Hypereosinophilic syndrome (HES) is a heterogeneous group of disorders characterized by tissue eosinophilic infiltration and a wide spectrum of clinical manifestations. The issue of pathogenetic therapy for this condition remains unresolved, as some patients are refractory to conventional treatment. Case report. This article discusses the main challenges of differential diagnosis and current approaches to the treatment of HES in pediatric practice, and presents a rare clinical case of primary HES in a 14yearold girl. After a thorough diagnostic workup and confirmation of the diagnosis, the patient received systemic glucocorticoid therapy, which produced a temporary effect. However, due to the development of a severe exacerbation upon attempted withdrawal of hormonal therapy, treatment with mepolizumab — a humanized monoclonal antibody against the interleukin5 receptor — was initiated. Conclusion. The management of patients with HES often presents significant difficulties due to the polymorphism of clinical manifestations, the need to rule out a wide range of diseases, and possible refractoriness to standard therapy. The usage of this genetically engineered biological agent demonstrated high efficacy, enabling the patient to overcome glucocorticoid dependence and prevent the development of glucocorticoid-related adverse effects.

Infant acute lymphoblastic leukemia (ALL) is a rare and biologically unique form of hematologic malignancy occurring in children during the first year of life. It is characterized by an aggressive clinical course and unfavorable prognosis, particularly in the presence of KMT2A gene rearrangements. This article provides a review of current data on the clinical, immunological, and molecular-genetic features of B-cell precursor infant ALL. The mechanisms of epigenetic dysregulation and potential targets for targeted therapy are discussed in detail. The evolution of risk stratification approaches, the role of minimal residual disease, and the results of international collaborative studies aimed at improving treatment outcomes are reviewed. Particular attention is paid to the introduction of immunotherapeutic agents — blinatumomab and chimeric antigen receptor T-cells (CAR-T) — and their efficacy in disease control. The limited role of hematopoietic stem cell transplantation and current trends toward narrowing its indications are discussed. In conclusion, the importance of integrating genetic and dynamically changing laboratory parameters for treatment personalization is emphasized, and future perspectives for further improving outcomes in infants with this disease are outlined.

ROHHAD syndrome (Rapid-onset Obesity with Hypoventilation, Hypothalamic Dysfunction, and Autonomic Dysregulation) is a life-threatening, multisystem disorder of childhood with high mortality rate, estimated at 50–60%. The clinical picture is characterized by triad of symptoms: rapid onset of obesity between 1.5 and 7 years of age, central alveolar hypoventilation, and complex hypothalamic dysfunction including central hypothyroidism, hyperprolactinemia, fluid and electrolyte imbalances, growth hormone deficiency, adrenal insufficiency, and impaired pubertal development. Autonomic dysregulation often accompanies this triad. Development of neural crest tumors (mainly ganglioneuromas and ganglioneuroblastomas) can be significant co-morbidity as they are detected in approximately half of patients. ROHHAD syndrome epidemiological characteristics and prevalence are still unclear. Diagnosis relies only on clinical data as there are no specific laboratory or genetic markers, thus, it significantly complicates disease recognition and leads to late or missed diagnosis. Early diagnosis is crucial due to the high risk of life-threatening complications and death without timely management. ROHHAD syndrome etiopathogenesis remains unclear; the leading hypothesis is autoimmune origin as immunosuppressive therapy can achieve partial response. Management strategies should be multidisciplinary and supportive in the absence of any etiotropic treatment. Thus, ROHHAD remains a disease with numerous unresolved questions regarding its pathogenesis, diagnosis, and management, highlighting the need for further research. This review examines key aspects of ROHHAD syndrome including its proposed etiology, clinical signs, diagnostic approaches, treatment strategies, and prognosis. Publications were selected and analyzed in the PubMed, Google Scholar, and eLIBRARY databases.

This review presents the main approaches to the treatment of children suffering from Crohn’s disease (CD). Special attention is paid to conservative methods, which primarily maintain remission in patients with uncomplicated forms of the disease. The cornerstone of CD treatment includes lifestyle modifications, dietary therapy, and the elimination of factors that trigger exacerbations. Pharmacological therapy has demonstrated the greatest efficacy, comprising both time-tested drugs and modern high-tech genetically engineered biological agents. Thuswise, the combination of these technologies, which reduces the frequency of relapses and improves patients’ quality of life, is widely used in the management of moderate and uncomplicated forms of CD. However, in complicated and severe cases where conservative therapy fails to produce positive results, surgical treatment methods should be considered. Currently, the laparoscopic approach is the most appropriate, characterized by lower invasiveness and a shorter recovery period. It should also be noted that disease recurrence occurs much less frequently compared to open surgical techniques. The choice of the correct therapeutic strategy remains a decisive factor in the management of pediatric patients with CD, as inappropriate tactics can lead to relapses and complications that could otherwise be avoided.

The article presents the position of experts from the Joint Committee on Infant Hearing on the role of immunoprophylaxis in patients with cochlear implants. It emphasizes that viral and bacterial infections are a significant cause of sensorineural hearing loss, underscoring the importance of routine vaccination as a primary prevention method. In cochlear implants patients, surgery and the presence of the implant create additional risks of infectious complications, including acute otitis media and meningitis. Particular attention is paid to the necessity of vaccination against pneumococcal, Haemophilus influenzae type b infections, as well as influenza. The authors recommend assessing vaccination status before and after surgery, administering immunizations according to the National Immunization Schedule, and implementing an individual schedule for high-risk groups. Specific vaccination regimens are provided, including the combined use of pneumococcal conjugate and polysaccharide vaccines. It is concluded that strategically sound immunoprophylaxis is a key factor in minimizing risks and enhancing the effectiveness of auditory-speech rehabilitation.