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Reference intervals for plasma total bilirubin in children
Line Philipsen1, Lærke Andersen1, Stine Linding Andersen1,2
1Department of Clinical Biochemistry, Aalborg University Hospital, Gistrup, Denmark.
Summary
This study established age-dependent reference intervals for plasma total bilirubin in children aged 0-18 years. Results show bilirubin levels are dynamic in the first month of life and stable thereafter, consistent across common laboratory methods.
Area of Science:
- Clinical Biochemistry
- Pediatric Laboratory Medicine
Background:
- Plasma total bilirubin testing is crucial for assessing hyperbilirubinemia in children.
- Interpreting bilirubin levels in newborns is challenging due to physiological adaptations.
- Establishing accurate reference intervals (RIs) across different analyzers is needed for clinical laboratories.
Purpose of the Study:
- To establish age-dependent reference intervals for plasma total bilirubin in children aged 0-18 years.
- To evaluate the dynamics of plasma total bilirubin across different routinely used laboratory analyzers.
- To provide evidence supporting the choice of RIs in pediatric clinical practice.
Main Methods:
- Retrospective analysis of routine laboratory results for plasma total bilirubin in 29,195 children (0-18 years).
- Non-parametric establishment of RIs using the 2.5th and 97.5th percentiles.
- Analysis of data from three common analyzers: Alinity (Abbott), Atellica (Siemens), and Cobas 8000 (Roche).
Main Results:
- Plasma total bilirubin levels exhibited dynamic changes within the first month of life.
- Levels stabilized to a low range from 1 month to 18 years of age.
- Upper RI limits varied by age group and analyzer, particularly in the neonatal period.
Conclusions:
- Age-dependent reference intervals for plasma total bilirubin are essential for accurate interpretation in children.
- The observed bilirubin dynamics were consistent across the evaluated laboratory methods.
- The findings support the implementation of age-specific RIs for pediatric patients.
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