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Pediatric reference ranges for creatine kinase, CKMB, Troponin I, iron, and cortisol
S J Soldin1, J N Murthy, P K Agarwalla
1Department of Laboratory Medicine, Children's National Medical Center, Washington, DC 20010, USA. ssoldin@cnmc.org
Insights
This study establishes pediatric reference ranges for iron, cortisol, creatine kinase (CK), CK-myocardial band (CKMB), and troponin I. New data provides vital insights into these biomarkers, particularly for infants.
Area of Science:
- Biochemistry
- Pediatric Medicine
- Clinical Diagnostics
Background:
- Accurate pediatric reference ranges are crucial for diagnosing various health conditions in children.
- Existing data for certain biomarkers like CK-myocardial band and troponin I in pediatric populations is limited.
- Understanding diurnal variations in iron and cortisol levels is important for accurate interpretation.
Purpose of the Study:
- To establish comprehensive pediatric reference ranges for iron, cortisol, CK, CKMB, and troponin I.
- To expand the knowledge base on pediatric biomarker reference values.
- To provide data essential for clinical decision-making in pediatric care.
Main Methods:
- Utilized the Hoffmann approach to determine pediatric reference ranges on hospitalized patients.
- Measured iron and CK using the Vitros analyzer.
- Measured CKMB, troponin I, and cortisol using the Immuno I analyzer.
Main Results:
- Established pediatric reference ranges for iron (AM/PM) and cortisol (AM/PM).
- Determined reference ranges for CKMB, troponin I, and total CK.
- Observed significantly higher 97.5th percentiles for iron in the PM compared to AM.
- Noted a 10-20% diurnal fluctuation in 97.5th percentiles for cortisol.
Conclusions:
- This study significantly expands the available pediatric reference range data for key biomarkers.
- New pediatric reference ranges for CKMB are now available, crucial for early life diagnosis.
- Novel data on elevated troponin I levels in the first year of life is presented.
Objectives:
To determine the pediatric reference ranges for iron, cortisol, CK, CKMB, and troponin I.
Methods:
Iron and CK were measured on the Vitros analyzer (Johnson and Johnson) while CKMB, troponin I, and cortisol were measured on the Immuno I (Bayer Corp.). Pediatric reference ranges were determined on hospitalized patients using the Hoffmann approach.
Results:
Pediatric reference ranges were obtained for iron (AM and PM) and cortisol (AM and PM). Ranges were also obtained for CKMB, troponin I, and total CK.
Conclusion:
This work represents an expansion in our knowledge base on pediatric reference ranges. For iron, the 97.5th percentiles were significantly higher in the PM than in the AM. The diurnal fluctuation in 97.5th percentiles for cortisol was only 10-20%. Pediatric reference ranges for CKMB were not previously available and are important especially in the first year of life. The elevated Troponin I is found in the first year of life also represents new data.