Hepcidin Levels

Hepcidin Levels in Pediatric Diagnostics

Key Points

Master regulator of systemic iron homeostasis
25-amino acid peptide hormone primarily produced by hepatocytes
Controls iron absorption from enterocytes and iron release from macrophages
Essential diagnostic tool for iron disorders and anemia evaluation

Biochemical Characteristics

Hepcidin exists in several isoforms:

Hepcidin-25 (bioactive form)
Hepcidin-22
Hepcidin-20

Clinical Applications

Primary Indications

Differential diagnosis of iron deficiency anemia
Assessment of iron overload disorders
Evaluation of anemia of inflammation
Monitoring of hereditary hemochromatosis

Disease Associations

Elevated Hepcidin:

Anemia of chronic disease
Inflammatory conditions
Chronic kidney disease
Some types of cancer

Decreased Hepcidin:

Iron deficiency anemia
Hereditary hemochromatosis
β-thalassemia
Chronic liver disease

Result Interpretation

Reference Ranges

Newborns: 6.2-167.2 ng/mL
Infants (1-12 months): 3.5-139.2 ng/mL
Children (1-17 years): 1.9-254.4 ng/mL

Clinical Correlation

Interpretation factors include:

Time of sample collection (diurnal variation)
Inflammatory status
Iron status
Erythropoietic activity
Liver function

Age-Specific Considerations

Developmental Changes

Newborn period: Higher levels due to maternal inflammatory mediators
Early infancy: Gradual decline as iron stores normalize
Childhood: Stabilization with greater variability
Adolescence: Gender differences emerge

Special Populations

Premature infants: Modified reference ranges
Adolescent athletes: Impact of exercise
Children with chronic diseases: Need for individualized interpretation

Limitations & Pitfalls

Analytical Challenges

Lack of standardization across laboratories
Multiple testing methodologies
Sample stability concerns
Cost and availability limitations

Clinical Considerations

Diurnal variation affects results
Impact of acute inflammation
Storage conditions affect sample integrity
Need for multiple measurements in some cases

Further Reading