI 1.30-5.21), morning stiffness (aOR 3.47, 95% CI 1.69-7.11), migratory pain (aOR 3.45, 95% CI 1.01-11.80), and fever (aOR 12.89, 95% CI 4.41-37.68) were independent predictors, whereas myalgia was associated with non-rheumatic conditions (aOR 0.35, 95% CI 0.15-0.83). Conclusion. In conclusion, this study emphasized the importance of clinical clues in diagnosing rheumatic diseases in children with joint pain. An accurate diagnosis depends on a thorough history and physical examination. Improving the differential diagnosis of joint pain is essential to reduce unnecessary referrals…
subject: Original Article
  topic: section
subject: arthralgia
  topic: keywords
subject: arthritis
  topic: keywords
subject: joint complaints
  topic: keywords
subject: pediatric rheumatology
  topic: keywords
subject: rheumatic disease
  topic: keywords
creator: Hatice İvedi
creator: Sibel Balcı
creator: Yunus Emre Bayrak
creator: Ali Öksel
creator: Nihal Şahin
creator: Hafize Emine Sönmez
rights: Copyright (c) 2026 The Author(s) https://creativecommons.org/licenses/by/4.0
date: 2026-02-27
publication date: 2026-02-27
starting page: 94
ending page: 106
doi: 10.24953/turkjpediatr.2026.6305

The relationship between early feeding skills and general movements of preterm infants in the neonatal intensive care unit
type: item
description: Background. Early feeding skills and general movements (GMs) are negatively affected by hypotonia due to prematurity. Interventions for feeding skills can be guided by understanding the relationship between feeding skills and GMs. In the light of this, the study focused on understanding the relationship between early feeding skills and preterm infants’ GMs in the neonatal intensive care unit (NICU). Methods. Participants in this cross-sectional study were forty infants with a postmenstrual age of 34–37 weeks who were hospitalized in the NICU at Abant İzzet Baysal University Training and Research Hospital. The data consisted of demographic characteristics (birth weight, gestational age, date of birth, age, and sex), feeding skills, assessed with the Early Feeding Skills Assessment Tool, and GMs, assessed with the General Movement Assessment. Results. A strong correlation was found between the Oral-Motor Function subscale of the Early Feeding Skills Assessment Tool and the Upper Limbs subscale of the General Movements Motor Optimality Score (rho=0.74, p=0.001). Among the demographic characteristics, only maternal age was associated with feeding skills. A weak correlation was determined between the Physiologic Stability subscale of the Early Feeding Skills Assessment Tool and maternal age (rho=0.34 p=0.03). Conclusions. This study reveals the relationship between feeding skills and general movement of preterm infants at NICU. GMs of upper extremity were found to positively affect feeding skills. This process may be accelerated by interventions to improve the GMs of upper extremity during the transition to oral feeding.
subject: Original Article
  topic: section
subject: infant
  topic: keywords
subject: movement
  topic: keywords
subject: premature
  topic: keywords
subject: upper extremity
  topic: keywords
creator: Seda Ayaz Taş
creator: Seda Yakıt Yeşilyurt
creator: Tansu Birinci Olgun
creator: Sezen Tezcan
creator: Sinan Taş
creator: Mustafa Dilek
rights: Copyright (c) 2026 The Author(s) https://creativecommons.org/licenses/by/4.0
date: 2026-02-27
publication date: 2026-02-27
starting page: 54
ending page: 67
doi: 10.24953/turkjpediatr.2026.6500

Impact of a structured influenza seminar on pediatric residents’ knowledge and attitudes: a pre-post single-group study
type: item
description: Background. Influenza remains a primary global health concern associated with significant morbidity and mortality, especially among high-risk pediatric populations. Pediatric residents are involved in the diagnosis, treatment, and prevention of influenza during their training; however, gaps in influenza-related knowledge have been reported. The aim of this study was to evaluate the impact of a structured educational seminar on improving pediatric residents’ knowledge of influenza symptoms, complications, treatment, and vaccination practices. Methods. This prospective, single-center, pre-post study included pediatric residents at a tertiary hospital. Participants completed the same structured 25-item questionnaire immediately before and one month after a 60-minute educational seminar on influenza. The questionnaire assessed knowledge of clinical symptoms, transmission routes, antiviral treatment, chemoprophylaxis, and vaccination. Item-level correct response rates and the total knowledge score (range 0-25) were compared between pre- and post-seminar assessments. Results. Sixty-two residents participated. After the seminar, correct response rates increased for several clinical features, including sudden onset of illness (p = 0.006), rapid progressive disease (p = 0.003), diarrhea (p < 0.001), abdominal pain (p < 0.001), febrile seizure (p = 0.003), and complex febrile seizure (p < 0.001). Knowledge regarding transmission routes and oseltamivir-related adverse effects improved significantly (p < 0.05), while chemoprophylaxis-related items showed mixed changes in correct response rates. The total knowledge score increased from 14 (interquartile range [IQR]: 12-16.25) to 18 (IQR: 15-21) after the seminar (p < 0.001). Conclusion. A single, structured educational seminar was associated with improvements in several domains of influenza-related knowledge among pediatric residents. The observed declines in selected chemoprophylaxis items indicate that some topics may require …
subject: Short Communication
  topic: section
subject: children
  topic: keywords
subject: influenza
  topic: keywords
subject: post-training
  topic: keywords
subject: resident
  topic: keywords
subject: survey
  topic: keywords
creator: Pınar Garipçin Sarı
creator: Yıldız Ekemen Keleş
creator: Esra Bal Yüksel
creator: Eda Karadağ Öncel
creator: Ahu Kara Aksay
creator: Dilek Yılmaz
rights: Copyright (c) 2026 The Author(s) https://creativecommons.org/licenses/by/4.0
date: 2026-02-27
publication date: 2026-02-27
starting page: 130
ending page: 137
doi: 10.24953/turkjpediatr.2026.6530

Prognostic significance of serum apelin-13 and galectin-3 concentrations as potential indicators of severity and mortality in pediatric acute respiratory distress syndrome
type: item
description: Background. The predictive and prognostic significance of apelin and galectin-3 as biomarkers in pediatric acute respiratory distress syndrome (PARDS) and lung injury has remained limited. This study examined the association between serum apelin-13 and galectin-3 levels, PARDS severity, and patient outcomes. Methods. The study included children aged 1 month to 18 years diagnosed with PARDS on admission to a pediatric intensive care unit, alongside age- and sex-matched outpatient controls. PARDS was diagnosed and classified by severity according to Second Pediatric Acute Lung Injury Consensus Conference (PALICC-2) guidelines, based on oxygenation indices for non-invasive and invasive ventilation. Exclusion criteria included prior transplants, chronic lung disease, cyanotic congenital heart disease, prolonged ventilation, and other major conditions. After informed parental consent, 3 mL of peripheral venous blood was collected from all participants. Serum samples for apelin-13 and galectin-3 were stored at −80°C and analyzed using commercial enzyme-linked immunosorbent assay (ELISA) kits. Demographic, clinical, and laboratory data were systematically recorded for analysis. Results. The study and control groups were comparable in age and gender. Patients had significantly lower hemoglobin, hematocrit, red blood cell, calcium, and phosphorus levels, and higher neutrophil counts, C-reactive protein, and liver enzymes. Apelin-13 levels did not differ significantly between groups, wheras median galectin-3 levels were significantly higher in patients (p=0.003). Apelin-13 levels were significantly lower and galectin-3 levels significantly higher with increasing PARDS severity. Severe PARDS was associated with lower PaO2/FiO2 ratios, arterial pH, and higher ventilator pressures. Mortality was 36.4% in severe and 22.7% in moderate PARDS. Serum galectin-3 level was the sole independent predictor of mortality (OR: 1.20, 95% CI 1.02–1.39, p=0.02). Conclusion. Although the apelin/…
subject: Original Article
  topic: section
subject: apelin-13
  topic: keywords
subject: biomarkers
  topic: keywords
subject: galectin-3
  topic: keywords
subject: pediatric acute respiratory distress syndrome (PARDS)
  topic: keywords
subject: prognosis
  topic: keywords
creator: Serçin Taşar
creator: Nuri Alacakır
creator: İsmail Bulut
creator: Ayşe Esra Tapcı
creator: Gül Kırtıl
creator: Naz Koçoğlu
creator: Rukiye Ünsal Saç
creator: Medine Ayşin Taşar
rights: Copyright (c) 2026 The Author(s) https://creativecommons.org/licenses/by/4.0
date: 2026-02-27
publication date: 2026-02-27
starting page: 68
ending page: 78
doi: 10.24953/turkjpediatr.2026.6648

The impact of hematocrit, punch location, and cellular interference on neonatal screening for biotinidase deficiency
type: item
description: Background. Biotinidase deficiency is a core condition in newborn screening programs worldwide. While fluorometric enzyme activity assays from dried blood spots (DBS) are the standard first-tier test, their accuracy can be susceptible to pre-analytical variation. To date, the specific impact of hematocrit (HCT), punch location, and cellular interference on fluorometric biotinidase measurements have not been systematically examined. Methods. We prepared blood pools to isolate specific variables: a reference pool at 50% HCT (HCT50), a low-HCT pool at 34% (HCT34), and a leukocyte-depleted pool (HCT50(-W)). Secondary pools were created with biotinidase activities of 0, 50, 100, and 200 U. DBS samples were prepared from all pools. Biotinidase activity was measured fluorometrically from central and peripheral punches (n=12 per condition). Statistical analysis included t-tests and Cohen’s d effect sizes, with a >10% deviation set as the threshold for clinical significance. Results. Our results demonstrated a significant systematic bias: Peripheral punches yielded higher biotinidase activity than central punches across all sample types (13.36%–16.61% difference, p<0.05). Lower hematocrit (HCT34) led to a significant overestimation of activity, yielding >20% higher values at the critical biotinidase activity-50 U level. Crucially, leukocyte depletion resulted in a statistically significant decrease in measured activity (~10.6%, p<0.05), indicating that approximately 10% of the quantified activity in DBS is leukocyte-derived and constitutes a previously unaccounted source of analytical bias. Conclusion. This study is the first to definitively quantify the effects of key pre-analytical variables on fluorometric biotinidase testing. Punch location, hematocrit, and cellular content are not merely sources of noise but are significant confounders that can lead to both false-positive and false-negative results. We strongly recommend that DBS calibrators and patient samples be punch…
subject: Original Article
  topic: section
subject: biotinidase deficiency
  topic: keywords
subject: newborn screening
  topic: keywords
subject: dried blood spot testing
  topic: keywords
subject: punch location
  topic: keywords
subject: hematocrit
  topic: keywords
subject: filter paper
  topic: keywords
creator: Ceyhan Ceran Serdar
rights: Copyright (c) 2026 The Author(s) https://creativecommons.org/licenses/by/4.0
date: 2026-02-27
publication date: 2026-02-27
starting page: 107
ending page: 119
doi: 10.24953/turkjpediatr.2026.6966

Problematic social media use and eating behaviors in adolescence: gender-based differences
type: item
description: Background. Adolescence is a key period for shaping eating behaviors. Social media, central to identity formation and peer interaction, may influence diet through appearance-related mechanisms, with possible gender differences. This study investigated associations between social media use, addiction, and disorder with eating behaviors among Turkish adolescents, focusing on the mediating role of appearance-related social media consciousness. Methods. A cross-sectional survey was conducted with 487 high school students aged 14–18 years in Manavgat, Antalya, Türkiye. Measures included the Social Media Addiction Scale for Adolescents (SMASA), Social Media Disorder Scale (SMDS), Appearance-Related Social Media Consciousness Scale (ASMC), Scale of Effects of Social Media on Eating Behavior (SESMEB) and Eating Habits Questionnaire for Adolescents (EHQA). Non-parametric tests were used due to non-normal data distributions; gender-stratified multiple regression models identified independent predictors of unhealthy eating habits. Simple mediation analyses (PROCESS Model 4) were performed to test indirect effects, as mediation models allow evaluation of whether ASMC explains the pathway between social media–related variables and unhealthy eating. Results. Female adolescents reported longer daily social media use than males (median = 3.0 vs. 2.0 hours, p < 0.05). Across genders, healthy eating (EHQA) was negatively correlated with ASMC and SESMEB (all p < 0.01). Regression analyses showed that SMDS, ASMC, and SESMEB were significant predictors of unhealthy eating among females, while ASMC and SESMEB predicted unhealthy eating among males. Mediation analyses showed partial mediation in females in both models (SMASA → ASMC → EHQA; SMDS → ASMC → EHQA), with both direct and indirect effects being significant. In males, direct effects were non-significant, whereas indirect effects were significant. Conclusions. Problematic social media use was associated with unhealthy eating among …
subject: Original Article
  topic: section
subject: adolescent behavior
  topic: keywords
subject: body image
  topic: keywords
subject: feeding behavior
  topic: keywords
subject: social media
  topic: keywords
creator: Büşra Başar Gökcen
creator: Ozan Fırat Varol
rights: Copyright (c) 2026 The Author(s) https://creativecommons.org/licenses/by/4.0
date: 2026-02-27
publication date: 2026-02-27
starting page: 38
ending page: 53
doi: 10.24953/turkjpediatr.2026.7083

Authors’ reply to the letter “Beyond contamination rates: a broader lens on diagnosing neonatal sepsis”
type: item
subject: Letter to the Editor
  topic: section
creator: Şebnem Çalkavur
creator: Oğuz Han Kalkanlı
creator: Tuna Ketenci
creator: Nazan Kavas
creator: Miray Yılmaz Çelebi
creator: Arzu Bayram
creator: İlker Devrim
rights: Copyright (c) 2026 The Author(s) https://creativecommons.org/licenses/by/4.0
date: 2026-02-27
publication date: 2026-02-27
starting page: 166
ending page: 167
doi: 10.24953/turkjpediatr.2026.7245

Assessment of hormone measurement methods in girls with premature adrenarche, polycystic ovary syndrome, and non-classical congenital adrenal hyperplasia
type: item
description: Introduction. Hyperandrogenism is a clinical condition in girls, resulting from excessive androgen production originating from the adrenal glands or ovaries. The measurement of androgen hormones plays an essential role in supporting the clinical diagnosis. These hormone levels can be assessed using immunoassay methods or liquid chromatography – tandem mass spectrometry (LC-MS/MS). Our study aimed to assess the efficacy of hormone measurement with both methods in girls clinically diagnosed with hyperandrogenism. Methods. Girls presenting with hyperandrogenism were included in this cross-sectional retrospective study. The exclusion criteria included a diagnosis of precocious puberty, classical congenital adrenal hyperplasia (CAH), adrenocortical tumors, and the use of medications known to affect androgen levels. Hormones measured simultaneously by both methods were compared. Regression analysis was performed to adjust hormone levels for age and pubertal stage. Receiver operating characteristic (ROC) analysis was performed based on diagnosis, and androgen hormones with the highest specificity and sensitivity for diagnosis were identified. Results. A total of 96 girls with hyperandrogenism were included in the study. 60 (62.5%) were diagnosed with premature adrenarche (PA), 31 (32.3%) with polycystic ovary syndrome (PCOS), and 5 (5.2%) with non-classical congenital adrenal hyperplasia (NCCAH). Dehydroepiandrosterone sulfate (DHEAS) measured by LC-MS/MS was significantly lower (p<0.001) but less concordant with clinical diagnosis than electrochemiluminescence immunoassay in PA cases. The androgen hormone with the highest area under the curve (AUC) value was androstenedione for PCOS (AUC: 0.792), and 17-hydroxyprogesterone (AUC: 0.994) using LC-MS/MS for NCCAH. Conclusions. The measurement of DHEAS levels by both methods has low specificity. Androstenedione and total testosterone measured by LC-MS/MS had the highest sensitivity and specificity in PCOS.
subject: Original Article
  topic: section
subject: hyperandrogenism
  topic: keywords
subject: liquid chromatography – tandem mass spectrometry
  topic: keywords
subject: premature adrenarche
  topic: keywords
subject: polycystic ovary syndrome
  topic: keywords
creator: Mert Uçar
creator: Aysun Ata
creator: Burcu Barutçuoğlu
creator: Güneş Ak
creator: Sara Habif
creator: Zühal Parıldar
creator: Damla Gökşen
creator: Şükran Darcan
creator: Samim Özen
rights: Copyright (c) 2025 The Author(s) https://creativecommons.org/licenses/by/4.0
date: 2025-10-20
publication date: 2025-10-20
starting page: 692
ending page: 699
doi: 10.24953/turkjpediatr.2025.5939

Response to modulator therapy in a cystic fibrosis patient with a single identified CFTR variant not eligible for modulator treatment
type: item
description: Background. Cystic fibrosis (CF) is a multisystem disease caused by variants in the CF transmembrane conductance regulator (CFTR) gene affecting ion transport. CFTR modulator therapy has become a significant treatment option for many CF patients. However, access to modulator therapy remains a challenge for cases with rare variants. Case Presentation. Our 9-year-old female patient, diagnosed with CF by elevated sweat chloride and history of steatorrhea from birth, carried the rare W1282X variant with no clear eligibility for modulator therapy. The family self-financed one month of elexacaftor / tezacaftor / ivacaftor (ETI) treatment. After one-month, clinical evaluation showed improvements in body mass index (BMI; 14.98 to 15.05 kg/m2), an increase in forced expiratory volume in 1 second (FEV1%) by 12% (72% to 84%), decreased sweat chloride levels (from 83 mEq/L to 9 mEq/L), and enhanced exercise capacity. No pulmonary exacerbations occurred during therapy. Based on these findings, modulator therapy approval was obtained for continued treatment. Our patient is currently 10 years old and has been on modulator therapy for approximately 12 months. Conclusions. Facilitating access to modulator therapies for patients with rare mutations is crucial, considering the potential long-term complications of CF. While organoid studies may not always predict clinical response, real-world cases demonstrate clinically meaningful benefit despite lack of organoid responsiveness. Short-term assessment of modulator response may not adequately reflect improvement in pulmonary function or exacerbation frequency, but decreases in sweat chloride, improvements in nutritional and functional parameters such as weight, BMI, and exercise capacity may be indicative of improvement in pulmonary function and exacerbation rates.
subject: Case Report
  topic: section
subject: cystic fibrosis
  topic: keywords
subject: CFTR modulatory therapy
  topic: keywords
subject: W1282X
  topic: keywords
creator: Mukaddes Ağırtıcı
creator: Merve Nur Tekin
creator: Secahattin Bayav
creator: Esin Gizem Olgun
creator: Emine Semra Küçük Öztürk
creator: Nazan Çobanoğlu
rights: Copyright (c) 2025 The Author(s) https://creativecommons.org/licenses/by/4.0
date: 2026-02-27
publication date: 2026-02-27
starting page: 138
ending page: 142
doi: 10.24953/turkjpediatr.2025.6369

Exploring the link between adenovirus infection and Guillain-Barré syndrome in children: a case-based analysis
type: item
description: Background. Adenovirus infections are commonly associated with respiratory tract infections, conjunctivitis, gastrointestinal disturbances, and in some cases, more severe illnesses such as pneumonia. Guillain-Barré syndrome (GBS), a rare autoimmune disorder that causes progressive peripheral nerve inflammation and paralysis, has been linked to various infections, including viral ones. Case Presentation. We describe two newly diagnosed pediatric cases of GBS following adenovirus infection. Both patients were previously healthy boys, aged 3 and 6 years. Adenovirus was detected by nasopharyngeal PCR shortly preceding the neurological manifestations. Both were treated with intravenous immunoglobulin (IVIG); one also required plasma exchange and respiratory support. Both recovered fully during follow-up. Additionally, a relevant case from the literature was reviewed for comparison. Treatment included respiratory support, IVIG and plasma exchange therapy. During the 12-month follow-up no severe complications were observed in our patients. Conclusions. In conclusion, while GBS is a well-established complication of several viral infections, including adenovirus, the association between adenovirus and GBS remains relatively underexplored. Our case reports, along with a review of the literature, highlight the rare but plausible link between adenovirus infection and the development of GBS. Although adenovirus infections are common, the occurrence of GBS following these infections appears to be uncommon, suggesting that additional factors may be at play. However, given the potential severity of GBS and the growing body of evidence, it is important for clinicians to remain vigilant for this rare complication in patients with a history of adenovirus infection.
subject: Case Report
  topic: section
subject: Guillain-Barré syndrome
  topic: keywords
subject: adenovirus
  topic: keywords
subject: respiratory tract infection
  topic: keywords
creator: Gulrukh Tuychiboeva
creator: İbrahim Öncel
creator: Gökçen Çoban Çifci
creator: Ali Bülent Cengiz
creator: Kübra Aykaç
rights: Copyright (c) 2026 The Author(s) https://creativecommons.org/licenses/by/4.0
date: 2026-02-27
publication date: 2026-02-27
starting page: 150
ending page: 155
doi: 10.24953/turkjpediatr.2026.6729

Neuroblastoma-associated opsoclonus-myoclonus-ataxia syndrome: an important yet overlooked diagnosis in pediatric ataxia
type: item
description: Background. Opsoclonus-myoclonus-ataxia syndrome (OMAS) is a rare, immune-mediated neurological disorder, often associated with neuroblastoma (NB) in children. This study aimed to describe the clinical features, diagnostic challenges, treatment, and outcomes of pediatric patients with NB-associated OMAS. Methods. We retrospectively reviewed medical records of seven children diagnosed with NB-associated OMAS between November 1, 2015 and January 31, 2025. Data on demographics, clinical presentation, tumor characteristics, treatment protocols, relapses, and outcomes were collected. The Mitchell-Pike OMS Rating Scale was used to assess severity. Results. The cohort included four girls and three boys, aged 18–36 months (median 31). All had a history of infection and/or vaccination preceding symptom onset. Ataxia was the most common initial symptom (6/7, 85.7%), followed by behavioral disturbances and sleep disorders (5/7, 71.4% each). At presentation, opsoclonus was present in two patients, which was initially misdiagnosed as nystagmus. All but one patient had opsoclonus during the disease course. Neuroblastomas were located in abdominal (n=4), thoracic (n=1), and sacral (n=2) regions; all tumors measured <50 mm and were stage L1. First-line treatment included tumor resection, intravenous immunoglobulin, and corticosteroids. Three patients required second-line therapy (rituximab, cyclophosphamide, mycophenolate mofetil, or azathioprine). After a median follow-up of 40 months (range 26-64), four patients had no neurological sequelae; three had mild cognitive impairment. Conclusion. NB-associated OMAS may present with non-specific symptoms, leading to diagnostic delays. Early recognition, thorough tumor screening, and prompt immunotherapy may improve neurological outcomes. Clinicians should suspect NB in children presenting with ataxia and behavioral/sleep disturbances, even in the absence of opsoclonus or abnormal findings on initial imaging.
subject: Original Article
  topic: section
subject: Opsoclonus-myoclonus syndrome
  topic: keywords
subject: ataxia
  topic: keywords
subject: neuroblastoma
  topic: keywords
subject: behavioral symptoms
  topic: keywords
subject: sleep disorders
  topic: keywords
subject: immunotherapy
  topic: keywords
creator: Ayfer Arduç Akçay
creator: Banu Oflaz Sözmen
creator: Mehmet Fatih Erbey
creator: Serap Uysal
creator: Rejin Kebudi
rights: Copyright (c) 2026 The Author(s) https://creativecommons.org/licenses/by/4.0
date: 2026-02-27
publication date: 2026-02-27
starting page: 120
ending page: 129
doi: 10.24953/turkjpediatr.2026.6821

Turkish pediatricians’ knowledge, attitudes, and awareness of respiratory syncytial virus (RSV) infection and immunization strategies: a cross-sectional study
type: item
description: Background. This study aims to assess Turkish pediatricians’ knowledge and attitudes regarding respiratory syncytial virus (RSV) infection and its current immunization strategies. Methods. From May 10 to June 4, 2024, we invited 1603 pediatricians who subscribed to the website of The Turkish Pediatrics Atelier via e-mail to respond to an online questionnaire. A total of 401 pediatricians responded. Results. Of pediatricians, 11% stated that they routinely use chest X-ray (CXR) for diagnosing RSV illness. When managing RSV-positive patients, while 44.4% of pediatricians indicated that they need a CXR if there are lung auscultation findings, the rate of routine CXR usage was 22.7%. While most pediatricians (74.8%) stated that they prefer nebulized salbutamol and/or corticosteroid; 43.4% used hypertonic saline; and 22.7% used nebulized epinephrine as a treatment option. While 60.3% of pediatricians had no information about the maternal RSV vaccine; 58.1% stated that they would recommend it to only willing women; 16% stated that they would not recommend it; and 25.9% indicated that they would recommend it to every pregnant individual. While most pediatricians (79.8%) had knowledge about nirsevimab; 14% indicated that it was not approved in children worldwide; 49.1% stated that it is more effective than palivizumab; and 37.9% indicated that they would start administrating it immediately after its approval and availability in Türkiye. Conclusions. The use of CXR and administration of non-evidence-based therapies in diagnosing and managing RSV illness were relatively high. Additionally, there is a notable gap in knowledge and awareness regarding the maternal RSV vaccine and nirsevimab.
subject: Original Article
  topic: section
subject: respiratory syncytial virus
  topic: keywords
subject: immunization
  topic: keywords
subject: nirsevimab
  topic: keywords
subject: pediatrician
  topic: keywords
creator: İsmail Yıldız
creator: Erdem Gönüllü
creator: Sıla Yılmaz
creator: Elvan Zengin
creator: Osman Yeşilbaş
creator: Ahmet Soysal
rights: Copyright (c) 2025 The Author(s) https://creativecommons.org/licenses/by/4.0
date: 2025-05-02
publication date: 2025-05-02
starting page: 153
ending page: 161
doi: 10.24953/turkjpediatr.2025.5528

https://turkjpediatr.org/article/view/8115
type: item
title: Author Correction to: “Turkish pediatricians’ knowledge, attitudes, and awareness of respiratory syncytial virus (RSV) infection and immunization strategies: a cross-sectional study.” [Turk J Pediatr 2025; 67: 153-161.]
subject: Corrigendum
  topic: section
creator: İsmail Yıldız
creator: Erdem Gönüllü
creator: Sıla Yılmaz
creator: Elvan Zengin
creator: Osman Yeşilbaş
creator: Ahmet Soysal
rights: Copyright (c) 2026 The Author(s) https://creativecommons.org/licenses/by/4.0
date: 2026-02-27
publication date: 2026-02-27
starting page: 173
ending page: 173
doi: 10.24953/turkjpediatr.2026.8115

https://turkjpediatr.org/article/view/8020
type: item
title: Author Correction to: “Assessment of hormone measurement methods in girls with premature adrenarche, polycystic ovary syndrome, and non-classical congenital adrenal hyperplasia.” [Turk J Pediatr 2025; 67: 692-699.]
subject: Corrigendum
  topic: section
creator: Mert Uçar
creator: Aysun Ata
creator: Burcu Barutçuoğlu
creator: Güneş Ak
creator: Sara Habif
creator: Zühal Parıldar
creator: Damla Gökşen
creator: Şükran Darcan
creator: Samim Özen
rights: Copyright (c) 2026 The Author(s) https://creativecommons.org/licenses/by/4.0
date: 2026-02-27
publication date: 2026-02-27
starting page: 172
ending page: 172
doi: 10.24953/turkjpediatr.2026.8020

Clinical significance of human herpesvirus 6 detected in cerebrospinal fluid: a 10-year retrospective study in children
type: item
description: Background. Human herpesvirus 6 (HHV-6) is occasionally detected in the cerebrospinal fluid (CSF) of young children, but its clinical significance remains uncertain. This study aimed to describe HHV-6–positive cases and to explore features that may help distinguish presumed infection from bystander detection. Methods. We retrospectively reviewed pediatric patients with CSF HHV-6 detected by multiplex polymerase chain reaction or the FilmArray Meningitis/Encephalitis (FA-ME) panel between January 2015 and March 2025 at a single tertiary hospital. Cases were categorized as presumed HHV-6 infection or bystander detection based on clinical features and the presence of alternative pathogens or diagnoses. Clinical and laboratory findings were compared between the two groups. Results. Among 1,865 children tested, HHV-6 was detected in 25 (1.3%; median age, 6 months), all of whom presented with fever. Seizures occurred in seven (28%) and ataxia in one (4%). Two patients developed encephalitis; one had abnormal imaging and later developed epilepsy. Seventeen patients were classified as presumed infection. In this group, rash was more prevalent (59% vs. 13%, p = 0.04), neutrophil and platelet counts were lower at admission and declined further at follow-up (p < 0.05), and aspartate aminotransferase (AST) levels were higher (p < 0.01) than those in the bystander infection group. CSF pleocytosis did not differ significantly between groups. Two patients received ganciclovir; both had HHV-6 detected early by the FA-ME panel, and one was subsequently diagnosed with bacterial sepsis. Conclusions. HHV-6 encephalitis was uncommon. Rash, changes in neutrophil and platelet counts, along with elevated AST levels may help interpret CSF HHV-6 detection, but these findings require validation in larger studies incorporating virologic confirmation.
subject: Original Article
  topic: section
subject: human herpesvirus 6
  topic: keywords
subject: cerebrospinal fluid
  topic: keywords
subject: exanthema
  topic: keywords
subject: cytopenia
  topic: keywords
creator: Jung Sook Yeom
creator: Young-Soo Kim
creator: Ji Sook Park
creator: Eun Sil Park
creator: Ji-Hyun Seo
creator: Jae-Young Lim
creator: Hyang-Ok Woo
rights: Copyright (c) 2025 The Author(s) https://creativecommons.org/licenses/by/4.0
date: 2025-12-24
publication date: 2025-12-24
starting page: 829
ending page: 840
doi: 10.24953/turkjpediatr.2025.6969