LabCorp recognizes that pediatricians and pediatric endocrinologists have special needs and

Transcription

1 LabCorp recognizes that pediatricians and pediatric endocrinologists have special needs and requirements for the laboratory testing of their patients. -specific reference intervals and specimen collection issues are particular concerns in pediatric patient care and evaluation. Frequently, adult reference intervals are not appropriate for pediatric patients. To assist physicians in treating their pediatric patients, this document lists age-specific reference intervals for many of the endocrine tests offered by LabCorp. Where available, reference ranges are also provided by Tanner stage. LabCorp realizes that pediatric specimen collection can be challenging and is a major concern for health care providers. It is frequently difficult to obtain substantial volumes of blood or urine from pediatric patients. For this reason, we have provided an appropriate specimen volume as well as an analytical minimum specimen volume for each test. The minimum volumes listed in this document represent the analytical minimum specimen required to perform the test once. This volume does not permit any repeat analysis. It is highly recommended that the preferred volume indicated below be submitted whenever possible. Aldosterone (ng/dl) < 1 yr yr yr yr yr Aldosterone (µg/24 hours) Volume: 0.3 ml (0.1 ml minimum) Urine 0-1 mo mo yr a-Androstane-3a,.. 17b-Diol Glucuronide Volume: 0.3 ml (0.2 ml minimum) Serum 0-3 yr < 80 < yr < 70 < yr < 399 < yr < 220 < yr < 311 < yr < yr yr I (< 8yr) <400 < 330 I (> 8yr) <513 < 144 II < III IV V

2 Androstenedione (ng/dl) Volume: 0.3 ml (0.2 ml minimum) Serum 0-5 mo mo yr yr yr yr yr I (<7 yr) < 35 < 42 I (>7 yr) < 49 < 83 II < 89 <143 III <152 IV < Angiotensin-converting Enzyme (U/L) Volume: 0.5 ml (0.2 ml minimum) Serum 0-2 yr yr yr 6-89 >14 yr 8-52 Antidiuretic Hormone, ADH (pg/ml) Volume: 2.0 ml (1.0 ml minimum) Frozen Plasma Range 0-1 mo Less than mo Less than yr Less than 6.9 b 2 -Microglobulin (mg/l) Volume: 0.5 ml (0.2 ml minimum) Serum/Plasma 0-1 mo mo mo yr yr yr yr yr yr Bone-Specific Alkaline Phoshphatase (µg/l) Volume: 0.2 ml (0.1 ml minimum) Frozen Plasma < 1 yr yr yr yr yr yr yr yr < yr < 69 Catecholamines, Fractionated (pg/ml) Volume: 3.0 ml (1.5 ml minimum) Plasma, Frozen Epinephrine 2-9 days days-2 mo mo-11 mo mo mo yr Norepinephrine 2-9 days days-2 mo mo-11 mo mo mo yr Catecholamines (µg/g creatinine) Volume: 10 ml (4.0 ml minimum) Urine Epinephrine 0-23 mo < yr < yr < yr < 34 2

3 Norepinephrine 0-23 mo < yr < yr < yr < 82 Dopamine 0-23 mo < yr < yr < yr < 545 Cortisol (µg/dl) Volume: 0.5 ml (0.3 ml minimum) Serum 5th day mo-13 yr yr yr II-III IV-V Cortisol, Urinary Free by HPLC (µg/24 hr) Volume: 15 ml (5.0 ml minimum) Urine 2-11 yr yr 2-38 C-Peptide (ng/ml) Volume: 1.0 ml (0.4 ml minimum) Serum, Frozen 0-9 yr yr Dehydroepiandrosterone (DHEA) (ng/dl) Volume: 0.3 ml (0.1 ml minimum) Serum 0-5 yr yr yr yr yr I II III IV V Dehydroepiandrosterone (DHEA) Sulfate (µg/dl) Volume: 1.0 ml (0.4 ml minimum) Serum 1-7 days days yr < 30 < yr < 186 < yr < 94 < yr < 75 < yr < 152 < yr < 344 < yr < 242 < yr < yr yr yr yr I < 87 < 65 II & III < 151 < 175 IV V

4 Deoxypyridinoline (Dpd) Cross-Links (nmol Dpd/mmol creatinine) Volume: 10 ml (1.0 ml minimum) Urine 8-11 yr yr Dihydrotestosterone (ng/dl) * Volume: 1.2 ml (0.5 ml minimum) Serum Newborn <15.0 Prepubertal <3.0 <3.0 I <3.0 <3.0 II III IV V Adult Erythropoietin (miu/ml) yr yr yr yr yr Estradiol (pg/ml) yr <15 < yr <15 < yr < yr < yr I II III IV V Estrogens, Total (pg/ml) Volume: 2.8 ml (1.1 ml minimum) Serum 0-10 yr I II III IV V Estrone (pg/ml) Volume: 0.4 ml (0.2 ml minimum) Serum 0-5 yr yr yr yr yr I II III IV V Follicle-stimulating Hormone (miu/ml) Volume: 1.0 ml (0.4 ml minimum) Serum 0-23 mo yr yr yr I & II III & IV V *This test may be considered by Medicare and other carriers as investigational and, therefore, may not be payable by the carrier as a covered benefit for patients. 4

5 Gastrin (pg/ml) Volume: 0.5 ml (0.3 ml minimum) Serum, Frozen 0-1 mo mo mo-16 yr (fasting 3-4 hr) mo-16 yr (fasting 5-6 hr) mo-16 yr (fasting >8 hr) Glutamic Acid Decarboxylase * Autoantibody (U/mL) Volume: 0.2 ml (minimum) 0.02 ml Serum Male & Female < 1.5 U/mL Growth Hormone (ng/ml) day wk mo yr to Adult Less than 5.0 Homovanillic Acid (µg/mg creatinine) Volume: 10 ml (4.0 ml minimum) Urine 0-2 mo mo mo yr yr yr Hydroxyindoleacetic Acid (mg/g creatinine) Volume: 1.0 ml (0.3 ml minimum) Urine 3-8 yr yr yr Hydroxypregnenolone (ng/dl) Volume: 2.5 ml (1.1 ml minimum) Serum/Plasma < 1 yr yr yr II-III IV-V Hydroxyprogesterone (ng/dl) Volume: 1.0 ml (0.5 ml minimum) Serum < 1mo mo mo yr yr yr yr yr yr IA2 Autoantibodies (U/mL) Volume: 0.3 ml (0.1 ml minimum) Serum Male & Female less than 0.75 Insulin, Fasting (µiu/ml) I II & III IV & V Insulin Autoantibodies (U/mL) Volume: 0.5 ml (0.2 ml minimum) Serum Male & Female less than 1.0 *This test may be considered by Medicare and other carriers as investigational and, therefore, may not be payable by the carrier as a covered benefit for patients. 5

6 Insulin-like Growth Factor I (ng/ml) Volume: 0.5 ml (0.2 ml minimum) Serum 2 mo-5 yr yr yr yr yr I II III IV V Insulin-like Growth Factor II (ng/ml) * Volume: 0.4 ml (0.2 ml minimum) Serum Newborn yr yr yr yr yr yr yr yr Insulin-Iike Growth Factor-binding Protein 3 (mg/l) Volume: 0.3 ml (0.1 ml minimum) Serum 0-1 yr yr yr yr yr yr yr yr yr yr Ketogenic Steroids (mg/24 hr) Volume: 12 ml (10 ml minimum) Urine 0-11 mo < yr < yr < Ketosteroids (mg/24 hr) Volume: 25 ml (15 ml minimum) Urine 0-4 yr <2 <2 5-9 yr <3 < yr yr yr Luteinizing Hormone (miu/ml) mo yr yr I II III IV & V Metanephrines, Fractionated (µg/24 hr) Volume: 25 ml (10 ml minimum) Urine Metanephrine Normetanephrine 3-8 yr yr yr Neopterin (ng/ml) * Volume: 0.4 ml (0.2 ml minimum) Serum 0-18 yr *This test may be considered by Medicare and other carriers as investigational and, therefore, may not be payable by the carrier as a covered benefit for patients. 6

7 N-Telopeptide Cross-links (NTX) (mm BCE/mmol creatinine) Volume: 1.0 ml (0.3 ml minimum) Urine Male Female I II III IV <609 <389 V <240 <132 Osteocalcin (ng/ml) Volume: 1.0 ml (0.3 ml minimum) Serum, Frozen 6 yr < 28 < 52 7 yr < 41 < 53 8 yr < 54 < 54 9 yr < 48 < yr < 47 < yr < 76 < yr < 126 < yr < 99 < yr < 116 < yr < 115 < yr < 70 < yr < 41 < yr < 38 < yr < 28 < 16 Parathyroid Hormone (PTH), Intact (pg/ml) Volume: 1.0 ml (0.4 ml minimum) Serum, Frozen 2-20 yr 9-52 Pregnenolone (ng/dl) Volume: 2.5 ml (1.1 ml minimum) Serum/Plasma < 1 yr yr yr II & III IV-V Progesterone (ng/ml) Volume: 0.5 ml (0.3 ml minimum) Serum 1-10 yr < 0.5 < 0.5 I < 0.3 < 0.3 II < 0.3 < 0.5 III < 0.5 < 4.5 IV < 1.1 < 13.0 V Prolactin (ng/ml) Volume: 0.5 ml (0.3 ml minimum) Serum <1 mo mo yr yr yr yr yr Renin, Active (uu/ml) Volume: 1.0 ml (0.5 ml minimum) EDTA Plasma Range 1-6 yr yr yr 2-37 Renin Activity (ng/ml/hr) Volume: 2.5 ml (1.1 ml minimum) Plasma, Frozen 0-1 mo mo yr yr yr yr Serotonin (ng/ml) Volume: 1.5 ml (minimum) 0.6 ml Blood, Frozen 0-18 yr

8 Serotonin, Platelet (ng/10 9 platelets) See Directory of Services and Interpretive Guide for specimen requirements 0-19 mo mo - 15 yr Sex Hormone-binding Globulin (nmol/l) Volume: 0.3 ml (0.1 ml minimum) Serum 0-1 mo mo yr yr yr yr yr yr Testosterone, Total (ng/dl) mo mo yr yr yr yr yr I II III IV V Testosterone, Free by Ultrafiltration with Total (ng/dl) Volume: 1.8 ml (0.7 ml minimum) Serum Free Testosterone (ng/dl) Cord Blood days mo mo mo yr yr yr yr Percentage of Total Testosterone Cord Blood days mo mo mo yr yr yr yr Thyroglobulin, Quantitative (ng/ml) * Term Infants Cord Blood day day Premature Infants (27 to 31 weeks) 1 day day day *This test may be considered by Medicare and other carriers as investigational and, therefore, may not be payable by the carrier as a covered benefit for patients. 8

9 Premature Infants (31 to 34 weeks) 1 day day day yr yr 9-27 Thyroid-stimulating Hormone (µiu/ml) days mo-5 yr yr Thyroxine (T 4 ) (µg/dl) < 1 mo mo yr yr yr yr Thyroxine (T 4 ), Free by Equilibrium Dialysis (ng/dl) Volume: 0.5 ml (0.2 ml minimum) Serum Range Birth-4 days wk - 20 yr Thyroxine (T 4 ), Free, Direct (ng/dl) days days mo yr yr yr yr Thyroxine-binding Globulin (µg/ml) mo yr yr yr yr Triiodothyronine (T 3 ), (ng/ml) mo mo yr yr yr yr Triiodothyronine (T 3 ), Free (pg/ml) Volume: 0.5 ml (0.3 ml minimum) Serum 1-3 days days mo yr yr yr yr Triiodothyronine (T 3 ), Reverse (pg/ml) Volume: 0.3 ml (0.2 ml minimum) Serum 1-4 yr yr yr

10 Triiodothyronine (T 3 ), Uptake (%) mo yr yr yr yr yr Vanillylmandelic Acid (VMA) (mg/g creatinine) Volume: 10 ml (4 ml minimum) Random Urine 0-1 yr yr yr yr Vitamin D, 25-Hydroxy (ng/ml) Volume: 0.3 ml (0.2 ml minimum) Serum Summer Ranges < 1 mo mo yr yr yr Winter Ranges < 1 mo mo yr yr yr Note: Use plastic transport tubes for all frozen specimens. In addition, to avoid delays in turnaround time when requesting multiple tests on frozen samples, please 10

11 References Aldosterone, Serum Meites S, Buffone GJ, Cheng MH, et al, eds. Pediatric Clinical Chemistry, Reference (Normal) Values. 3rd ed. Washington, DC: AACC Press; 1989:45. Stark P, Beckerhoff R, Leumann EP, et al. Control of plasma aldosterone in infancy and childhood. Helv Paediatr Acta. 1976; 30: Aldosterone, Urine Meites S, Buffone GJ, Cheng MH, et al, eds. Pediatric Clinical Chemistry, Reference (Normal) Values. 3rd ed. Washington, DC: AACC Press; 1989: Loeuile GA, Racadot A, Vasseur P, Vandewalle B. Blood and urinary aldosterone levels in normal neonates, infants and children. Pediatrie. 1981; 36: α-Androstane-3α,17ß-Diol Glucuronide Rittner HL, Lee PDK, Blum WF, et al. Developmental patterns of serum 3 alpha-androstanediol glucuronide. J Edocrinol Invest. 1997; 20: Androstenedione Soldin SJ, Hicks JM, eds. Pediatric Reference Ranges. Washington, DC: AACC Press; 1995: 30. Meites S, Buffone GJ, Cheng MH, et al, eds. Pediatric Clinical Chemistry, Reference (Normal) Values. 3rd ed. Washington, DC: AACC Press; 1989:56. Angiotensin-converting Enzyme Tietz NW, ed. Clinical Guide to Laboratory Tests. 3rd ed. Philadelphia: W.B. Saunders Company; 1995:54. Lieberman J. Elevation of serum angiotensin-converting enzyme (ACE) level in sarcoidosis. Am J Med. 1975; 59:365. Antidiuretic Hormone Rascher W, Rauh W, Brandeis WE, Huber K-H, Schärer K. Determinants of plasma arginine-vasopressin in children. Acta Paediatr Scand. 1986;75: β 2 -Microglobulin Soldin SJ, Hicks JM, Bailey J, Beatey J, Watson P. Pediatric reference ranges for B2-microglobulin and ceruloplasmin. Clin Chem. 1997; 43:S199. Bone-Specific Alkaline Phoshphatase Tobiume H, Kanzaki S, Hida S, et al. Serum bone alkaline phosphatase isoenzyme levels in normal children and children with growth hormone (GH) deficiency: A potential marker for bone formation and response to GH therapy. J Clin Endocrinol Metab. 1997;82(7): Cathecholamines, Serum Candito M, Albertini M, Politano S, et al. Plasma catecholamine levels in children. J Chromatogr B Biomed Sci Appl. 1993; 617: Cathecholamines, Urine Soldin SJ, Lam G, Pollard A, et al. High performance liquid chromatographic analysis of urinary catecholamines employing amperometric detection: Reference values and use in laboratory diagnosis of neural crest tumors. Clin Biochem. 1980; 13: Cortisol, Serum Jonetz-Mentzel L, Wiedmann G. Establishment of reference ranges for cortisol in neonates, infants, children and adolescents. Eur J Clin Chem Biochem. 1993; 31: Lashansky G, Saenger P, Fishman K, et al. Normative data for adrenal steroidogenesis in a healthy pediatric population: - and sex-related changes after adrenocorticotropin stimulation. J Clin Endocrinol Metab. 1991; 73: Cortisol, Urine Tietz NW, ed. Clinical Guide to Laboratory Tests. 3rd ed. Philadelphia: W.B. Saunders Company; 1995:174. C-Peptide, Serum Ratzmann KP, Strese J Kohnert DK, et al. -dependent relationship of fasting C-peptide concentration and insulin secretion in non-obese subjects with normal glucose tolerance. Exp Clin Endocrinol. 1986; 88: Dehydroepiandrosterone (DHEA) Ducharme JR, Forest MG, De Peretti E, et al. Plasma adrenal and gonadal sex steroids in human pubertal development. J Clin Endicrinol Metab. 1976; 42: Tietz NW, ed. Clinical Guide to Laboratory Tests. 3rd ed. Philadelphia: W.B. Saunders Company; 1995:

12 Dehydroepiandrosterone Sulfate (DHEA-S) Kühnel W. Immulite and Immulite 2000 Reference Range Compendium. Los Angeles, Calif: Diagnostic Products Corporation; [DPC Technical Report] Deoxypyridinoline (Dpd) Cross-links Bjorgaas M, Haug E, Johnsen HJ. The urinary excretion of deoxypyridinium cross-links is higher in diabetic than in nondiabetic adolescents. Calcif Tissue Int. 1999;65: Dihydrotestosterone Tietz NW, ed. Clinical Guide to Laboratory Tests. 3rd ed. Philadelphia: W.B. Saunders Company; 1995: Erythropoietin Krafte-Jacobs B, Williams J, Soldin SJ. Plasma erythropoetin reference ranges in children. J Pediatrics. 1995; 126: Estradiol Soldin SJ, Brugnara C, Gunter KC, Hicks JM, eds. Pediatric Reference Ranges. 2nd ed. Washington, DC: AACC Press; 1997:68. Abraham GE, Odell WD, Swerdloff RS, Hopper K. Simultaneous radioimmunoassay of plasma FSH, LH, progesterone, 17-hydroxyprogesterone, and estradiol-17beta during the menstrual cycle. J Clin Endocrinol Metab. 1972; 34: Tietz NW, ed. Clinical Guide to Laboratory Tests. 3rd ed. Philadelphia: W.B. Saunders Company; 1995:216. Estrogens, Total Tietz NW, ed. Clinical Guide to Laboratory Tests. 3rd ed. Philadelphia: W.B. Saunders Company; 1995:220. Estrone Meites S, Buffone GJ, Cheng MH, et al, eds. Pediatric Clinical Chemistry, Reference (Normal) Values. 3rd ed. Washington, DC: AACC Press; 1989:123. Ducharme JR, Forest MG, De Peretti E, et al. Plasma adrenal and gonadal sex steroids in human pubertal development. J Clin Endicrinol Metab. 1976; 42: Tietz NW, ed. Clinical Guide to Laboratory Tests. 3rd ed. Philadelphia: W.B. Saunders Company; 1995:222. Follicle-stimulating Hormone (FSH) Murthy JN, Hicks JM, Soldin SJ. Evaluation of the Technicon Immuno I Random Access Immunoassay Analyzer and calculation of pediatric reference ranges for endocrine tests, T-uptake and ferritin. Clin Biochem. 1995; 28: Tietz NW, ed. Clinical Guide to Laboratory Tests. 3rd ed. Philadelphia: W.B. Saunders Company; 1995:248. Gastrin Meites S, Buffone GJ, Cheng MH, et al, eds. Pediatric Clinical Chemistry, Reference (Normal) Values. 3rd ed. Washington, DC: AACC Press; 1989:131. Sann L, Chayvialle JAP, Bremond A, Lambert R, Serum gastrin level in early childhood. Arch Disease Childhood. 1975; 50: Janik JS, Akbar AM, Burrington JD, Burke G. Serum gastrin levels in infants and children. Pediatrics. 1977; 60: Glutamic Acid Decarboxylase Kronus (kit manufacturer) Directional Insert. Growth Hormone Tietz NW, ed. Clinical Guide to Laboratory Tests. 3rd ed. Philadelphia: W.B. Saunders Company; 1995:300. Baumann G. Growth hormone binding protiens and various forms of growth hormone: Implications for measurements. Acta Paediatr Scand Suppl. 1990; 370: Homovanillic Acid (HVA) Tuchman M, Morris CL, Ramnaraine ML, et al. Value of random urinary homovanillic acid and vanillylmandelic acid levels in the diagnosis of and management of patients with neuroblastoma: Comparison with 24-hour urine collections. Pediatrics. 1985; 75: Hydroxyindoleacetic Acid Soldin SJ, et al, eds. Pediatric Reference Ranges. 2nd ed. Washington, DC: AACC Press; 1997: Hydroxypregnenolone Lashanski G, Saenger P, Fishman K, et al. Normative data for adrenal steroidogenesis in a healthy pediatric population: - and sex-related changes after adrenocorticotropin stimulation. J Clin Endocinol Metab. 1991;73(3): Hydroxyprogesterone Soldin SJ, Bailey J, Beatey J, et al. Pediatric Reference ranges for 17 alpha-hydroxy progesterone. Clin Chem. 1995; 41:S92. Insulin, Fasting Smith P, Dunger DB, Williams AJK, et al. Relationship between insulin, insulin-like growth factor I, and dehydroepiandrosterone sulfate concentrations during childhood, puberty and adult life. J Clin Endocrinol Metab. 1989; 68:

13 Insulin-like Growth Factor I (IGF-I) Nichols Institute Diagnostics (kit manufacturer) Directional Insert. Insulin-like Growth Factor II (IGF-II) Diagnostic Systems Laboratory Technical Communication. Insulin-like Growth Factor-binding Protein 3 Nichols Institute Diagnostics (kit manufacturer) Directional Insert. 17-Ketogenic Steroids Tietz NW, ed. Clinical Guide to Laboratory Tests. 3rd ed. Philadelphia: W.B. Saunders Company; 1995: Ketosteroids Tietz NW, ed. Clinical Guide to Laboratory Tests. 3rd ed. Philadelphia: W.B. Saunders Company; 1995:380. Luteinizing Hormone (LH) Soldin SJ, Morales A, Albalos, et al. Pediatric reference ranges on the Abbott Imx for FSH, LH, prolactin, TSH, T 4, T 3, free T 4, free T 3, T-uptake, IgE and ferritin. Clin Biochem. 1995; 28: Tietz NW, ed. Clinical Guide to Laboratory Tests. 3rd ed. Philadelphia: W.B. Saunders Company; 1995:410. Metanephrines Soldin SJ, Hicks JM, eds. Pediatric Reference Ranges. Washington, DC: AACC Press; N-Telopeptide Cross-links (NTX) Mora S, Prinster C, Proverbio MC, et al. Urinary markers of bone turnover in healthy children and adolescents: -related changes and effect of puberty. Calcif Tissue Int. 1998; 63: Neopterin Werner ER, Bichler A, Daxenbichler G, et al. Determination of neopterin in serum and urine. Clin Chem. 1987; 33: Osteocalcin Johansen JS, Giwercman A, Hartwell D, et al. Serum bone Gla-protein as a marker of bone growth in children and adolescents: Correlation with age, height, serum insulin-like growth factor I, and serum testosterone. J Clin Endocrinol Metab. 1988;67(2): Parathyroid Hormone, Intact Soldin SJ et al, eds. Pediatric Reference Ranges. 2nd ed. Washington, DC: AACC Press; 1997:119. Pregnenolone Lashanski G, Saenger P, Dimartino-Nardi J, et al. Normative data for the steroidogenic response of mineralocorticoids and their precursors to adrenocorticotropin in a healthy pediatric population. J Clin Endocinol Metab. 1992;75(6): Progesterone Tietz NW, ed. Clinical Guide to Laboratory Tests. 3rd ed. Philadelphia: W.B. Saunders Company; 1995:508. Prolactin Cook JF, Hicks JM, Godwin ID, et al. Pediatric reference ranges for prolactin. Clin Chem. 1992; 38:959. Renin Active Coates JE, Chapelsky LJ, Yatscoff RW. Pediatric reference intervals for plasma renin. Clin Biochem. 1994;27(4): Renin Activity Tietz NW, ed. Clinical Guide to Laboratory Tests. 3rd ed. Philadelphia: W.B. Saunders Company; 1995:538. Serotonin, Whole Blood Goldsmith BM, Feinstein C, Munson S, et al. Determination of a reference range for whole blood serotonin in a pediatric population using high pressure liquid chromatography with electrochemical detection. Clin Biochem. 1986; 19: Serotonin, Platelet Flachaire E, Beney C, Berthier A, et al. Determination of reference values for serotonin concentration in platelets of healthy newborns, children, adults and elderly subjects by HPLC with electrochemical detection. Clin Chem. 1990; 36: Sex Hormone-binding Globulin Hicks SJ, Bailey JM, Beatey J, Watson P. Pediatric reference ranges for sex hormone binding globulin. Clin Chem. 1997; 43:S200. Testosterone, Total Soldin SJ, Hicks JM, eds. Pediatric Reference Ranges. Washington, DC: AACC Press; 1995:124. Meites S, Buffone GJ, Cheng MH, et al, eds. Pediatric Clinical Chemistry, Reference (Normal) Values. 3rd ed. Washington, DC: AACC Press; 1989:247. Tietz NW, ed. Clinical Guide to Laboratory Tests. 3rd ed. Philadelphia: W.B. Saunders Company; 1995:

14 Testosterone, Free by Ultrafiltration Tietz NW, ed. Clinical Guide to Laboratory Tests. 3rd ed. Philadelphia: W.B. Saunders Company; 1995:578. Thyroglobulin Meites S, Buffone GJ, Cheng MH, et al, eds. Pediatric Clinical Chemistry, Reference (Normal) Values. 3rd ed. Washington, DC: AACC Press; 1989:249. Thyroid-stimulating Hormone (TSH) Soldin SJ, Morales A, Albalos, et al. Pediatric reference ranges on the Abbott Imx for FSH, LH, prolactin, TSH, T 4, T 3, free T 4, free T 3, T-Uptake, IgE and ferritin. Clin Biochem. 1995; 28: Thyroxine (T 4 ) Soldin SJ, Hicks JM, eds. Pediatric Reference Ranges. Washington, DC: AACC Press; 1995:141. Soldin SJ, Cook J, Beaty et al. Pediatric reference ranges for thyroxine and triiodothyronine uptake. Clin Chem. 1992; 38:960. Thyroxine (T 4 ), Free by Ultrafiltration Tietz NW, ed. Clinical Guide to Laboratory Tests. 3rd ed. Philadelphia: W.B. Saunders Company; 1995:596. Thyroxine (T 4 ), Free, Direct Soldin SJ, Morales A, Albalos, et al. Pediatric reference ranges on the Abbott Imx for FSH, LH, prolactin, TSH, T 4, T 3, free T 4, free T 3, T-Uptake, IgE and ferritin. Clin Biochem. 1995; 28: Thyroxine-binding Globulin (TBG) Hicks JM, Godwin ID, Beatey J, et al. Pediatric reference ranges for thyroid binding globulin. Clin Chem. 1993; 39:1172. Triiodothyronine (T 3 ) Soldin SJ, Morales A, Albalos, et al. Pediatric reference ranges on the Abbott Imx for FSH, LH, Prolactin, TSH, T 4, T 3, free T 4, free T 3, T-Uptake, IgE and ferritin. Clin Biochem. 1995; 28: Triiodothyronine (T 3 ), Free Soldin SJ, Morales A, Albalos, et al. Pediatric reference ranges on the Abbott Imx for FSH, LH, Prolactin, TSH, T 4, T 3, free T 4, free T 3, T-Uptake, IgE and ferritin. Clin Biochem, 1995; 28: Triiodothyronine (T 3 ), Reverse Soldin SJ, Hicks JM, eds. Pediatric Reference Ranges. Washington, DC: AACC Press; 1995:132. Triiodothyronine Uptake (T 3 U) Soldin SJ, Cook J, Beaty, et al. Pediatric reference ranges for thyroxine and triiodothyronine uptake. Clin Chem. 1992; 38:960. Vanillylmandelic Acid (VMA) Soldin SJ, Hill JG. Liquid chromatographic analysis for urinary 4-hydrozy-3-methoxy-mandelic acid and 4-hydroxy-3-mehoozyphenyl acetic acid and ist use in investigation of neural crest tumors. Clin Chem. 1981; 27: Vitamin D, 25-Hydroxy Soldin SJ, Murthy JN, Lauber B, MacFarlane G. Pediatric reference ranges for 25-hydroxy vitamin D using the DiaSorin Kit. Clin Chem. 1998; 44:A14. 14