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      Normal Range of Calcitonin in Children Measured by a Chemiluminescent Two-Site Immunometric Assay

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          Abstract

          Calcitonin (CT) assay is of considerable importance in the routine evaluation of thyroid nodules and for screening and follow-up of patients with medullary thyroid carcinoma and their relatives. Aim of this study was to assess the reference ranges for CT levels in healthy children and to evaluate possible differences in CT levels between sex and age. Serum CT levels were measured by a commercially available two-site chemiluminescence immunometric assay (sensitivity = 0.2 pg/ml). The ILMA recognizes the mature monomeric form of CT. We evaluated a cohort of 125 healthy children and compared these results with those from 98 healthy adult men and women. The ranges for human CT in children were <0.2–11.7 pg/ml and <0.2–17 pg/ml for female and male, respectively. No gender differences were observed in children population, though higher CT levels were observed in males. Serum CT levels did not correlate with age. Adult female had statistically significant lower CT levels than female children (p ≤0.05). In the adult population, males showed levels of CT higher than females. In conclusion, this study provide normal range for children population at different age with a sensible two-site chemiluminescent immunoassay. Since the normal range of serum CT levels is wider in healthy children than in adults, these data suggest establishing different normal range values in different age groups.

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          Most cited references10

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          Prophylactic thyroidectomy in multiple endocrine neoplasia type 2A.

          Medullary thyroid carcinoma is the most common cause of death in patients with multiple endocrine neoplasia (MEN) type 2A (MEN-2A) or type 2B or familial medullary thyroid carcinoma. We sought to determine whether total thyroidectomy in asymptomatic young members of kindreds with MEN-2A who had a mutated allele of the RET proto-oncogene could prevent or cure medullary thyroid carcinoma. A total of 50 patients 19 years of age or younger who were consecutively identified through a genetic screening program as carriers of a RET mutation characteristic of MEN-2A underwent total thyroidectomy. Five to 10 years after the surgery, each patient was evaluated by physical examination and by determination of plasma calcitonin levels after stimulation with provocative agents. In 44 of the 50 patients, basal and stimulated plasma calcitonin levels were at or below the limits of detection of the assay (proportion, 0.88; 95 percent confidence interval, 0.76 to 0.95). Two patients had basal and stimulated plasma calcitonin levels above the normal range. Stimulated plasma calcitonin levels had increased but remained within the normal range in four patients. The data suggest that there was a lower incidence of persistent or recurrent disease in children who underwent total thyroidectomy before eight years of age and in children in whom there were no metastases to cervical lymph nodes. In this study, young patients identified by direct DNA analysis as carriers of a RET mutation characteristic of MEN-2A had no evidence of persistent or recurrent medullary thyroid carcinoma five or more years after total thyroidectomy. A longer period of evaluation will be necessary to confirm that they are cured. Copyright 2005 Massachusetts Medical Society.
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            Sex-related C cell hyperplasia in the normal human thyroid: a quantitative autopsy study.

            We report a prospective quantitative image analysis study of C cells in 57 normal autopsy thyroid glands, serially sectioned and wholly embedded in paraffin; all slides were immunohistochemically stained for calcitonin. Computerized quantitative image analysis was performed on 47 cases to measure C cell surface area and parenchymatous surface area after immunoperoxidase staining for calcitonin. The method was time-effective, with a good reproducibility. C cells were mainly found in the middle third of each lobe. Important inter-individual variations were observed; the maximum C cell surface area in a section (Amax) ranged from 28 x 10(3) to 470 x 10(3) microns2 (mean, 167 x 10(3) microns2) among 42 adults. Of particular interest was the important difference observed between sexes; Amax was twice as high in men (mean, 201 x 10(3) microns2) as in women (mean, 91 x 10(3) microns2; P = 0.0009). Moreover, 14 (33%) adult subjects [2 women (15%) and 12 men (41%)] fulfilled C cell hyperplasia criteria, i.e. at least 3 fields at x 100 magnification containing more than 50 C cells, suggesting that a substantial part of the normal adult population could have C cell hyperplasia.
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              • Abstract: not found
              • Article: not found

              Physiologic versus neoplastic C-cell hyperplasia of the thyroid: Separation of distinct histologic and biologic entities

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                Author and article information

                Journal
                HRE
                Horm Res Paediatr
                10.1159/issn.1663-2818
                Hormone Research in Paediatrics
                S. Karger AG
                1663-2818
                1663-2826
                2006
                June 2006
                23 June 2006
                : 66
                : 1
                : 17-20
                Affiliations
                aDepartment of Medical Sciences, Endocrine Unit, University of Milan, Fondazione Policlinico, Mangiagalli e Regina Elena IRCCS, Milan, and bDepartment of Pediatrics, Regional Hospital of Bolzano, Bolzano, Italy
                Article
                92848 Horm Res 2006;66:17–20
                10.1159/000092848
                16636574
                e8620ced-9df2-43ae-b3d5-668eb973ebe9
                © 2006 S. Karger AG, Basel

                Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher. Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug. Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

                History
                : 30 November 2005
                : 08 March 2006
                Page count
                Figures: 2, Tables: 1, References: 15, Pages: 4
                Categories
                Original Paper

                Endocrinology & Diabetes,Neurology,Nutrition & Dietetics,Sexual medicine,Internal medicine,Pharmacology & Pharmaceutical medicine
                C-cell hyperplasia,Medullary thyroid carcinoma,Immunometric assay,Children,Calcitonin

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