Journal of Yeungnam Medical Science

Review articles

Pediatric headache: a narrative review: Saeyoon Kim; J Yeungnam Med Sci. 2022;39(4):278-284. Published online September 14, 2022; DOI: https://doi.org/10.12701/jyms.2022.00528

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Headache is one of the most common neurological disorders in children and adults and can cause significant distress and disability in children and their families. The spectrum of pediatric headaches is broad, and the underlying etiology is variable. The symptoms and phenotypes of headaches in children may differ slightly from those in adults. It is important to have a good understanding of headaches in children and to distinguish between primary and secondary headaches through appropriate history assessment and neurological examination. Accurate diagnosis and appropriate drug selection are helpful for effective treatment. This article reviews headaches in children and adolescents, focusing on approaches for diagnosis and management.

Citations

Citations to this article as recorded by

Exploring downstream effects of gender roles in healthcare decision-making and relationships within systems: A cross-sectional analysis of openness to treatment in pediatric headache
Zoë Schefter, Allison M. Smith
Journal of Psychosomatic Research.2024; 179: 111611. CrossRef
Occipital nerve stimulation in pediatric patients with refractory occipital neuralgia
James Mossner, Nour B. Saleh, Maryam N. Shahin, Joshua M. Rosenow, Jeffrey S. Raskin
Child's Nervous System.2024;[Epub] CrossRef
Multivariate prediction of long COVID headache in adolescents using gray matter structural MRI features
Minhoe Kim, Sunkyung Sim, Jaeseok Yang, Minchul Kim
Frontiers in Human Neuroscience.2023;[Epub] CrossRef

Home mechanical ventilation in children with chronic respiratory failure: a narrative review: Soyoung Kwak; J Yeungnam Med Sci. 2023;40(2):123-135. Published online May 27, 2022; DOI: https://doi.org/10.12701/jyms.2022.00227

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Abstract PDF

Advances in perinatal and pediatric intensive care and recent advances in mechanical ventilation during the last two decades have resulted in an exponential increase in the number of children undergoing home mechanical ventilation (HMV) treatment. Although its efficacy in chronic respiratory failure is well established, HMV in children is more complex than that in adults, and there are more considerations. This review outlines clinical considerations for HMV in children. The goal of HMV in children is not only to correct alveolar hypoventilation but also to maximize development as much as possible. The modes of ventilation and ventilator settings, including ventilation masks, tubing, circuits, humidification, and ventilator parameters, should be tailored to the patient’s individual characteristics. To ensure effective HMV, education for the parent and caregiver is important. HMV continues to change the scope of treatment for chronic respiratory failure in children in that it decreases respiratory morbidity and prolongs life spans. Further studies on this topic with larger scale and systemic approach are required to ensure the better outcomes in this population.

Citations

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Indications and practice of home invasive mechanical ventilation in children
Secahattin Bayav, Nazan Çobanoğlu
Pediatric Pulmonology.2024;[Epub] CrossRef
Rehabilitation in children with home invasive mechanical ventilation
Aysun Genç, Birkan Sonel Tur
Pediatric Pulmonology.2024;[Epub] CrossRef
Transitioning children using home invasive mechanical ventilation from hospital to home: Discharge criteria, disparities, and ethical considerations
Jennifer Henningfeld, Annie B. Friedrich, Grace Flanagan, Cynthia Griffith, Anna Hughes, Lisa Molkentine, Rebecca Steuart, Stuart Wilkinson, Christopher D. Baker
Pediatric Pulmonology.2024;[Epub] CrossRef
Mask interfaces and devices for home noninvasive ventilation in children
Sonia Khirani, Vivian Ducrot
Pediatric Pulmonology.2024;[Epub] CrossRef
The follow‐up of children on home invasive mechanical ventilation after hospital discharge
Halime Nayır Büyükşahin, Ebru Yalcın
Pediatric Pulmonology.2023;[Epub] CrossRef
Identifying and managing psychosocial problems in children on home invasive mechanical ventilation
Gizem Özcan, Nazan Çobanoğlu
Pediatric Pulmonology.2023;[Epub] CrossRef
Management of gastrointestinal and nutritional problems in children on home invasive mechanical ventilation
Ceyda Tuna Kirsaçlioğlu
Pediatric Pulmonology.2023;[Epub] CrossRef

Case reports

Successful treatment with vedolizumab in an adolescent with Crohn disease who had developed active pulmonary tuberculosis while receiving infliximab: Sujin Choi, Bong Seok Choi, Byung-Ho Choe, Ben Kang; Yeungnam Univ J Med. 2021;38(3):251-257. Published online February 19, 2021; DOI: https://doi.org/10.12701/yujm.2020.00878

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Abstract PDF

Vedolizumab (VDZ) has been approved for the treatment of inflammatory bowel diseases (IBDs) in patients aged ≥18 years. We report a case of a pediatric patient with Crohn disease (CD) who was successfully treated with VDZ. A 16-year-old female developed severe active pulmonary tuberculosis (TB) during treatment with infliximab (IFX). IFX was stopped, and TB treatment was started. After a 6-month regimen of standard TB medication, her pulmonary TB was cured; however, gastrointestinal symptoms developed. Due to the concern of the patient and parents regarding TB reactivation on restarting treatment with IFX, VDZ was started off-label. After the second dose of VDZ, the patient was in clinical remission and her remission was continuously sustained. Ileocolonoscopy at 1-year after VDZ initiation revealed endoscopic healing. Therapeutic drug monitoring conducted during VDZ treatment showed negative antibodies to VDZ. No serious adverse events occurred during the VDZ treatment. This is the first case report in Korea demonstrating the safe and effective use of VDZ treatment in a pediatric CD patient. In cases that require recommencement of treatment with biologics after recovery of active pulmonary TB caused by anti-tumor necrosis factor agents, VDZ may be a good option even in pediatric IBD.

Citations

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The safety of vedolizumab in a patient with Crohn’s disease who developed anti-TNF-alpha agent associated latent tuberculosis infection reactivation: A case report
Yuya Sugiyama, Nobuhiro Ueno, Shion Tachibana, Yu Kobayashi, Yuki Murakami, Takahiro Sasaki, Aki Sakatani, Keitaro Takahashi, Katsuyoshi Ando, Shin Kashima, Kentaro Moriichi, Hiroki Tanabe, Toshikatsu Okumura, Mikihiro Fujiya
Medicine.2023; 102(28): e34331. CrossRef
Vedolizumab Is Safe and Efficacious for the Treatment of Pediatric-Onset Inflammatory Bowel Disease Patients Who Fail a Primary Biologic Agent
Sujin Choi, Eun Sil Kim, Yiyoung Kwon, Mi Jin Kim, Yon Ho Choe, Byung-Ho Choe, Ben Kang
Journal of Korean Medical Science.2022;[Epub] CrossRef

Delayed treatment-free response after romiplostim discontinuation in pediatric chronic immune thrombocytopenia: Hyun Ji Lim, Young Tae Lim, Jeong Ok Hah, Jae Min Lee; Yeungnam Univ J Med. 2021;38(2):165-168. Published online August 7, 2020; DOI: https://doi.org/10.12701/yujm.2020.00493

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Abstract PDF

We report the case of a 16-month-old patient with chronic immune thrombocytopenia (ITP) patient who experienced delayed treatment-free response (TFR) after romiplostim treatment. He received intravenous immunoglobulin every month to maintain a platelet count above 20,000/μL for 2 years. Thereafter, he received rituximab and cyclosporine as second-line therapy, with no response, followed by romiplostim. After 4 weeks of treatment, the platelet count was maintained above 50,000/μL. Following 7 months of treatment, he discontinued romiplostim, and the platelet count decreased. His platelet counts remained above 50,000/μL, without any bleeding symptoms, 2 years after romiplostim discontinuation. This is the first report of TFR after romiplostim treatment in pediatric chronic ITP.

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A cost–utility analysis of thrombopoietin receptor agonists for treating pediatric immune thrombocytopenia purpura after failure of first‐line therapies
Huimin Du, Jiamin Wang, Joel Livingston, Ziyad Alrajhi, Melanie Kirby‐Allen, Brian Chan, Rebecca Hancock‐Howard, Peter C. Coyte
Pediatric Blood & Cancer.2023;[Epub] CrossRef
Generic romiplostim for children with persistent or chronic immune thrombocytopenia: Experience from a tertiary care centre in North India
Chandana Mareddy, Manas Kalra, Anupam Sachdeva
British Journal of Haematology.2022; 197(5): 618. CrossRef
Tapering of the thrombopoietin receptor agonist in paediatric patients with chronic immune thrombocytopenia: Is it possible?
María Solsona, Rubén Berrueco, Elena Sebastián, Áurea Cervera, Ana Sastre, Itziar Astigarraga, Bienvenida Argilés, María Ángeles Dasí, José Luís Dapena, Emilio Monteagudo
British Journal of Clinical Pharmacology.2022; 88(9): 4220. CrossRef

Original article

Evaluation of craniofacial morphology in short-statured children: growth hormone deficiency versus idiopathic short stature: Ki Bong Kim, Eun-Kyong Kim, Kyung Mi Jang, Min Seon Kim, Eun Young Park; Yeungnam Univ J Med. 2021;38(1):47-52. Published online July 7, 2020; DOI: https://doi.org/10.12701/yujm.2020.00325

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Abstract PDF

Background
Short stature is defined as a height below the 3rd percentile or more than two standard deviations below the mean for a given age, sex, and population. There have been inconsistent results regarding craniofacial morphology in short-statured children. This study aimed to analyze the differences between short-statured children with growth hormone deficiency, idiopathic short-statured children, and normal children.
Methods
Thirty-one short-statured children with growth hormone deficiency, 32 idiopathic short-statured children, and 32 healthy children were enrolled in this study. The measurements of their craniofacial structures from lateral cephalograms were evaluated.
Results
There were statistically significant differences among the three groups seven variables (anterior cranial base length, posterior cranial base length, total cranial base length, upper posterior facial height, posterior total facial height, mandibular ramus length, and overall mandibular length) in the linear measurement and five variables (saddle angle, gonial angle, mandibular plane angle, position of mandible, and maxilla versus mandible) in the angular measurement.
Conclusion
Compared to the control group, many linear and angular measurements of the craniofacial structures were significantly different in the two short-statured groups (p<0.05). Treatment plans by orthodontists should include these craniofacial structure characteristics.

Citations

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Dental arches in inherited severe isolated growth hormone deficiency
Rafaela S. Girão, Manuel H. Aguiar-Oliveira, Bruna M.R. Andrade, Marcos A.V. Bittencourt, Roberto Salvatori, Evânio V. Silva, André L.M. Santos, Matheus M. Cunha, Wilton M. Takeshita, Alaíde H.A. Oliveira, Eugênia H.O. Valença, Alécia A. Oliveira-Santos,
Growth Hormone & IGF Research.2022; 62: 101444. CrossRef
Sella turcica dimensions and maxillary growth in patients with unilateral cleft lip and palate
Gregory S. Antonarakis, Luis Huanca Ghislanzoni, David M. Fisher
Journal of Stomatology, Oral and Maxillofacial Surgery.2022; 123(6): e916. CrossRef
Clinical Implications of Growth Hormone Deficiency for Oral Health in Children: A Systematic Review
Natalia Torlińska-Walkowiak, Katarzyna Anna Majewska, Andrzej Kędzia, Justyna Opydo-Szymaczek
Journal of Clinical Medicine.2021; 10(16): 3733. CrossRef
A Clinical Study on the Treatment of Children’s Short Stature with Auxiliary Comprehensive Management Combined with Growth Patch
Haiying Feng, Weizhu Zhao, Huijun Yu, Guanfu Wang, Qunhong Wang, Songwen Tan
Evidence-Based Complementary and Alternative Medicine.2021; 2021: 1. CrossRef

Case Reports

Colchicine for steroid-resistant recurrent pericarditis in a child: Ju Hee Shin, Dong Hyun Lee, Hee Joung Choi; Yeungnam Univ J Med. 2018;35(2):222-226. Published online December 31, 2018; DOI: https://doi.org/10.12701/yujm.2018.35.2.222

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Abstract PDF

Recurrent pericarditis is rare in children and is considered idiopathic in most cases. Its course is chronic, and preventing recurrences is important for the patient’s quality of life. Although a treatment strategy in pediatric recurrent pericarditis has not yet been established, non-steroidal anti-inflammatory drugs (NSAIDs) are the most common treatment for management of this condition, followed by corticosteroids, colchicine, immunosuppressive agents, immunoglobulins, and interleukin-1β receptor antagonists (e.g. anakinra). Herein, we report a case of recurrent pericarditis with pericardial effusion in a 5-year-old child who presented with fever and epigastric pain. He responded poorly to NSAIDs and corticosteroid therapy, but was successfully treated with colchicine.

Citations

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Anakinra in idiopathic recurrent pericarditis: a comprehensive case series and literature review
Zeynep Toker Dincer, Sejla Karup, Erkin Yilmaz, Osman Corbali, Feyza Nur Azman, Melike Melikoglu, Serdal Ugurlu
Zeitschrift für Rheumatologie.2024;[Epub] CrossRef
Pediatric Pericarditis: Update
Rida Shahid, Justin Jin, Kyle Hope, Hari Tunuguntla, Shahnawaz Amdani
Current Cardiology Reports.2023;[Epub] CrossRef
Effects of Systemic Steroid Administration on Recurrence of Pericardial Effusion in Pediatric Patients After Hematopoietic Stem Cell Transplantation
Kieran Leong, Martha E. Heal, John L. Bass, Varun Aggarwal, Shanti Narasimhan, Ashish Gupta, Gurumurthy Hiremath
Journal of Pediatric Hematology/Oncology.2020; 42(4): 256. CrossRef

Successful difficult airway management using GlideScope video laryngoscope in a child with Cornelia de Lange Syndrome: Sang-Jin Park, Eun Kyung Choi, Suyong Park, Kunjin Bae, Deokhee Lee; Yeungnam Univ J Med. 2018;35(2):219-221. Published online December 31, 2018; DOI: https://doi.org/10.12701/yujm.2018.35.2.219

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Abstract PDF: Management of airway in a child with Cornelia de Lange Syndrome (CdLS) should be given due consideration because most of them have the problems related to difficult airway. The GlideScope video laryngoscope can be attempted during routine intubation, however it is mostly used in case of difficulty. With adequate preoperative airway assessment, we used the pediatric video laryngoscope as useful alternative airway device in a child with CdLS and orotracheal intubation proceeded uneventfully.

Original Articles

Clinical characteristics of acute lower respiratory tract infections according to respiratory viruses in hospitalized children without underlying disease during the last 3 years: Min Hae Seo, Hyung Young Kim, Tae Min Um, Hye Young Kim, Hee Ju Park; Yeungnam Univ J Med. 2017;34(2):182-190. Published online December 31, 2017; DOI: https://doi.org/10.12701/yujm.2017.34.2.182

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Abstract PDF: BACKGROUND
Respiratory viruses play a significant role in the etiology of acute respiratory infections and exacerbation of chronic respiratory illnesses. This study was conducted to identify the epidemiological and clinical characteristics of children with acute viral lower respiratory infections. METHODS: This study investigated 1,168 children diagnosed with acute viral lower respiratory tract infections (RTIs) between January 2012 and December 2014. Specimens of respiratory viruses were collected using a nasopharyngeal swab and analyzed by reverse transcriptase polymerase chain reaction. We retrospectively reviewed the medical records and analyzed the clinical features of children hospitalized for acute lower respiratory infections. RESULTS: Respiratory syncytial virus (RSV), the main cause of infection in children aged <5 years, was the most commonly detected pathogen in children with bronchiolitis and pneumonia, and resulted in high proportions of children requiring oxygen treatment and intensive care unit admission. Rhinovirus was preceded by RSV as the second most common cause of bronchiolitis and pneumonia, and was detected most frequently in the children aged ≥6 years. In addition, asthma was predominantly caused by rhinovirus in children aged ≥6 years, whereas croup was mostly caused by parainfluenza virus in those aged <5 years. Rhinovirus infection (p < 0.001) and history of asthma (p=0.049) were identified as significant risk factors for readmission within a month. CONCLUSION: We identified the epidemiological and clinical characteristics of respiratory viruses in children with acute lower respiratory infections during the last 3 years. Our findings may provide useful clinical insight to comprehend the acute viral lower RTIs in children.

Clinical features according to chest radiologic patterns of Mycoplasma pneumonia in children.: Young Hyun Kim, Jin Hyeon Kim, Sae Yoon Kim, Young Hwan Lee; Yeungnam Univ J Med. 2016;33(2):98-104. Published online December 31, 2016; DOI: https://doi.org/10.12701/yujm.2016.33.2.98

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Abstract PDF: BACKGROUND
Clinical differences in Mycoplasma pneumonia (MP) in children and adolescent patients according to abnormal infiltrate patterns on the chest X-ray were compared. METHODS: From 2012 to 2015, patients (n=336) diagnosed with MP at Yeungnam University Medical Center have been classified as eiher lobar pneumonia or bronchopneumonia based on the infilterate patterns observed on chest X-ray. Cases were analyzed retrospectively for gender, age, seasonal incidence rate, main symptoms (fever duration, extrapulmonary symptoms), and laboratory results, including white blood cell count, hemoglobin, platelets, C-reactive protein (CRP), and erythrocyte sedimentation rate (ESR), as well as concurrent respiratory virus infection. RESULTS: The following results were observed. First, lobar pneumonia affected 22.0% of all MP patients and was the most common in preschool children, with a high incidence rate in November and December. Second, lobar pneumonia had a longer fever duration than bronchopneumonia (p<0.001), and also showed significantly higher platelets (336.8 vs. 299.1 k/µL, p=0.026), ESR(46.3 vs. 26.0mm/hr, p<0.001) and CRP (4.86 vs. 2.18mg/dL, p=0.001). Third, viral co-infection was more common in bronchopneumonia (p=0.017), affecting 66.7% of infants and toddlers (p=0.034). Finaly, lobar consolidation was most common in both lower lobes. CONCLUSION: MP in children has increased in younger age groups, and the rate of lobar pneumonia with severe clinical symptoms is higher in older children.

Urinary tract infections in pediatric oncology patients with febrile neutropenia.: Kyoo Hyun Suh, Sun Young Park, Sae Yoon Kim, Jae Min Lee; Yeungnam Univ J Med. 2016;33(2):105-111. Published online December 31, 2016; DOI: https://doi.org/10.12701/yujm.2016.33.2.105

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Abstract PDF: BACKGROUND
Neutropenic fever is one of the most common and potentially severe complications of chemotherapy in pediatric oncology patients, while urinary tract infection (UTI) is one of the most prevalent bacterial infections in these patients. Therefore, this study was conducted to investigate features of UTI with neutropenic fever in pediatric oncology patients. METHODS: We retrospectively reviewed and analyzed the medical records, laboratory results and image findings of cases of neutropenic fever in the Department of Pediatrics of Yeungnam University Medical Center, South Korea between November 2013 and May 2015. Episodes were divided into two groups, UTI vs. non-UTI group according to the results of urine culture. The results were then compared between groups. The analysis was performed using IBM SPSS 23.0. A p-value <0.05 was considered to indicate a significant difference between groups. RESULTS: Overall, 112 episodes of neutropenic fever were analyzed, among which 22 episodes (19.6%) showed organisms on urine culture and were classified as UTI. The remaining 90 episodes were classified as non-UTI. Only four episodes (18.2%) of the UTI group showed pyuria on urine analysis. In the UTI group, 76.5% were sensitive to the first line antibiotics and showed higher clinical response than the non-UTI group. Among hematologic malignancy patients, the UTI group revealed higher serum β 2-microglobulin levels than the non-UTI group (1.56±0.43 mg/L vs. 1.2±0.43 mg/L, p<0.028). CONCLUSION: UTI in pediatric neutropenic fever responds well to antibiotics. Hematologic malignancy cases with UTI reveal increased serum β2-microglobulin level. These results will be helpful to early phase diagnosis of UTI.

Presumptive Diagnosis of Mycoplasma pneumoniae Pneumonia in Children.: Chang Eon Lee, Su Jin Park, Won Duck Kim; Yeungnam Univ J Med. 2012;29(2):89-95. Published online December 31, 2012; DOI: https://doi.org/10.12701/yujm.2012.29.2.89

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Abstract PDF: BACKGROUND
As Mycoplasma pneumoniae pneumonia has increased in Korea, its relevance to infants, toddlers, and adolescents has magnified as well as. However, it is difficult to perform the serological test and PCR test routinely for diagnosis in actual clinical practice. Thus, the authors conducted this study to help clinicians do presumptive diagnosis of Mycoplasma pneumoniae pneumonia using clinical, radiological, and hematological findings. METHODS: The study population consisted of 224 children between 1 month and 14 years old, hospitalized for radiographically confirmed pneumonia. Patients were divided into two groups of 100 children with Mycoplasma pneumoniae pneumonia, as diagnosed using the ELISA method. Groups with negative result in Mycoplasma IgM antibody test were classified into the viral group (98 patients with respiratory virus) and the bacterial group (46 patients with the bacteria detected in the blood sputum culture or antibiotic treatment except macrolide improved the patient's condition). These groups were compared and analyzed using clinical, hematological,and radiographic differences and scoring system. RESULTS: Clinical, hematological, and radiographic characteristics of Mycoplasma pneumoniae pneumonia have shown the intermediate level results between bacterial pneumonia and viral pneumonia. In terms of scoring system, the mean score of Mycoplasma pneumoniae pneumonia was 4.23, which was the intermediate level between bacterial pneumonia (mean score=6.67) and viral pneumonia (mean score=1.48). CONCLUSION: Results suggest that the combination of the scoring system information can increase the accuracy in the diagnosis even if they may have difficulties on diagnosis, because clinical manifestations, hematological, and radiographic findings are nonspecific.

Review

Obesity and Insulin Resistance in Childhood.: Kwang Hae Choi; Yeungnam Univ J Med. 2012;29(2):73-76. Published online December 31, 2012; DOI: https://doi.org/10.12701/yujm.2012.29.2.73

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Abstract PDF: More and more children are becoming obese and overweight due to several factors that include a high energy density in the diet (a high fat intake) and low energy expenditure. Consequently childhood obesity is becoming a significant health problem. Fat tissue releases many cytokines such as resistin, tumor necrosis factor-alpha, leptin, interleukin-6. These adipocytokines induce obesity-related insulin resistance. Insulin resistance is a key component of obesity-related metabolic problems such as hypertension, type 2 diabetes mellitus, dyslipidemia, non-alcoholic steatohepatitis, acanthosis nigricans and polycystic ovarian syndrome. This review article focused on insulin resistance and its related metabolic diseases.

Original Article

Chemokines Expression in Children with a Non-productive Cough.: Young Hwan Lee, Hee Sun Kim; Yeungnam Univ J Med. 2007;24(2):129-136. Published online December 31, 2007; DOI: https://doi.org/10.12701/yujm.2007.24.2.129

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Abstract PDF: PURPOSE: To evaluate the chemokine expression in children with a non-productive cough. MATERIALS AND METHODS: Six children with a non-productive cough who visited Yeungnam University Hospital were evaluated for the mRNA expression of interferon-gamma-inducible protein 10(IP-10), macrophage cationic protein 1 and 3 (MCP-1, 3), interleukin (IL)-8, regulated upon activation in normal T cells expressed and secreted (RANTES), eotaxin and growth-related oncogene-alpha (Gro-alpha) using the reverse transcription polymerase chain reaction. RESULTS: The chemokines IP-10 and MCP-3 were expressed in all samples. The chemokine RANTES was expressed in five cases, and IL-8 was expressed in three among them. However, eotaxin, Gro-alpha and MCP-1 were not expressed at all. The expression of chemokine MCP-3, RANTES and IL-8 were suppressed after the resolution of coughing in just one available case. CONCLUSION: The chemokines MCP-3, RANTES and IL-8 may contribute to airway inflammation in children with a non-productive cough, whereas IP-10 is of secondary importance in this condition.

Case Report

One Case of Lupus Nephritis Flare in Child During Tapering the Steroid: Jung Youn Choi, Yong Hoon Park; Yeungnam Univ J Med. 2007;24(2 Suppl):S755-760. Published online December 31, 2007; DOI: https://doi.org/10.12701/yujm.2007.24.2S.S755

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Abstract PDF: Systemic lupus erythematosus (SLE) is a chronic multisystemic inflammatory autoimmune disease. Hematologic abnormality is more frequent and the frequency of using high dose steroid and immunosuppressant as treatment is higher in children, because the number of involved major organ is numerous and the disease progress is often rapid in the SLE of children. We reported an experience of lupus nephritis flare after tapering the steroid in 9 years old boy who was diagnosed focal proliferative glomerulonephritis.

Review Article

Clinical Manifestation and Psychopharmacotherpy of Pediatric Bipolar Disorder: Wan Seok Seo; Yeungnam Univ J Med. 2007;24(2 Suppl):S252-261. Published online December 31, 2007; DOI: https://doi.org/10.12701/yujm.2007.24.2S.S252

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Abstract PDF: Pediatric bipolar disorder(BD) is one of the significant psychiatric health problems, which begins in childhood, has chronic persisting clinical course and leads impairs academic, occupational and legal problems of the patients. Fortunately, there has been increasing recognition of pediatric bipolar disorder during the past 10 years, even there are still controversy about clinical features and diagnosis. The clinical presentation of pediatric BD is greatly different to classic BD, relatively higher percentage of mixed, rapid cycling subtypes, not episodic and chronic lasting nature. In addition, pediatric BD has many comorbid psychiatric conditions such as attention deficit hyperactivity disorder, anxiety disorder and that makes more difficult to treat the patients with pediatric BD. To reduce confusion about diagnosis, the National Institute of Mental Health Research Roundtable divided pediatric BD into narrow and broad phenotype. 1) Given the paucity of medication trial studies of pediatric BD, no psychotrophic medications have been approved by U.S. Food and Drug Administration, except lithium. There have been a few open trials and retrospective chart reviews on the efficacy and side effects of mood stabilizers, anticonvulsants and atypical antipsychotics. More short and long-term randomized, double blind, well controlled trials of medication for pediatric BD are needed.

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