Paediatric reference ranges for plasma chromogranin A

Sofie Lieberoth, Frederik Friis-Hansen, Lennart Friis-Hansen*

*Corresponding author for this work

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Background: Neuroendocrine neoplasms (NENs) are a heterogeneous group of rare diseases with varied aggressiveness originating from endocrine cells belonging to the diffuse endocrine system and most often produce and secrete chromogranin A (CgA). CgA in plasma is therefore used to screen, diagnose, and monitor for NENs in both adults and children with sporadic or familial NENs. Methods: Plasma CgA was measured using the Brahms Kryptor assay in 268 healthy children/adolescents; 85 children were tested as part of a familial cancer screening program and 183 additional children younger than 20 years of age underwent screening for allergies. Repeated measurements (month – years) was used to calculate the intra-individual variation. The dataset was analysed in R using the referenceInterval package. Results: The plasma CgA concentration decreased with age and was 32–118 µg/L for children aged 0–3 years, 18–85 µg/L for children aged 4–13 years, and 6–79 µg/L for adolescents aged 14–19 years. Earlier reported CgA reference intervals for adults have upper limits from 88 to 102 µg/L while no lower limits have been reported. The median for the three groups were 78, 51, and 39 µg/L, respectively. The median intra-individual variation was 14% (25%-centile 9.4%/75%-centile 21%). Conclusions: The reference interval will be useful when screening, diagnosing, and monitoring children for NENs respecting the limitations plasma CgA has.

Original languageEnglish
JournalAnnals of Clinical Biochemistry
Publication statusE-pub ahead of print - 7. Sept 2023

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© The Author(s) 2023.


  • analytes
  • clinical studies
  • Immunoassay
  • laboratory methods
  • peptide hormones
  • tumour markers


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