Mirko Peitzsch1, Anastasios Mangelis2, Graeme Eisenhofer3, Angela Huebner4. 1. Institute of Clinical Chemistry and Laboratory Medicine, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany. Electronic address: Mirko.Peitzsch@uniklinikum-dresden.de. 2. Institute of Clinical Chemistry and Laboratory Medicine, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany. 3. Institute of Clinical Chemistry and Laboratory Medicine, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany; Department of Internal Medicine III, University Hospital Carl Gustav Carus, Technische Universität Dresden, Medical Faculty Carl Gustav Carus, Dresden, Germany. 4. Department of Pediatrics, Division of Pediatric Endocrinology and Diabetology, University Hospital Carl Gustav Carus, Technische Universität Dresden, Medical Faculty Carl Gustav Carus, Dresden, Germany.
Abstract
BACKGROUND: Availability of appropriately established reference intervals for biochemical tests can be troublesome in pediatrics. Here we establish age-specific continuous reference intervals for catecholamine O-methylated metabolites in children evaluated for catecholamine producing tumors, particularly younger children with suspected neuroblastoma. METHODS: Plasma concentrations of 3-methoxytyramine, normetanephrine, metanephrine, and 3-O-methyldopa were analyzed by liquid chromatography tandem mass spectrometry in 533 children aged 2 days to 18 years. RESULTS: Concentrations of plasma free normetanephrine, 3-methoxytyramine and 3-O-methyldopa were higher in neonates up until six months of age, but thereafter declined steeply to levels after one year that were <38% those of neonatal concentrations and to further lower concentrations in teenagers that were <23% those in neonates. In contrast, concentrations of plasma free metanephrine showed a reciprocal pattern with 50% lower concentrations in infants below one year compared to later in childhood. CONCLUSION: The dynamic reciprocal changes in plasma concentrations of normetanephrine, 3-methoxytyramine and 3-O-methyldopa compared to metanephrine during early childhood suggest underlying developmental changes in extra-adrenal and adrenal chromaffin tissue that must be considered for pediatric reference intervals, particularly in infants. With such reference intervals at hand, biochemical testing for catecholamine producing tumors in young children is substantially improved.
BACKGROUND: Availability of appropriately established reference intervals for biochemical tests can be troublesome in pediatrics. Here we establish age-specific continuous reference intervals for catecholamine O-methylated metabolites in children evaluated for catecholamine producing tumors, particularly younger children with suspected neuroblastoma. METHODS: Plasma concentrations of 3-methoxytyramine, normetanephrine, metanephrine, and 3-O-methyldopa were analyzed by liquid chromatography tandem mass spectrometry in 533 children aged 2 days to 18 years. RESULTS: Concentrations of plasma free normetanephrine, 3-methoxytyramine and 3-O-methyldopa were higher in neonates up until six months of age, but thereafter declined steeply to levels after one year that were <38% those of neonatal concentrations and to further lower concentrations in teenagers that were <23% those in neonates. In contrast, concentrations of plasma free metanephrine showed a reciprocal pattern with 50% lower concentrations in infants below one year compared to later in childhood. CONCLUSION: The dynamic reciprocal changes in plasma concentrations of normetanephrine, 3-methoxytyramine and 3-O-methyldopa compared to metanephrine during early childhood suggest underlying developmental changes in extra-adrenal and adrenal chromaffin tissue that must be considered for pediatric reference intervals, particularly in infants. With such reference intervals at hand, biochemical testing for catecholamine producing tumors in young children is substantially improved.
Authors: Michaela Kuhlen; Christina Pamporaki; Marina Kunstreich; Stefan A Wudy; Michaela F Hartmann; Mirko Peitzsch; Christian Vokuhl; Guido Seitz; Michael C Kreissl; Thorsten Simon; Barbara Hero; Michael C Frühwald; Peter Vorwerk; Antje Redlich Journal: Front Endocrinol (Lausanne) Date: 2022-06-17 Impact factor: 6.055
Authors: Laurence Amar; Karel Pacak; Olivier Steichen; Scott A Akker; Simon J B Aylwin; Eric Baudin; Alexandre Buffet; Nelly Burnichon; Roderick J Clifton-Bligh; Patricia L M Dahia; Martin Fassnacht; Ashley B Grossman; Philippe Herman; Rodney J Hicks; Andrzej Januszewicz; Camilo Jimenez; Henricus P M Kunst; Dylan Lewis; Massimo Mannelli; Mitsuhide Naruse; Mercedes Robledo; David Taïeb; David R Taylor; Henri J L M Timmers; Giorgio Treglia; Nicola Tufton; William F Young; Jacques W M Lenders; Anne-Paule Gimenez-Roqueplo; Charlotte Lussey-Lepoutre Journal: Nat Rev Endocrinol Date: 2021-05-21 Impact factor: 43.330
Authors: Lila S Nolan; Angela N Lewis; Qingqing Gong; James J Sollome; Olivia N DeWitt; Robert D Williams; Misty Good Journal: Nutrients Date: 2021-10-14 Impact factor: 6.706
Authors: Karin Eijkelenkamp; Thamara E Osinga; Martijn van Faassen; Ido P Kema; Michiel N Kerstens; Karel Pacak; Wim J Sluiter; Thera P Links; Anouk N A van der Horst-Schrivers Journal: Clin Chem Date: 2021-08-05 Impact factor: 12.167