As part of the diagnosis and workup of precocious and delayed puberty in females and, to a lesser degree, males
As part of the diagnosis and workup of suspected disorders of sex steroid metabolism (eg, aromatase deficiency and 17 alpha-hydroxylase deficiency)
As an adjunct to clinical assessment, imaging studies and bone mineral density measurement in the fracture risk assessment of postmenopausal women, and, to a lesser degree, older men
Monitoring low-dose female hormone replacement therapy in postmenopausal women
Centrifuge and remove serum from red blood cells within 2 hours of draw
Aliquot serum to submission container.
Minimum Sample Volume
0.8 mL
Stability
Refrigerated (preferred): 28 days
Ambient: 28 days
Frozen: 28 days
Unacceptable Specimen Conditions
Serum gel or SST tube
Methodology
Liquid Chromatography-Tandem Mass Spectrometry (LC-MS/MS)
Estimated TAT
2-4 days
Testing Schedule
Monday-Saturday
Retention
14 days
CPT Code(s)
82679
Reference Range
Gender
Tanner Stage
Mean Age (years)
Ref Range (pg/mL)
Males
Stage I (>14 days and prepubertal)
7.1
< 16
Stage II*
11.5
< 22
Stage III
13.6
10 - 25
Stage IV
15.1
10 - 46
Stage V
18.0
10 - 60
Adult
10 - 60
Females
Stage I (>14 days and prepubertal)
7.1
< 29
Stage II**
10.5
10 - 33
Stage III
11.6
15 - 43
Stage IV
12.3
16 - 77
Stage V
14.5
17 - 200
Adult - Premenopausal
17 - 200
Adult - Postmenopausal
7 - 40
Newborns (1-14 days): Estrone levels in newborns are very elevated at birth but will fall to prepubertal levels within a few days
* Boys: Puberty onset (transition from Tanner stage I to Tanner stage II) occurs for boys at a median age of 11.5 (+/- 2) years. For boys there is no proven relationship between puberty onset and body weight or ethnic origin. Progression through Tanner stages is variable. Tanner stage V (adult) should be reached by age 18
** Girls: Puberty onset (transition from Tanner stage I to Tanner stage II) occurs for girls at a median age of 10.5 (+/- 2) years. There is evidence that it may occur up to 1 year earlier in obese girls and in African American girls. Progression through Tanner stages is variable. Tanner stage V (adult) should be reached by age 18.
The reference ranges for children are based on the published literature,(1,2) cross-correlation of our assay with assays used to generate the literature data and on our data for young adults.
Conversion-factor E1: pg/mL x 3.704=pmol/L (molecular weight=270)
