Copeptin assays in children for the differential diagnosis of polyuria‐polydipsia syndrome and reference levels in hospitalized children

Bonnet, Laura; Marquant, E.; Fromonot, Julien; Hamouda, Ilyes; Berbis, Julie; Godefroy, A.; Vierge, M.; Tsimaratos, Michel; Reynaud, Rachel

doi:10.1111/cen.14620

Cited by 22 publications

(21 citation statements)

References 25 publications

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“…In addition, emotional or physical stress is a strong stimulus for copeptin, leading to very high copeptin levels: a subset of six non‐AVPD (non‐CDI) patients (out of 68) had high to very high baseline copeptin levels that decreased during stimulation. Similar observations have been reported by others 14 . Therefore, in general proposed reference ranges for baseline copeptin levels have to be viewed with caution.…”

Section: Discussionsupporting

confidence: 85%

“…The median baseline copeptin value was 7.6 pmol/L, the 5th percentile was 2.5 pmol/L. The higher median copeptin level in comparison to this study may be explained by the high percentage of obese children (59%) in the French study 14 . Copeptin levels were described to be higher in obesity 15–17 .…”

Section: Discussioncontrasting

confidence: 58%

“…For baseline copeptin, hydration status has been described to influence the level, which is expected based on the physiology of water regulation 16 . Bonnet et al described lower baseline copeptin levels in children with primary polydipsia than in healthy controls 14 . The tests in this study were performed after overnight fasting and probably moderate hydration.…”

Section: Discussionmentioning

confidence: 82%

“…Different medians of the baseline copeptin level of healthy children were reported by several investigators. 12,13 The biggest pediatric cohort was reported by Bonnet et al, 14 who measured baseline copeptin in 238 healthy children (mean age 10.3 years). The median baseline copeptin value was 7.6 pmol/L, the 5th percentile was 2.5 pmol/L.…”

Section: Discussionmentioning

confidence: 99%

“…The higher median copeptin level in comparison to this study may be explained by the high percentage of obese children (59%) in the French study. 14 Copeptin levels were described to be higher in obesity. [15][16][17] In our cohort of 68 non-AVPD (non-CDI) children and adolescents, there were only two obese patients (3%).…”

Section: Discussionmentioning

confidence: 99%

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Arginine‐stimulated copeptin in children and adolescents

Binder

Weber

Schweizer

2023

Clinical Endocrinology

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Objective Copeptin is secreted in isomolar amounts along with arginine vasopressin peptide (AVP) from the neurohypophysis. Its stability makes it a perfect candidate for the endocrine approach in the diagnosis of AVP deficiency (AVPD; cranial diabetes insipidus; CDI). However, pediatric reference values are lacking. Design and Patients This is a monocentric retrospective analysis of donated residual serum samples from 72 children and adolescents who underwent arginine or growth hormone‐releasing hormone‐arginine stimulation to test GH secretory capacity from 2018 to 2022. Measurements Copeptin was measured in baseline, 30‐, and 60‐min samples by BRAHMS Copeptin proAVP Kryptor immunofluorescence assay. Results Of the 72 patients, 4 suffered from complete AVPD (CDI). The baseline level of copeptin in the 68 non‐AVPD (non‐CDI) patients was highly variable (range: 1.3–44.4 pmol/L). The increase after arginine was moderate (30 min range: 1.6–40.4 pmol/L). The median baseline and peak copeptin levels were 5.6 and 8.0 pmol/L, respectively. The 2.5th percentile of the baseline and peak values of copeptin were 2.1 and 3.3 pmol/L, respectively. The increase and peak value of copeptin were inversely related to age (R = −.405; p = .011, and R = −.335; p = .0072, respectively) but not to gender, body mass index (standard deviation score) or GH secretion. In the four patients with AVPD (CDI), baseline or stimulated copeptin was below the 2.5th percentile of non‐AVPD (non‐CDI) patients. Conclusions Stimulated copeptin is a promising parameter for the differential diagnosis of polyuria‐polydipsia syndrome. However, the low copeptin increase after arginine and the high limit of quantification of the assay are problematic for use in paediatrics.

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Section: Discussionsupporting

confidence: 85%

Section: Discussioncontrasting

confidence: 58%

Section: Discussionmentioning

confidence: 82%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Arginine‐stimulated copeptin in children and adolescents

Binder

Weber

Schweizer

2023

Clinical Endocrinology

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The role of copeptin in kidney disease

et al. 2022

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The diagnostic role of arginine-stimulated copeptin in the differential diagnosis of polyuria-polydipsia syndrome (PPS) in pediatric age

Tuli,

Munarin,

De Sanctis

2023

Endocrine

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in recent years, copeptin stimulation through arginine administration has been evaluated as a new potential tool in the differential diagnosis of polyuria-polydipsia syndrome (PPS) in adults; to date very few data, all retrospective, exist in pediatric age. The aim of this prospective study is to evaluate the diagnostic performance of the arginine-stimulation test for copeptin in a cohort of pediatric patients affected by PPS. Methods:all children (<18 years) referred to the Department of Pediatric Endocrinology of the Regina Margherita Children Hospital for polyuria-polydipsia in the period January 2021-June 2023 were enrolled. The Arginine-stimulation test for copeptin was performed in all patients presenting PPS after water deprivation test (WDT). Patients with polyuria-polydipsia were then classi ed as having primary polyuria (PP), complete and partial central diabetes insipidus (CDI), according to the standardized interpretation. Arginine-stimulation test for copeptin was also performed in a control cohort. Results:A signi cant difference in arginine-stimulated copeptin values was observed at baseline (p = 0.005), at 60 minutes (p= 0.01), and at 90 minutes (p = 0.005) in 7 subjects presenting PP, 6 patients affected by CDI and 50 subjects of the control cohort. Plasma osmolality values remained stable at all measurements. The arginine-stimulated copeptin test demonstrated sensitivity and speci city of 100%, whereas the sensitivity of the WDT test was 83.3% and the speci city was 85.7%. Conclusiongiven the reliability and the minor adverse effects and costs, the copeptin level after arginine administration could replace the WDT in the diagnostic workup of these in pediatric age.

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Copeptin assays in children for the differential diagnosis of polyuria‐polydipsia syndrome and reference levels in hospitalized children

Cited by 22 publications

References 25 publications

Arginine‐stimulated copeptin in children and adolescents

Arginine‐stimulated copeptin in children and adolescents

The role of copeptin in kidney disease

The diagnostic role of arginine-stimulated copeptin in the differential diagnosis of polyuria-polydipsia syndrome (PPS) in pediatric age

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