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Drug Dosing: Infants and Children

Pediatric patient dosages diverge from adults due to disparities in body surface area, total body water, and extracellular fluid per kilogram of body weight. The dosing regimen considers the variations in pharmacokinetics and pharmacology across distinct age groups, encompassing preterm newborns, infants, young children, older children, and adolescents. Calculation of pediatric patient doses is predicated on determining body surface area, which exhibits a superior correlation with the child's...
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Understanding the physiological differences in the pediatric population is crucial for effective pharmacotherapy. Neonates, infants, and children exhibit significant variations in gastric pH, gastric emptying time, intestinal transit time, and biliary function. These variations profoundly affect oral drug absorption, necessitating a nuanced approach to pediatric dosing.Neonates present with a unique physiological profile, having a gastric pH greater than 4 and faster and more irregular gastric...
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Drug distribution in the pediatric population exhibits unique challenges and considerations due to the physiological differences between children, particularly neonates and infants, and adults. A crucial aspect of pediatric pharmacology is understanding how these differences impact the pharmacokinetics of various drugs, necessitating age-specific dosing strategies to ensure efficacy and safety.Neonates and infants have a higher total body water content, ~75%–90% of their body weight, compared...
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Paediatric reference ranges for plasma chromogranin A.

Sofie Lieberoth1, Frederik Friis-Hansen1, Lennart Friis-Hansen1,2,3

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This study establishes plasma chromogranin A (CgA) reference intervals for children and adolescents, crucial for diagnosing neuroendocrine neoplasms (NENs). The findings provide age-specific ranges to aid in the accurate screening and monitoring of NENs in pediatric populations.

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Immunoassayanalytesclinical studieslaboratory methodspeptide hormonestumour markers

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Area of Science:

  • Biochemistry
  • Pediatric Oncology
  • Clinical Diagnostics

Background:

  • Neuroendocrine neoplasms (NENs) are rare, heterogeneous tumors originating from endocrine cells.
  • Plasma chromogranin A (CgA) is a key biomarker for NEN screening, diagnosis, and monitoring in all age groups.
  • Establishing age-specific reference intervals for CgA in children is essential for accurate clinical interpretation.

Purpose of the Study:

  • To determine plasma CgA reference intervals in healthy children and adolescents.
  • To analyze the age-dependent changes in plasma CgA concentrations.
  • To assess the intra-individual variation of plasma CgA measurements.

Main Methods:

  • Plasma CgA levels were measured using the Brahms Kryptor assay in a cohort of 268 healthy children and adolescents.
  • Data from familial cancer screening and allergy screening programs were included.
  • Intra-individual variation was calculated using repeated measurements over time, and data were analyzed using the referenceInterval package in R.

Main Results:

  • Plasma CgA concentrations decreased with age, with distinct ranges for different pediatric age groups (0-3, 4-13, and 14-19 years).
  • Upper limits for pediatric CgA reference intervals ranged from 6 to 118 µg/L, varying by age group.
  • The median intra-individual variation was 14%, indicating good measurement stability.

Conclusions:

  • The established plasma CgA reference intervals are valuable for screening, diagnosing, and monitoring pediatric NENs.
  • These age-specific intervals improve the accuracy of CgA interpretation in children and adolescents.
  • Clinical application of these intervals should consider the inherent limitations of plasma CgA as a biomarker.