Abstract
Objectives
Elevated free T3 (FT3) is an important feature for the early diagnosis of several diseases among which Grave’s disease or Allan-Hernon-Dudley syndrome. However, there is a lack of age-adapted reference intervals for plasma thyroid hormones in children. We conducted a study to define reference values of peripheral FT3 in children using a commonly used automated immunoassay.
Methods
All thyroid function test (TFT) results from our lab collected during 9 months were extracted anonymously, and reference intervals establishment followed recommendations validated by International Federation of Clinical Chemistry (IFCC).
Results
We defined five reference intervals covering the whole pediatric period. Overall, 26.1% of peripheral FT3 measured in children with normal TSH are out of the adult reference range, and 22.2% are upper it leading to misinterpretation. In a 9-month old patient with severe neurodevelopmental disorders, a pathological elevated FT3 has been securely interpreted using the newly established interval.
Conclusions
The study highlights the poor relevance of adult intervals in pediatric cares, as it confirms that plasmatic FT3 is higher during the whole pediatric period. This work reports useful age-adapted reference intervals for free T3 in pediatrics using a widely used electrochemiluminescent Immunoassay (ECLIA) kit.
Funding source: Hospices Civils de Lyon
Acknowledgments
This manuscript has been revised by native English speaker Philip Robinson for the Clinical Research and Innovation Department (DRCI) of the Hospices Civils de Lyon. We are very grateful for his contribution.
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Research funding: None declared.
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Author contributions: Clément Janot: Conceptualization, Methodology, Formal analysis, software, Visualization, Writing – original draft; Pauline Perrin: Formal analysis, Data curation, Writing – Review; Patricia Bretones, Vincent des Portes, Ingrid Plotton & Florence Roucher-Boulez: Writing – review; Véronique Raverot: Conceptualization, Methodology, Validation, Writing – review. All authors have accepted responsibility for the entire content of this manuscript and approved its submission.
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Competing interests: Authors state no conflict of interest.
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Informed consent: Not applicable.
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Ethical approval: The use of human biological material in this research is in accordance with the tenets of the Declaration of Helsinki and the author’s institution ethical policy.
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Data availability: Data are available on request to the corresponding author.
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