TEST VALUE STUDIED

Reference RangesHematology Reference RangesSerum, Plasma, and Whole Blood Chemistries Reference RangesImmunodiagnostic Tests Reference RangesUrine Chemistry Reference RangesCerebrospinal Fluid (CSF) Miscellaneous Values

SELECTED ABBREVIATIONS USED IN REFERENCE RANGES

Conventional Units
kg = kilogram gm = gram mg = milligram g = microgram g = micromicrogram ng = nanogram pg = picogram dL = 100 milliliters mL = milliliter mm3 = cubic millimeter fL = femtoliter mM = millimole nM = nanomole mOsm = milliosmole mm = millimeter m = micron or micrometer mm Hg = millimeters of mercury U = unit mU = milliunit U = microunit mEq = milliequivalent IU = International Unit mIU = milliInternational Unit

SI Units
g = gram L = liter d = day h = hour mol = mole mmol = millimole mol = micromole nmol = nanomole pmol = picomole

REFERENCE RANGE - HEMATOLOGY

REFERENCE RANGE
DETERMINATION
A2 hemoglobin Bleeding time Factor V assay (proaccelerin factor) Factor VIII assay (antihemophiliac factor) Factor IX assay (plasma thromboplastin component) Factor X (Stuart factor) Fibrinogen Fibrin split (degradation) products Fibrinolysins (whole blood clot lysis time) Partial thromboplastin time (activated)

Conventional Units
2.0%3.2% of total hemoglobin 1.59.5 min 60%140% 60%140% 60%140% 60%140% 200400 mg/dL <5 g/mL No lysis in 24 h Lower limit 2025 sec; Upper limit 3239 sec Lower limit sec Lower limit sec 9.512 sec of normal: of normal: of normal: 10 of normal: 14

SI Units
Mass fraction: 0.015 0.035 of total hemoglobin 1.59.5 min

CLINICAL SIGNIFICANCE
Increased in certain types of thalassemia Prolonged in thrombocytopenia, defective platelet function, and aspirin therapy

Deficient in classical hemophilia Deficient in Christmas disease (pseudohemophilia) Deficient in Stuart clotting defect Increased in pregnancy, infections accompanied by leukocytosis, nephrosis Decreased in severe liver disease, abruptio placentae Increased in disseminated intravascular coagulation Increased activity associated with massive hemorrhage, extensive surgery, transfusion reactions Prolonged in deficiency of fibrinogen, factors II, V, VIII, IX, X, XI, and XII, and in heparin therapy Impaired in deficiency of factors VIII, IX, and X Prolonged by deficiency of factors I, II, V, VII,

24 g/dL <5 g/mL

Prothrombin consumption Prothrombin time

INR

1.0 23 for therapy in atrial fibrillation, deep vein thrombosis, and pulmonary enbolism 2.53.5 for therapy in prosthetic heart valves Males: 4,600,000 6,200,000/cu mm Females: 4,200,000 5,400,000/cu mm

and X, fat malabsorption, severe liver disease, coumarin anticoagulant therapy. INR used to standardize the prothrombin time and anticoagulation therapy

Erythrocyte count

4.66.2 1012/L 4.25.4 1012/L

Increased in severe diarrhea and dehydration, polycythemia, acute poisoning, pulmonary fibrosis Decreased in all anemias in leukemia, and after hemorrhage, when blood volume has been restored Increased in macrocytic anemias; decreased in microcytic anemia Increased in macrocytic anemias; decreased in microcytic anemia Decreased in severe hypochromic anemia

Erythrocyte indices Mean corpuscular volume (MCV) Mean corpuscular hemoglobin (MCH) Mean corpuscular hemoglobin concentration (MCHC) Reticulocytes

8496 cu m 2833 g/cell 33%35%

8496 fL 2833 pg Concentration fraction: 0.330.35 Number fraction: 0.0050.015

0.5%1.5% of red cells

Erythrocyte sedimentation rate (ESR) Westergren method

Males under 50 yr: <15 mm/h Males over 50 yr: <20 mm/h Females under 50 yr:

<15 mm/h <20 mm/h <25 mm/h <30 mm/h

Increased with any condition stimulating increase in bone marrow activity (ie, infection, blood loss [acute and chronically following iron therapy in iron deficiency anemia], polycythemia rubra vera) Decreased with any condition depressing bone marrow activity, acute leukemia, late stage of severe anemias Increased in tissue destruction, whether inflammatory or degenerative; during menstruation and pregnancy; and in acute febrile diseases

Erythrocyte sedimentation ratioZeta centrifuge Hematocrit

<25 mm/h Females over 50 yr: <30 mm/h <50 years: <55% 5080 years: 40%60% Males: 42%52% Females: 35%47%

Volume fraction: <0.55 0.400.60 Volume fraction: 0.42 0.52 Volume fraction: 0.35 0.47 2.022.79 mmol/L 1.862.48 mmol/L

Significance similar to ESR Decreased in severe anemias, anemia of pregnancy, acute massive blood loss Increased in erythrocytosis of any cause, and in dehydration or hemoconcentration associated with shock Decreased in various anemias, pregnancy, severe or prolonged hemorrhage, and with excessive fluid intake Increased in polycythemia, chronic obstructive pulmonary disease, failure of oxygenation because of congestive heart failure, and normally in people living at high altitudes Increased in infants and children, and in thalassemia and many anemias Increased in polycythemia vera, myelofibrosis, and infections Decreased in chronic granulocytic leukemia, paroxysmal nocturnal hemoglobinuria, hypoplastic marrow, and viral infections, particularly infectious mononucleosis Neutrophils increased with acure infections, trauma or surgery, leukemia, malignant disease, necrosis; decreased with viral infections, bone marrow suppression, primary bone marrow disease Eosinophils increased in allergy, parasitic disease, collagen disease, subacute infections; decreased with stress, use of some medications (ACTH, epinephrine, thyroxine)

Hemoglobin

Males: 1318 gm/dL Females: 1216 gm/dL

Hemoglobin F Leukocyte alkaline phosphatase

Less than 2% of total hemoglobin Score of 15130 (varies among labs)

Mass fraction: <0.02

Leukocyte count Neutrophils Eosinophils Basophils Lymphocytes Monocytes

Total: 4,50011,000/cu mm 45%73% 0%4% 0%1% 20%40% 2%8%

4.511 109/L Number fraction: 0.450.73 Number fraction: 0.000.04 Number fraction: 0.000.01 Number fraction: 0.2 0.4 Number fraction: 0.020.08

Basophils increased with acute leukemia

and following surgery or trauma; decreased with allergic reactions, stress, allergy, parasitic disease, use of corticosteroids Lymphocytes increased with infectious mononucleosis, viral and some bacterial infections, hepatitis; decreased with aplastic anemia, SLE, immunodeficiency including AIDS Monocytes increased with viral infections, parasitic disease, collagen and hemolytic disorders; decreased with use of corticosteroids, RA, HIV infection Increased in malignancy, myeloproliferative disease, rheumatoid arthritis, and postoperatively; about 50% of patients with unexpected increase of platelet count will be found to have a malignancy; Decreased in thrombocytopenic purpura, acute leukemia, aplastic anemia, and during cancer chemotherapy.

Platelet count

150,000450,000/cu mm

0.150.45 1012/L

REFERENCE RANGES SERUM, PLASMA AND WHOLE BLODE CHEMESTRIES

NORMAL ADULT RANGE
DETERMINATIO N
Acetoacetate Acetone Acid, total phosphatase

CLINICAL SIGNIFICANCE
Increased
Diabetic acidosis Fasting Diabetic ketoacidosis Toxemia of pregnancy Carbohydrate-free diet High-fat diet Carcinoma of prostate

Conventional Units
0.21.0 mg/dL 0.32.0 mg/dL Males: 212 UL

SI Units
19.698 mol/L 51.6344.0/ mol/L Males: 212 UL

Decreased

Females: 0.39.2 UL Acid, phosphatase, rostaticRIA Alkaline phosphatase 2.53.37 ng/mL Adults: 50120 UL

Females: 0.39.2 UL 2.53.37 g/L 50120 UL

Advanced Pagets disease Hyperparathyroidism Gauchers disease Carcinoma of prostate Conditions reflecting increased steoblastic activity of bone Rickets Hyperparathyroidism Hepatic disease Bone disease

Alkaline phosphatase, hermostable fraction Adrenocorticotropic hormone (ACTH) (plasma)RIA Aldolase

Hepatic: >25% Combined: 10%25% Skeletal: <10% <50 pg/mL <50 ng/L Pituitary-dependent Cushings syndrome Ectopic ACTH syndrome Primary adrenal atrophy Hepatic necrosis Granulocytic leukemia Myocardial infarction Skeletal muscle disease Adrenocortical tumor Adrenal insufficiency secondary to hypopituitarism

38 Sibley-Lehninger U/dL at 37 C

2259 mU/L at 37 C

Aldosterone (plasma)RIA

Supine: 310 ng/dL Upright: 530 ng/dL Adrenal vein: 200800 ng/dL 110140 mg/dL

0.080.30 nmol/L 0.140.90 nmol/L 5.5422.16 nmol/L 1.11.4 g/L

Primary aldosteronism Secondary aldosteronism

Addisons disease Certain forms of chronic lung and liver disease in young adults

Alpha-1-antitrypsin

Alpha-1-fetoprotein

<15 ng/mL

<15 g/L

Alpha-hydroxybutyric dehydrogenase

<140 U/L

<140 U/L

Hepatocarcinoma Metastatic carcinoma of liver Germinal cell carcinoma of the testicle or ovary Fetal neural tube defects elevation in maternal serum Myocardial infarction Granulocytic leukemia

Ammonia (plasma) Amylase

1545, g/dL (varies with method 60160 Somogyi U/dL

1132/ mol/L 111296U/L

Arsenic

<70 g/dL; poisoning: 100150 g/dL

<0.932.6 mol/L; poisoning: 1336.65 mol/L

Ascorbic acid (vitamin C)

0.41.5 mg/dL

2385 mol/L

Hemolytic anemias Muscular dystrophy Severe liver disease Hepatic decompensation Acute pancreatitis Mumps Duodenal ulcer Carcinoma of head of pancreas Prolonged elevation with pseudocyst of pancreas Increased by medications that constrict pancreatic duct sphincters: morphine, codeine, cholinergics Intentional or unintentional poisoning Excessive occupational exposure Large doses of ascorbic acid as a prophylactic against the common cold

Chronic pancreatitis Pancreatic fibrosis and atrophy Cirrhosis of liver Pregnancy (2nd and 3rd trimesters)