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Horm Metab Res 2011; 43(6): 422-426
DOI: 10.1055/s-0031-1275326
Humans, Clinical

© Georg Thieme Verlag KG Stuttgart · New York

Reference Ranges for Analytes of Thyroid Function in Children

F. A. Verburg1 , C. Kirchgässner1 , H. Hebestreit2 , U. Steigerwald3 , E. G. W. M. Lentjes4 , K. Ergezinger2 , I. Grelle1 , C. Reiners1 , M. Luster1 , 5
  • 1Department of Nuclear Medicine, University of Würzburg, Würzburg, Germany
  • 2Department of Pediatrics, University of Würzburg, Würzburg, Germany
  • 3Department of Clinical Biochemistry, University of Würzburg, Würzburg, Germany
  • 4Department of Clinical Chemistry & Hematology, University Medical Center Utrecht, Utrecht, The Netherlands
  • 5Department of Nuclear Medicine, University of Ulm, Ulm, Germany
Further Information

Publication History

received 04.08.2010

accepted 10.03.2011

Publication Date:
11 April 2011 (online)

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Abstract

Promptly detecting pediatric thyroid dysfunction requires age-appropriate reference ranges for serum thyroid-stimulating hormone (TSH), serum free thyroxine (FT4), and serum free triiodothyronine (FT3). We sought to establish such ranges, employing the widely-used Immulite® 2000 automated immunoluminometric assays in a large population. We assayed the analytes according to manufacturer's instructions in serum samples from 359 male and 297 female university hospital patients, aged between newborn to 18 years, without evidence of thyroid or pituitary dysfunction. As data were not normally distributed, the reference ranges were assumed to lie between the 2.5th and 97.5th percentiles. Curves for age-related changes in the reference ranges were calculated using the linearity, median and skewness method. TSH, FT4, and FT3 reference ranges showed a wide spread immediately after birth, rapidly decreasing within the first 2 years of life. Reference range width was fairly stable after about age 4 years. However, from that time, the ranges’ lower and upper limits steadily declined, essentially reaching (FT3) or approximating (TSH, FT4) healthy adult values by age 18 years. Age-specific reference ranges should be used when measuring TSH, FT4, and FT3 in children. During very early life, values of these analytes range widely, making it challenging to interpret measurements in infants, and, especially, newborns.

Key words

TSH - free thyroxine - free triiodothyronine - children - reference ranges

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Correspondence

F. A. VerburgMD, PhD 

University Hospital Aachen

Department of Nuclear

Medicine

Pauwelsstraße 30

52074 Aachen

Germany

Phone: +49/241/80 36619

Fax: +49/241/80 82520

Email: fverburg@ukaachen.de