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Age-specific pediatric reference intervals for plasma free normetanephrine, metanephrine, 3-methoxytyramine and

Mirko Peitzsch1, Anastasios Mangelis1, Graeme Eisenhofer2

  • 1Institute of Clinical Chemistry and Laboratory Medicine, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany.

Clinica Chimica Acta; International Journal of Clinical Chemistry
|March 25, 2019
PubMed

Insights

Establishing age-specific reference intervals for catecholamine metabolites is crucial for diagnosing neuroblastoma in children. These new intervals account for significant developmental changes in metabolite levels during infancy and childhood.

Area of Science:

  • Biochemistry
  • Pediatric Endocrinology
  • Oncology

Background:

  • Establishing reliable reference intervals for biochemical tests in pediatric patients presents challenges.
  • Accurate reference intervals are essential for diagnosing conditions like neuroblastoma, especially in young children.

Purpose of the Study:

  • To establish age-specific, continuous reference intervals for catecholamine O-methylated metabolites in children.
  • To improve the accuracy of biochemical testing for catecholamine-producing tumors in pediatric populations.

Main Methods:

  • Plasma concentrations of 3-methoxytyramine, normetanephrine, metanephrine, and 3-O-methyldopa were measured.
  • Liquid chromatography tandem mass spectrometry was used for analysis.
  • The study included 533 children aged from 2 days to 18 years.

Main Results:

  • Plasma concentrations of normetanephrine, 3-methoxytyramine, and 3-O-methyldopa were elevated in neonates and young infants, decreasing significantly with age.
  • Metanephrine concentrations showed a reciprocal pattern, being lower in infants under one year compared to older children.
  • These findings highlight significant developmental shifts in catecholamine metabolite levels during early childhood.

Conclusions:

  • Reciprocal changes in plasma catecholamine metabolites during early childhood indicate developmental alterations in chromaffin tissues.
  • Consideration of these developmental changes is vital for establishing accurate pediatric reference intervals.
  • The developed reference intervals enhance biochemical testing for catecholamine-producing tumors in young children.
Abstract

Keywords:
3-O-methyldopa3-methoxytyramineLiquid chromatography tandem mass spectrometry (LC-MS/MS)MetanephrineNormetanephrinePediatric reference intervals

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