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

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

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              C-Cell Hyperplasia and Medullary Thyroid Microcarcinoma


                Author and article information

                Horm Res Paediatr
                Hormone Research in Paediatrics
                S. Karger AG
                June 2006
                23 June 2006
                : 66
                : 1
                : 17-20
                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
                92848 Horm Res 2006;66:17–20
                © 2006 S. Karger AG, Basel

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                Figures: 2, Tables: 1, References: 15, Pages: 4
                Original Paper


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