title: Reference range of serum calcitonin in pediatric population.
abstract: BACKGROUND
  Children belonging to the multiple endocrine neoplasia type 2 (MEN 2) pedigree and carrying germline RET mutations are candidates for prophylactic thyroidectomy, the timing of which is based on the mutation-associated risk and the calcitonin (CT) levels.
  
  
  METHODS
  The aim of this study was to establish the reference range for serum CT in a pediatric population. The study included 2740 subjects (1339 females and 1401 males) ranging in age from 1 day to 16 years and undergoing blood testing for any medical condition not affecting serum CT.
  
  
  RESULTS
  Overall, serum CT was undetectable in 61.5% of the samples and detectable in 38.5%. Detectable samples were more frequent in the first 2 years of life. Thereafter, undetectable samples became more frequent, particularly in females. Mean serum CT concentrations were higher in the first year of life (9.81 ± 8.8 pg/mL; range, 2.0-48.9 pg/mL) and the second year of life (4.56 ± 2.64 pg/mL; range, 2.0-14.7 pg/mL). A significant decrease of serum CT levels was observed thereafter (P < .001), and starting from the third year of life serum CT levels were similar to those found in adults. No gender difference was found in any age group. Based on these results, age-specific CT reference ranges are needed in the pediatric population, and especially in the first 2 years of life.
  
  
  CONCLUSIONS
  This is the first study defining the reference range for serum CT in the pediatric population and large enough to be statistically meaningful. Our proposal may facilitate the process of decision making when dealing with gene carriers of MEN 2.
authors.affiliation: Department of Medical, Surgical, and Neurological Sciences (M.G.C., F.M., S.M., F.S., C.F., F.P.), University of Siena, 53100 Siena, Italy; Endocrine Unit (L.F., D.C.), Fondazione Instituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Ca'Granda, and Department of Pathophysiology and Transplantation, University of Milan, 20122 Milan, Italy; Clinical Pathology Laboratory (C.F.F.), Fondazione IRCCS Ca'Granda, 20122 Milan, Italy; Laboratory of Clinical Pathology (C.S.), Azienda Ospedaliera Universitaria Senese, 53100 Siena, Italy; Pediatric Surgery Unit (F.M.), Fondazione IRCCS Ca'Granda, 20122 Milan, Italy; and Department of Surgery and Bioengineering (G.C.), University of Siena, 53100 Siena, Italy.
authors.forename: Maria G
authors.initials: MG
authors.lastname: Castagna
authors.forename: Laura
authors.initials: L
authors.lastname: Fugazzola
authors.forename: Fabio
authors.initials: F
authors.lastname: Maino
authors.forename: Danila
authors.initials: D
authors.lastname: Covelli
authors.forename: Silvia
authors.initials: S
authors.lastname: Memmo
authors.forename: Fausta
authors.initials: F
authors.lastname: Sestini
authors.forename: Carla
authors.initials: C
authors.lastname: Fioravanti
authors.forename: Chiara
authors.initials: C
authors.lastname: Ferraris Fusarini
authors.forename: Carlo
authors.initials: C
authors.lastname: Scapellato
authors.forename: Francesco
authors.initials: F
authors.lastname: Macchini
authors.forename: Gabriele
authors.initials: G
authors.lastname: Cevenini
authors.forename: Furio
authors.initials: F
authors.lastname: Pacini
mesh_terms: D000293:Adolescent; D002116:Calcitonin / Q000097:blood*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D012016:Reference Values
chemical_list: D002116:Calcitonin