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Pediatric Reference Intervals for Free Thyroxine and Free Triiodothyronine by Equilibrium Dialysis-Liquid

Sonia L La'ulu, Kyle J Rasmussen, Joely A Straseski1

  • 1ARUP Institute for Clinical and Experimental Pathology, Salt Lake City, Utah, USA, Phone: (800) 242-2787 ext. 3696

Journal of Clinical Research in Pediatric Endocrinology
|January 14, 2016
PubMed

Insights

Pediatric thyroid hormone reference intervals (RIs) for free thyroxine (fT4) and free triiodothyronine (fT3) were established using advanced methods in over 2200 children. These new RIs differ significantly from adult ranges, highlighting the need for pediatric-specific guidelines.

Area of Science:

  • Pediatric Endocrinology
  • Clinical Chemistry
  • Mass Spectrometry

Background:

  • Thyroid hormone levels change during childhood development.
  • Accurate diagnosis of pediatric thyroid disease requires age-specific reference intervals (RIs).
  • Establishing pediatric RIs is challenging due to difficulties in recruiting sufficient healthy subjects.

Purpose of the Study:

  • To determine non-parametric RIs for free thyroxine (fT4) and free triiodothyronine (fT3) in healthy children aged 6 months to 17 years.
  • To utilize equilibrium dialysis-high performance liquid chromatography-tandem mass spectrometry for precise measurements.
  • To establish RIs based on a large cohort of over 2200 healthy pediatric subjects.

Main Methods:

  • Recruited 2213 healthy children (6 months-17 years), screened for thyroid autoantibodies and normal thyrotropin.
  • Employed equilibrium dialysis-high performance liquid chromatography-tandem mass spectrometry for accurate fT4 and fT3 quantification.
  • Ensured adequate age-group representation with at least 120 subjects per year of life, where possible.

Main Results:

  • Established non-parametric RIs for fT4: 18.0-34.7 pmol/L (6 months-6 years) and 14.2-25.7 pmol/L (7-17 years).
  • Established age- and sex-specific RIs for fT3 across different pediatric age bands.
  • Observed significant variations in fT3 RIs between sexes in the 13-17 year olds.

Conclusions:

  • Significant differences exist between pediatric and adult thyroid hormone reference intervals.
  • Well-characterized, pediatric-specific RIs are crucial for accurate thyroid disease diagnosis in children.
  • This study provides essential data for updating clinical guidelines for pediatric thyroid function testing.
Abstract

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