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Reference intervals for haptoglobin in neonates and children 30 days to 18 years old

Jad El Maamari1,2, Vasiliki Karlaftis2, Chiara Braida2

  • 1Department of Pediatrics, The University of Alberta, Edmonton, Alberta, Canada.

Scandinavian Journal of Clinical and Laboratory Investigation
|June 2, 2026
PubMed

Insights

This study established pediatric reference intervals for haptoglobin, a protein that binds hemoglobin. Results indicate haptoglobin levels may have limited clinical utility in children under 15 due to naturally low concentrations.

Area of Science:

  • Clinical Chemistry
  • Pediatric Hematology
  • Biomarker Research

Background:

  • Haptoglobin, an α2-glycoprotein produced by the liver, binds free hemoglobin to prevent toxicity.
  • Haptoglobin functions as a biomarker for hemolysis, a condition involving red blood cell breakdown.
  • The HAPPI Kids initiative aimed to establish pediatric reference intervals for haptoglobin.

Purpose of the Study:

  • To define pediatric reference intervals for serum haptoglobin in healthy neonates and children.
  • To improve the diagnostic accuracy of haptoglobin testing in pediatric patients.
  • To establish continuous, age- and sex-specific reference ranges.

Main Methods:

  • Blood samples were collected from 335 children (30 days to 18 years) and 20 neonates.
  • Sample analysis was performed using three automated analyzers: Roche Cobas c501/c502, Roche Cobas c701, and Beckman Coulter Unicel DXL 600/800.
  • Data collection occurred between February 2015 and December 2016.

Main Results:

  • Continuous, age-specific reference intervals for serum haptoglobin were determined.
  • Results were reported with 95% confidence intervals.
  • Age and sex were considered in the reference range determination.

Conclusions:

  • Continuous age-specific reference intervals for serum haptoglobin in neonates and children are presented.
  • Haptoglobin levels in children under 13-15 years may be naturally low.
  • Low haptoglobin concentrations in younger children might fall below assay detection limits, limiting clinical value.
Abstract

Keywords:
Haptoglobinshemolysisinfantpediatricsreference values

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