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Archives of Pediatric Gastroenterology, Hepatology, and Nutrition
Published by Indonesian Society of Pediatric Gastroenterology, Hepatology, and Nutrition
ISSN : -     EISSN : 28305442     DOI : -
Core Subject : Health,
Medicine & Pharmacology
Archives of Pediatric Gastroenterology, Hepatology, and Nutrition (APGHN) is the official journal issued by the Indonesian Society of Pediatric Gastroenterology, Hepatology, and Nutrition (Perhimpunan Gastroenterologi, Hepatologi, dan Nutrisi Anak Indonesia). APGHN is issued four times in a year and published in English. Previously published in print form as Jurnal Gastrohepatologi Anak Indonesia (JGAI), APGHN is committed to promote scientific development in child’s health through high-quality publication and provides recent updates on pediatric gastroenterology, hepatology, and nutrition for health practitioners and scholars. APGHN accepts original articles, case reports, review articles, medical illustrations and clinical practice guidelines, all of which have been peer-reviewed carefully by our selected experts.
Arjuna Subject : Kedokteran - Pediatrics, Perinatology, and Child Health
Articles 89 Documents
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Infantile Liver Failure as the Initial Manifestation of SCYL1-Related CALFAN Syndrome: A Case Report and Literature Review Deepika Yadav; Nishant Wadhwa; Megha Sharma
Archives of Pediatric Gastroenterology, Hepatology, and Nutrition Vol. 5 No. 2 (2026): APGHN Vol. 5 No. 2 May 2026
Publisher : The Indonesian Society of Pediatric Gastroenterology, Hepatology, and Nutrition

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.58427/apghn.5.2.2026.86-97

Abstract

Background: CALFAN (Cholestasis, Acute Liver Failure, and Neurodegeneration) syndrome is a rare autosomal recessive disorder caused by biallelic pathogenic variants in SCYL1 (SCY1-like pseudo-kinase 1). It is classically associated with low or normal gamma-glutamyl transpeptidase (GGT) cholestasis, infection-triggered acute liver failure (ALF), and progressive neurodegeneration. Because neurological and skeletal manifestations may be absent during the first hepatic presentation, early diagnosis can be missed unless the hepatic phenotype is recognized. Case: We describe a 9-month-old female infant born to third-degree consanguineous parents who developed fever-triggered cholestatic jaundice and ALF. Structural biliary disease, viral hepatitis, and common metabolic disorders were excluded. Whole-exome sequencing revealed a homozygous pathogenic nonsense variant in SCYL1 (c.1567C>T; p.Arg523*), consistent with autosomal recessive CALFAN syndrome. No neurological, neuroimaging, or skeletal abnormalities were present at initial presentation. The clinical course was notable for persistent hyperbilirubinemia and a family history of sibling death from infantile liver failure. Discussion: This case adds to the SCYL1 spectrum by demonstrating isolated infantile ALF without neurological features at presentation, a severe hepatic phenotype with persistent cholestasis, and a novel homozygous null variant in a consanguineous family. Conclusion: SCYL1 deficiency should be considered in infants with fever-triggered ALF and low/normal-GGT cholestasis, even when neurological and skeletal signs are absent. Early genomic testing, systematic exclusion of low-GGT cholestasis mimics, longitudinal neurological surveillance, timely transplant referral, and recurrence-risk counselling are essential.
From Paper to Precision: A Systematic Review on Digital Technologies for Improving the Quality of Childhood Growth Monitoring Assyifa Gita Firdaus; Dhio Pratama Putra
Archives of Pediatric Gastroenterology, Hepatology, and Nutrition Vol. 5 No. 2 (2026): APGHN Vol. 5 No. 2 May 2026
Publisher : The Indonesian Society of Pediatric Gastroenterology, Hepatology, and Nutrition

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.58427/apghn.5.2.2026.74-85

Abstract

Background: Childhood growth monitoring is essential for detecting malnutrition and growth disorders. However, traditional paper-based methods are prone to errors, incompleteness, and fragmentation. Digital technologies have emerged as potential tools to enhance efficiency of growth monitoring. This systematic review aims to synthesize evidence on the benefits and challenges of implementing digital technologies for growth monitoring in children. Methods: A systematic review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A comprehensive literature search was conducted across multiple databases. Eligible studies evaluated digital interventions such as mobile health applications with automated anthropometric calculations, computer-based growth monitoring integrated into the electronic health record, and chatbot-based reporting systems. Data were extracted on study design, population, technology features, and outcomes related to data and implementation. Result: Seven studies were analyzed, representing over 50,000 child growth assessments and involving approximately 400 frontline health workers. Digital technologies improved the completeness, accuracy, and timeliness of data collection. Automation reduced human error, supporting more consistent interpretation of nutritional status, earlier detection and reporting of inadequate growth, along with improved nutritional outcomes. These technologies were highly accepted by frontline health workers for their ability to simplify complex tasks. However, most challenges arose from constraints in digital infrastructure and uneven technology implementation across healthcare facilities. Conclusion: Digital technologies can transform growth monitoring from a manual, error-prone process into a precise and scalable system for early detection of malnutrition. Addressing challenges is essential for successful implementation and scale-up in health systems.
Prediction of Development of Neonatal Jaundice by Cord Blood Bilirubin and Albumin Babita Rani; Leesha Kaushik; Preeti Raikwar; Renu Garg; Vijayata Sangwan; Sanjay Kumar Jha; Anita Punia; Deepika Kataria
Archives of Pediatric Gastroenterology, Hepatology, and Nutrition Vol. 5 No. 2 (2026): APGHN Vol. 5 No. 2 May 2026
Publisher : The Indonesian Society of Pediatric Gastroenterology, Hepatology, and Nutrition

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.58427/apghn.5.2.2026.62-73

Abstract

Background: Neonatal jaundice is a common cause of early postnatal readmission and contributes to both financial and socio-economic burden. In resource-constrained nations, where the patient-to-resource-constrained-bed ratio is very high, early prediction of hyperbilirubinaemia will help in early discharge, prevent re-hospitalization, and reduce the duration of hospital stay. This study aims to estimate the cord blood bilirubin (CBB) and albumin (CBA) levels for future prediction of neonatal jaundice among deliveries at Bhagat Phool Singh Government Medical College for Women (BPS GMC (W)). Methods: A prospective study was conducted among 384 randomly selected neonates delivered at BPS GMC (W). Socio-demographic data were recorded, and cord blood samples were collected at birth for bilirubin and albumin estimation. Neonates were followed for 10 days to assess the development of clinical jaundice. Result: Incidence of neonatal jaundice was 21.4% with 10 days of follow-up. 94.8% neonates developed jaundice with CBB level ≥ 2mg/dL, proving it statistically significant. Additionally, 62.7% of neonates with serum albumin < 3 g/dL developed jaundice. Cord blood Bilirubin-to-Albumin ratio proved a good indicator, as area under the curve is 0.933 with sensitivity and specificity of 68.30% and 99.0% respectively at a cut-off level of 0.61. Conclusion: Cord blood bilirubin and bilirubin-to-albumin ratio may help identify neonates at higher risk of subsequent jaundice and may assist in prioritizing follow-up in resource-limited settings. A bilirubin-to-albumin ratio ≥ 0.61 was found to be a highly specific predictor.
Gut Endocrine Regulation of Pediatric Growth and Weight: Integrating Intestinal Hormones, Inflammation, and the GH–IGF-1 Axis in Health and Disease Ashraf T. Soliman; Fawzia Alyafei; Nada Alaaraj; Shayma Mohamed; Noor Hamed; Sohair Elsiddig
Archives of Pediatric Gastroenterology, Hepatology, and Nutrition Vol. 5 No. 2 (2026): APGHN Vol. 5 No. 2 May 2026
Publisher : The Indonesian Society of Pediatric Gastroenterology, Hepatology, and Nutrition

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.58427/apghn.5.2.2026.106-120

Abstract

Background: The intestine is increasingly recognized as an endocrine organ through enteroendocrine cells, gut-derived peptides, mucosal trophic factors, and microbiota–host signaling. In children, these pathways influence appetite, nutrient handling, body composition, and growth, including the growth hormone–insulin-like growth factor-1 (GH–IGF-1) axis. This review summarizes how intestinal endocrine function affects linear growth, weight gain, and GH–IGF-1 regulation in children with celiac disease, inflammatory bowel disease, environmental enteric dysfunction, and obesity. Discussion: Evidence supports a convergent model linking gut function to growth via gut hormone signaling (GLP-1, PYY, CCK, GLP-2, ghrelin), inflammation-driven GH resistance, and microbiota-mediated IGF-1 modulation. Celiac disease can cause growth failure reversible with a gluten-free diet; Crohn's disease impairs growth through inflammation and malabsorption; environmental enteric dysfunction drives population-level stunting; and in obesity, altered incretin responses highlight the intestine as a therapeutic target. Gut-endocrine pathways remain underutilized in pediatric practice. IGF-1 is frequently interpreted without accounting for mucosal inflammation or malabsorption, and cross-specialty fragmentation limits holistic growth assessment. Emerging therapies including GLP-2 analogues and incretin-based agents offer promise, though pediatric data remain limited. Standardizing gut-endocrine biomarkers and integrating intestinal health into growth frameworks are key research priorities. Conclusion: The intestine is a clinically important endocrine organ in pediatric growth medicine. Integrating gut-endocrine biology into endocrine assessment improves the interpretation of IGF-1 and growth patterns and guides management across undernutrition, chronic intestinal disease, and obesity.
Eosinophilic Gastritis as an Intriguing Case of Gastric Outlet Obstruction in a Female Toddler: A Case Report Amanjot Kaur; Kanojiya Atul Ghanshyam; Sarthak Chakrabarti; Ashok Singh; Yash Shrivastava; Nowneet Kumar Bhat
Archives of Pediatric Gastroenterology, Hepatology, and Nutrition Vol. 5 No. 3 (2026): APGHN Vol. 5 No. 3 August 2026
Publisher : The Indonesian Society of Pediatric Gastroenterology, Hepatology, and Nutrition

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.58427/apghn.5.3.2026.157-166

Abstract

Background Eosinophilic gastritis (EoG) is an uncommon form of eosinophilic gastrointestinal disease (EGID) characterized by dense eosinophilic infiltration of the gastric wall, most often involving the antrum and fundus. Although EoG can mimic other causes of gastric outlet obstruction (GOO), including infantile hypertrophic pyloric stenosis (IHPS), such presentations are rare. Diagnosis requires histological confirmation, and management typically involves dietary modification with elimination diets, corticosteroids, and proton pump inhibitors. Case: We report the case of a 3-year-old girl presenting with recurrent non-bilious, non-bloody projectile vomiting and abdominal pain over 15 days, with a 3 kg weight loss. Imaging revealed pyloric canal hypertrophy not meeting IHPS criteria, and upper gastrointestinal endoscopy showed an erythematous, edematous antrum with pinpoint pylorus. Pyloric biopsy demonstrated dense eosinophilic infiltration (>30 eosinophils/HPF in 5 fields), confirming EoG. The child was treated with oral prednisolone (2 mg/kg/day) and lansoprazole (1 mg/kg/dose twice a day), resulting in marked clinical improvement and weight gain within two weeks Discussion: EoG represents a spectrum of EGIDs, with clinical manifestations depending on the gastric layer involved. It may occur with or without peripheral eosinophilia and is frequently associated with atopic conditions. Diagnosis rests on gastrointestinal symptoms, tissue eosinophilia, and exclusion of secondary causes. Corticosteroids remain the cornerstone of treatment, though dietary elimination and PPIs also contribute to remission. Conclusion: EoG should be considered in children presenting with unexplained GOO. Early endoscopic biopsy and corticosteroid-based therapy can lead to rapid symptom resolution and prevent long-term morbidity.
A Systematic Review of the Literature on the Clinical Presentation, Pathology, and Pathogenesis of Neonatal Dubin-Johnson Syndrome Imad Abdien El Hag; A. Malik Alsheikh; Alaa M Bokhari; Khalid A Alghamdi; Mohamed I El Hag
Archives of Pediatric Gastroenterology, Hepatology, and Nutrition Vol. 5 No. 3 (2026): APGHN Vol. 5 No. 3 August 2026
Publisher : The Indonesian Society of Pediatric Gastroenterology, Hepatology, and Nutrition

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.58427/apghn.5.3.2026.131-150

Abstract

Background: Neonatal Dubin-Johnson syndrome (DJS) is an unusual presentation of a rare autosomal recessive disease that typically manifests in adolescents. Methods: A thorough literature review was conducted, examining clinical, radiologic, morphological, and genetic features, as well as diagnostic pathways and long-term outcomes in neonatal-onset disease. The review adhered to the 2020 PRISMA guidelines, with study quality evaluated using the JBI checklist and influence assessed through leave- one-out analysis. Result: 141 cases were identified, most presenting within the first week as neonatal cholestatic liver disease. Males are affected twice as often as females. The condition is characterized by hyperbilirubinemia, elevated ALP, GGT, and bile acid levels, with normal transaminases. Common signs include hepatomegaly and acholic stools. Liver scintigraphy typically shows a bimodal pattern with excellent uptake but absent or delayed intestinal excretion, which may mimic biliary atresia (BA). Unlike BA, cholangiography appears normal. Liver biopsy reveals intrahepatic cholestasis (62%), paucity of interlobular bile ducts (22%), hepatopathy (33%), and steatosis (26%); the characteristic dark brown pigment is absent in 80% of cases. Fifty-five ABCC2 variants are associated with neonatal DJS. Additional risk factors include male sex, biliary immaturity, hepatitis, steatosis, bile acid retention, and maternally induced drug cholestasis. Urinary coproporphyrin I excretion, cholangiography, and genetic analysis are highly sensitive and specific diagnostic tools. Neonatal onset does not alter the disease's benign long-term course. Conclusion: Neonatal DJS should be considered in the differential diagnosis of neonatal cholestatic disease. Low transaminase levels and abnormal scintigraphy should prompt suspicion, with confirmation via cholangiography, coproporphyrin analysis, or genetic testing.
Nutritional Intake in Children with Functional Constipation in a Tertiary Care Hospital in Jakarta, Indonesia Cindy Febrina; Gendis Sekarnegari Putri; Kitra Latuasan; Adrian Himawan Singgih; Diana Sunardi; Ariani Dewi Widodo
Archives of Pediatric Gastroenterology, Hepatology, and Nutrition Vol. 5 No. 3 (2026): APGHN Vol. 5 No. 3 August 2026
Publisher : The Indonesian Society of Pediatric Gastroenterology, Hepatology, and Nutrition

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.58427/apghn.5.3.2026.121-130

Abstract

Background: Functional constipation affects 0.7–29.6% of children worldwide. Dietary factors, including carbohydrate, protein, fat, fiber and fluid intake, are known factors associated with constipation. Constipation impacts children's growth and psychosocial functioning. This study aims to assess macronutrients and fluid intake in children with functional constipation. Methods: A descriptive study was conducted at the Gastrohepatology Outpatient Clinic, Harapan Kita Mother & Children Hospital, from November to December 2025. Age, sex, nutritional status, and intake of carbohydrate, protein, fat, fiber, and fluid were assessed. Results: Thirty-one subjects were included. The majority were female (58.1%), aged 1–3 years (45.2%), with normal nutritional status (61.3%). Most subjects had lower energy intake than recommended (90.3%), while 12.9% had inadequate protein intake. More than half had adequate fat intake (58.1%) while only 32.3% met the carbohydrate target. Using the “age + 5” rule, the majority had fiber intakes below recommended values. Additionally, 90.3% had fluid intake below recommended levels. Conclusion: Children with functional constipation were predominantly young and female, and more than half had normal nutritional status; however, most did not meet recommended energy, carbohydrate, fiber, and fluid intake levels. These findings indicate that dietary intakes were frequently below recommended levels in this sample and underscore the need to strengthen public education regarding appropriate nutrition to support the prevention and management of constipation.
Desquamative Esophagitis Secondary to Mucous Membrane Pemphigoid in a Three-Year-Old Child: A Rare Case Report Sainath Preetam; Dr Meenakshi Swain; Ramesh Srinivasan
Archives of Pediatric Gastroenterology, Hepatology, and Nutrition Vol. 5 No. 3 (2026): APGHN Vol. 5 No. 3 August 2026
Publisher : The Indonesian Society of Pediatric Gastroenterology, Hepatology, and Nutrition

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.58427/apghn.5.3.2026.151-156

Abstract

Background: Esophagitis dissecans superficialis (EDS) is an uncommon disorder characterized by sloughing of the esophageal mucosa. Paediatric cases are infrequent and esophageal involvement due to mucous membrane pemphigoid (MMP) is exceptionally rare. We report a young child presenting with recurrent hematemesis secondary to EDS caused by MMP Case: A previously healthy three-year-old girl presented with hematemesis. Upper gastrointestinal endoscopy revealed severe desquamative esophagitis. Initial treatment with proton pump inhibitors resulted in temporary resolution, however symptoms recurred three months later. Careful examination identified intermittent blistering skin lesions. Skin biopsy and direct immunofluorescence demonstrating linear IgG deposition along the basement membrane zone confirmed MMP. Treatment with systemic corticosteroids and azathioprine resulted in sustained remission over 52 months of follow-up. Discussion: The absence of obvious mucocutaneous manifestations initially delayed diagnosis. Recurrent EDS should prompt evaluation for autoimmune blistering disorders. Multidisciplinary assessment and direct immunofluorescence were crucial for establishing the diagnosis and guiding treatment. Conclusion: Mucous membrane pemphigoid should be considered in children with recurrent desquamative esophagitis or unexplained hematemesis. Early diagnosis and immunosuppressive therapy may prevent long-term oesophageal complications and achieve durable remission.
Inflammatory Bowel Disease and Juvenile Idiopathic Arthritis: Coincidence or Connection? Nadira Muthi Tsania; Gading Yudha Pratama; Andy Darma
Archives of Pediatric Gastroenterology, Hepatology, and Nutrition Vol. 5 No. 3 (2026): APGHN Vol. 5 No. 3 August 2026
Publisher : The Indonesian Society of Pediatric Gastroenterology, Hepatology, and Nutrition

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.58427/apghn.5.3.2026.167-177

Abstract

Background: Inflammatory Bowel Disease (IBD) and Juvenile Idiopathic Arthritis (JIA) are chronic diseases characterized by persistent inflammation. The incidence of IBD in patients with JIA is higher than in the general pediatric population. The clinical manifestations of these diseases sometimes overlap or may even be absent, making early detection more difficult. This review aims to explore the pathophysiological interplay between IBD and JIA, highlighting their potential mutual influence and clinical implications. Discussion: Both IBD and JIA share a similar mechanism involving the interplay between immunological processes and environmental influences. A key common factor in both diseases is the involvement of gut microbiota. Alterations in gut microbiota can lead to gut dysfunction and immunological abnormalities. The involvement of intestinal factors in JIA pathophysiology is gaining more attention, as emerging evidence indicates a connection with the gastrointestinal system. Additionally, the use of specific medications in JIA patients has been recognized as a potential risk factor for developing IBD. Conclusion: Multiple underlying mechanisms suggest a connection between the IBD and JIA. However, additional research is needed to gain a more comprehensive understanding of this connection.

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