Tạp chí Nhi khoa

IMPLEMENTATION OF HOME-BASED ORAL FOOD CHALLENGE IN CHILDREN WITH NON-IGE-MEDIATED COW’S MILK PROTEIN ALLERGY SAFETY AND FEASIBILITY

Le Thi Bich Phuong, Nguyen Thi Kim Oanh, Nguyen Thi Ngoc, Nguyen Anh Tuan — Mon, 18 May 2026 00:00:00 +0000

This study aimed to evaluate the safety, feasibility, and diagnostic value of the slow, mainly home-based oral food challenge (OFC) protocol in children with non-IgE-mediated cow’s milk allergy (CMA). A cross-sectional study was conducted on 51 children, mostly under 2 years old, examined at Children’s Hospital 1 from July 2024 to July 2025. All participants underwent the slow-protocol OFC, starting with 30 mL of cow’s milk at the hospital, followed by gradual dose increases of 30 mL every 2–3 days at home, under remote medical supervision. Results showed that 78.4% of children tolerated cow’s milk again, while 21.6% had a positive OFC response, mainly presenting with mild to moderate gastrointestinal or skin symptoms. No severe adverse events were recorded. Symptoms appeared between day 2 and day 19 after dose escalation began; the median time from OFC initiation to final diagnosis was 28 days (IQR 20–30). The slow-protocol OFC conducted at home proved to be safe, feasible, and diagnostically valuable in pre-screened children, as the majority of those initially suspected of allergy were found to tolerate cow’s milk after a period of elimination.

FACTORS ASSOCIATED WITH THE SEVERITY OF COMMUNITY - ACQUIRED PNEUMONIA IN CHILDREN AT CAN THO CHILDREN’S HOSPITAL, 2024 - 2025

Tran Quang Khai, Bui Quang Nghia, Lam Minh Diep — Mon, 18 May 2026 00:00:00 +0000

Objectives: To investigate the factors associated with the severity of community - acquired pneumonia (CAP) in children at Can Tho Children’s Hospital from 2024 to 2025.

Methods: A cross - sectional descriptive study was conducted on 113 children admitted to the Respiratory Department of Can Tho Children’s Hospital from June 2024 to June 2025.

Results: Children with CAP are most commonly under 5 years of age (71.7%). The predominant clinical symptoms included cough (100%), fever (87.6%), tachypnea (87.6%), and crackles (89.4%). Elevated neutrophil count accounted for 61.1% and lymphocytes accounted for 54.9%. Severe CAP accounted for 18.6%. Tachycardia and elevated lymphocyte count were significantly associated with severe CAP, with odds ratios of 6.18 (95%CI: 1.72 - 22.12; p=0.005) and 4.41 (95%CI: 1.14 - 17.09; p=0.032), respectively.

Conclusion: Tachycardia and elevated lymphocyte count are two independent factors significantly associated with the severity of CAP in children.

PREVALENCE OF VITAMIN D DEFICIENCY AND ASSOCIATED FACTORS IN CHILDREN AGED 6 MONTHS TO 16 YEARS AT SUNGROUP INTERNATIONAL HOSPITAL IN 2024-2025

Mon, 18 May 2026 00:00:00 +0000

Objective: To determine the prevalence of vitamin D deficiency and describe associated factors among children aged 6 months to 16 years attending the Pediatrics - Vaccine Department, SunGroup International Hospital, during 2024-2025.

Subjects and Methods: A cross-sectional descriptive study was conducted on 120 conveniently selected children. Clinical information, medical history, nutritional and environmental factors were collected, and serum 25-hydroxyvitamin D [25(OH)D] levels were measured at the hospital’s Laboratory Department. Vitamin D status was classified according to the Global Consensus Recommendations (2016). Associations were analyzed using Chi-square tests and logistic regression.

Results: Among 120 participants, the mean serum vitamin D concentration was 23.7 ± 7.68 ng/ml. Vitamin D deficiency (<20 ng/ml) accounted for 37.7%, insufficiency (20-29 ng/ml) for 46.7%, while only 15.6% of children achieved sufficient levels (≥30 ng/ml). The prevalence of vitamin D deficiency in children aged 6-16 years is 4.88 times higher than that in children aged 6 months to 6 years. Children without vitamin D supplementation were 4.53 times more likely to be deficient than those receiving supplementation. The prevalence of deficiency was higher among exclusively breastfed children compared to those fed formula or mixed feeding. No significant associations were found between vitamin D status and nutritional condition, dyslipidemia, outdoor activity, or screen time.

Conclusion: The prevalence of vitamin D deficiency among children attending Sun Hospital in 2024-2025 was 37.7%. Deficiency was more common in children aged ≥6 years, those without supplementation, and those exclusively breastfed.

TWIN SISTER WITH SURFACTANT DISORDER MECHANISM DUE TO MUTATION IN SFTPC AT VIETNAM NATIONAL CHILDREN’S HOSPITAL

Mon, 18 May 2026 00:00:00 +0000

The twin sisters were identified mutation inSFTPC, leading to a surfactant disorder mechanism, at the Vietnam National Children’s Hospital. 15-month-old girls had a history of pneumonia and required ventilation when they were 3 months old, subsequently depending on oxygen support. Clinical examinations revealed chronic hypoxemia, finger clubbing, malnutrition, and the need for daily oxygen support at home. A clinical targeted genes related to childhood interstitial lung diseases was sequenced and a pathogenic missense variant c.218T>C (p.Ile73Thr) in SFTPCwas identified. Following the Delphi consensus, the patients are currently being treated with oral prednisolone, hydroxychloroquine, and azithromycin. Their mother was advised to purchase CPAP equipment for home respiratory support. However, acquiring CPAP is challenging due to its cost, not only for the machine but also for the accompanying staff required for daily home visits. Pediatric lung transplantation presents another difficult decision for the family, given the 50% success rate and the limited availability of centers capable of performing this procedure worldwide. Despite the emergence of new treatments for conditions due to mutations in SFTPC, treating these rare patients remains a challenge for pediatricians.

RECURRENT PNEUMONIA IN A PEDIATRIC PATIENT WITH CONGENITAL IMMUNODEFICIENCY DUE TO NUCLEOTIDE SUBSTITUTION MUTATION IN THE IKZF1 GENE

Nguyen Thi Thu Suong, Tran Anh Tuan — Mon, 18 May 2026 00:00:00 +0000

Background: Congenital immunodeficiency is an underlying cause of recurrent pneumonia in children. Mutations in the IKZF1 gene have been associated with immunodeficiency phenotypes that can lead to recurrent infections.

Methods: We report a case of a 7-month-old female infant with recurrent severe pneumonia and genetic testing revealing a pathogenic variant in the IKZF1 gene.

Results: The patient had recurrent pneumonia requiring prolonged hospitalization. Genetic analysis revealed a heterozygous, dominant missense mutation in the IKZF1 gene (chr7:50382594; c.476A>G; p.Asn159Ser), accompanied by deletions on chromosomes 17 (q12) and 18 (p11.32-p11.21). Treatment with intravenous immunoglobulin (IVIg) led to significant clinical improvement.

Conclusion: This case highlights the association between IKZF1 mutations and congenital immunodeficiency with recurrent pneumonia, underscoring the importance of early genetic diagnosis and targeted therapy.

WERNICKE’S ENCEPHALOPATHY IN PEDIATRIC PATIENTS AFTER LIVER TRANSPLANT SURGERY: CLINICAL CASE REPORT

Dang Anh Duong, Nguyen Duc Thuong, Nguyen Dung Tien — Mon, 18 May 2026 00:00:00 +0000

Pediatric liver transplantation has become increasingly important in the management of chronic liver diseases in children. During the postoperative intensive care period, several risk factors may impair absorption and alter the metabolism of essential vitamins, including vitamin B1. Deficiency of vitamin B1 can lead to Wernicke encephalopathy, which often presents clinically in a manner similar to acute encephalopathy. In this report, we describe a case of a 6-year-old girl who underwent living-donor liver transplantation from an unrelated donor. Nineteen days after surgery, the patient developed seizures accompanied by a decreased level of consciousness. Brain MRI revealed hyperintense lesions around the aqueduct and in the occipital region. After excluding other potential causes of impaired consciousness, blood samples were obtained for vitamin B1 quantification and the patient was administered intramuscular vitamin B1. Within two days of treatment, the patient showed marked neurological improvement and complete cessation of seizures. Subsequent testing confirmed a severe deficiency of vitamin B1. This is a rare and easily overlooked complication after liver transplantation.

UPDATE GUIDELINES FOR FOOD ALLERGY PREVENTION IN INFANTS AND YOUNG CHILDREN

Vo Le Vi Vi, Ngo Thi Thu Hien, Tran Anh Tuan, Nguyen Anh Tuan — Mon, 18 May 2026 00:00:00 +0000

Food allergies are increasing and have become a major global health concern. Prevention strategies have shifted from allergen avoidance to controlled early exposure. The latest guidelines on food allergy prevention in children, focus on maternal diet, infant nutrition, skin interventions, and the early introduction of food allergens. Analysis of recent studies, clinical trials and international guidelines show that allergen avoidance is unnecessary during pregnancy or breastfeeding; while breastfeeding has benefits, it does not prevent food allergies. Early introduction of eggs and peanut around 4–6 months reduces the risk of allergies. Skin barrier protection and the management of atopic dermatitis play a crucial role. Controlled early exposure promotes immune tolerance and lowers the risk of developing food allergies. Future research will explore immune mechanisms, the gut microbiome, and personalized interventions.

HIGH-FLOW NASAL CANNULA (HFNC) THERAPY FOR NEONATES

Le Thi Ha, Tran Thi Thanh Hang, Nguyen Thi Hoa — Mon, 18 May 2026 00:00:00 +0000

High-Flow Nasal Cannula (HFNC) therapy is a non-invasive respiratory support method that delivers a blend of air and oxygen at flow rates equal to or exceeding the patient’s inspiratory demand. It helps reduce the work of breathing, provides positive end-expiratory pressure (PEEP), washes out dead space, and preserves the respiratory mucosa using heated and humidified gas. The gas flow rate provided to the patient can range from 2 to 60 L/min.

The first High-Flow (HFNC) delivery devices were introduced around the 2000s, and several studies on the application of HFNC showed a significant reduction in intubation rates among children in pediatric intensive care and neonatal emergency units.

Many scientific studies and clinical practice guidelines on HFNC from medical societies worldwide, such as the European Respiratory Society [1], the European Society of Intensive Care Medicine [2], and the American Association for Respiratory Care [3], have been published. Guidelines from these global societies agree on the efficacy, timing of use, and benefits of HFNC in reducing intubation rates or facilitating early weaning from mechanical ventilation in respiratory diseases, thereby reducing hospital length of stay and treatment costs.

A study using HFNC on 298 children under 24 months of age with bronchiolitis, upper airway obstruction, and cardiovascular/neuromuscular diseases showed a reduction in the intubation rate in the Intensive Care Unit from 37% to 7% [4].

Another study in the US on 848 children with a mean age of 4.6 years suffering from bronchiolitis showed a reduction in intubation rates from 11% to 2% [5].

Several randomized controlled trials (RCTs) have compared the efficacy of HFNC and CPAP following extubation in neonates.

Conclusions from these studies suggest that HFNC can replace CPAP when the infant is clinically stable but still requires respiratory support greater than low-flow oxygen.

Studies comparing HFNC and CPAP in the initial management of respiratory distress immediately after birth show that CPAP has a lower treatment failure rate compared to HFNC when used as primary support; however, the indication for intubation in both groups was equivalent.