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C
Laboratory Reference Intervals
The tables in this appendix list some of the most common
tests, their reference intervals (formally referred to as normal
values), and possible etiologies of abnormal results. Laboratory results may vary depending on different techniques or
different laboratories. Possible etiologies are presented in
alphabetic order. Abbreviations appearing in the tables are
defined as follows:
mEq = milliequivalent
mm Hg = millimeter of mercury
mm = millimeter
mOsm = milliosmole
L
dL
mL
L
fL
=
=
=
=
=
liter
deciliter (101 liter)
milliliter (103 liter)
microliter (106 liter, 103 milliliter)
femtoliter (1015 liter, 1012 milliliter)
g
mg
mcg
ng
pg
=
=
=
=
=
gram
milligram (103 gram)
microgram (106 gram)
nanogram (109 gram)
picogram (1012 gram)
U = unit
U = microunit
IU = international unit
mmol
mol
nmol
pmol
kPa
kat
=
=
=
=
=
=
TABLE C-1
TEST
REFERENCE INTERVALS
CONVENTIONAL UNITS
SI UNITS
Acetone
Quantitative
Qualitative
Albumin
<2.0 mg/dL
Negative
3.5-5.0 g/dL
<344 mol/L
Negative
35-50 g/L
Aldolase
1-Antitrypsin
1.5-8.1 U/L
78-200 mg/dL
1.5-8.1 U/L
0.78-2.0 g/L
1-Fetoprotein
<10 ng/mL
<10 mcg/L
Ammonia
Amylase
Bicarbonate
22-26 mEq/L
22-26 mmol/L
b-Type natriuretic
peptide (BNP)
Bilirubin
Total
Indirect
Direct
<100 mcg/L
<100 pmol/L
0.2-1.2 mg/dL
0.1-1.0 mg/dL
0.1-0.3 mg/dL
3-21 mol/L
1.7-17.0 mol/L
1.7-5.1 mol/L
HIGHER
POSSIBLE ETIOLOGY
LOWER
Mosby items and derived items 2011, 2007 by Mosby, Inc., an affiliate of Elsevier, Inc.
1795
1796
APPENDIX C
TABLE C-1
TEST
REFERENCE INTERVALS
CONVENTIONAL UNITS
SI UNITS
Blood gases*
Arterial pH
Venous pH
PaCO2
7.35-7.45
7.32-7.43
32-48 mm Hg
7.35-7.45
7.32-7.43
4.26-6.38 kPa
PvCO2
PaO2
PvO2
Calcium (total)
38-55 mm Hg
80-100 mm Hg
38-42 mm Hg
8.6-10.2 mg/dL
5.06-7.32 kPa
10.6-13.33 kPa
5.04-5.57 kPa
2.15-2.55 mmol/L
Calcium (ionized)
Carbon dioxide (CO2)
Carotene
4.64-5.28 mg/dL
23-29 mEq/L
10-85 mcg/dL
1.16-1.32 mmol/L
23-29 mmol/L
0.19-1.58 mol/L
Chloride
96-106 mEq/L
96-106 mmol/L
Cholesterol
<200 mg/dL
<5.2 mmol/L
>1.04 mmol/L
>1.3 mmol/L
Recommended:
<2.6 mmol/L
Near optimal:
2.6-3.34 mmol/L
Moderate risk for CAD:
3.37-4.12 mmol/L
Copper
Cortisol
Creatine
CK-MB
Creatinine
Ferritin
<4%-6% of total CK
0.6-1.3 mg/dL
10-250 ng/mL
<0.4-0.6
53-115 mol/L
10-250 mcg/L
5-16 ng/mL
11-36 nmol/L
Gamma-glutamyl
transferase (GGT)
0-30 U/L
0-0.5 kat/L
Glucose (fasting)
70-99 mg/dL
3.9-5.5 mmol/L
HIGHER
POSSIBLE ETIOLOGY
LOWER
Alkalosis
Acidosis
Compensated metabolic
alkalosis
Respiratory acidosis
Administration of high
concentration of oxygen
Acute osteoporosis, hyperparathyroidism, vitamin D intoxication, multiple myeloma
Compensated metabolic
acidosis
Respiratory alkalosis
Chronic lung disease,
decreased cardiac output
Acute pancreatitis, hypoparathyroidism, liver disease,
malabsorption syndrome,
renal failure, vitamin D
deciency
Same as bicarbonate
Cystic brosis, hypothyroidism,
pancreatic insufciency
Metabolic acidosis, respiratory
alkalosis, corticosteroid
therapy, uremia
Biliary obstruction, hypothyroidism, idiopathic hypercholesterolemia, renal disease,
uncontrolled diabetes
Cirrhosis
Cushing syndrome, pancreatitis
Active rheumatoid arthritis,
biliary obstruction, hyperthyroidism, renal disorders,
severe muscle disease
Musculoskeletal injury or
disease, myocardial infarction,
severe myocarditis, exercise,
numerous IM injections
Acute myocardial infarction
Severe renal disease
Sideroblastic anemia, anemia
of chronic disease (infection,
inammation, liver disease)
Hypothyroidism
Wilsons disease
Adrenal insufciency,
panhypopituitary states
Diabetes mellitus
Iron-deciency anemia
PaCO2, Partial pressure of CO2 in arterial blood; PvCO2, partial pressure of CO2 in venous blood; PaO2, partial pressure of oxygen in arterial blood; PvO2, partial pressure of oxygen in
venous blood.
*Because arterial blood gases are inuenced by altitude, the value for PaO2 decreases as altitude increases. The lower value is normal for an altitude of 1 mile.
Mosby items and derived items 2011, 2007 by Mosby, Inc., an affiliate of Elsevier, Inc.
APPENDIX C
TABLE C-1
1797
TEST
REFERENCE INTERVALS
CONVENTIONAL UNITS
SI UNITS
Haptoglobin
26-185 mg/dL
260-1850 mg/L
Insulin (fasting)
4-24 U/mL
29-172 pmol/L
Iron, total
50-175 mcg/dL
9.0-31.3 mol/L
Iron-binding capacity
250-425 mcg/dL
44.8-76.1 mol/L
6.3-22.5 mcg/dL
140-280 U/L
0.7-2.5 mmol/L
0.83-2.5 kat/L
18%-33%
0.18-0.33
LDH2
28%-40%
0.28-0.40
LDH3
18%-30%
0.18-0.30
LDH4
6%-16%
0.06-0.16
LDH5
2%-13%
0.02-0.13
Lipase
31-186 U/L
0.5-3.2 kat/L
Magnesium
1.5-2.5 mEq/L
0.75-1.25 mmol/L
Osmolality
275-295 mOsm/kg
275-295 mmol/kg
Oxygen saturation
(arterial) (SaO2)
pH
Phenylalanine
Phosphatase, acid
>95%
>0.95
48-109 mol/L
0-90 kat/L
Phosphatase, alkaline
38-126 U/L
0.65-2.14 kat/L
Phosphorus
(phosphate)
2.4-4.4 mg/dL
0.78-1.42 mmol/L
Potassium
3.5-5.0 mEq/L
3.5-5.0 mmol/L
HIGHER
POSSIBLE ETIOLOGY
LOWER
Myocardial infarction,
pernicious anemia
Pulmonary embolus, sickle cell
crisis
Malignant lymphoma,
pulmonary embolus
Systemic lupus erythematosus,
pulmonary infarction
Heart failure, hepatitis,
pulmonary embolus and
infarction, skeletal muscle
damage
Acute pancreatitis, hepatic
disorders, perforated peptic
ulcer
Addisons disease, hypothyroidism, renal failure
Chronic renal disease, diabetes
mellitus
Polycythemia
Phenylketonuria
Advanced Pagets disease,
cancer of prostate,
hyperparathyroidism
Bone diseases, marked hyperparathyroidism, obstruction of
biliary system, rickets
Healing fractures, hypoparathyroidism, renal disease, vitamin
D intoxication
Addisons disease, diabetic
ketosis, massive tissue
destruction, renal failure
Mosby items and derived items 2011, 2007 by Mosby, Inc., an affiliate of Elsevier, Inc.
Continued
1798
APPENDIX C
TABLE C-1
TEST
REFERENCE INTERVALS
CONVENTIONAL UNITS
SI UNITS
Progesterone (Female)
Follicular phase
Luteal phase
15-70 ng/dL
200-2500 ng/dL
0.5-2.2 nmol/L
6.4-79.5 nmol/L
<40 ng/dL
<4 ng/mL
1.28 nmol/L
<4 mcg/L
6.4-8.3 g/dL
3.5-5.0 g/dL
2.0-3.5 g/dL
1.5:1-2.5:1
64-83 g/L
35-50 g/L
20-35 g/L
1.5:1-2.5:1
Sodium
135-145 mEq/L
135-145 mmol/L
Testosterone
Postmenopause
Prostate-specic
antigen (PSA)
Proteins
Total
Albumin
Globulin
Albumin/globulin
ratio
HIGHER
POSSIBLE ETIOLOGY
LOWER
Prostate cancer
Burns, cirrhosis (globulin
fraction), dehydration
Malnutrition, nephrotic
syndrome, proteinuria, renal
disease, severe burns
Addisons disease, diabetic
ketoacidosis, diuretic
therapy, excessive loss from
GI tract, excessive perspiration, water intoxication
Hypofunction of testes,
hypogonadism
T4 (thyroxine), total
4.6-11.0 mcg/dL
T4 (thyroxine), free
T3 uptake
T3 (triiodothyronine),
total
Thyroid-stimulating
hormone (TSH)
Transaminases
Aspartate aminotransferase (AST)
0.8-2.7 ng/dL
24%-34%
Ages 20-50: 70-204 ng/dL
Ages >50: 40-181 ng/dL
0.4-4.2 U/mL
10-35 pmol/L
0.24-0.34
1.08-3.14 nmol/L
0.62-2.79 nmol/L
0.4-4.2 mU/L
10-30 U/L
0.17-0.51 kat/L
10-40 U/L
0.17-0.68 kat/L
190-380 mg/dL
15%-50%
1.9-3.8 g/L
15%-50%
<150 mg/dL
<1.7 mmol/L
Malnutrition
Troponins (cardiac)
Troponin T (cTnT)
Troponin I (cTnI)
Urea nitrogen (BUN)
Diabetes mellitus,
hyperlipidemia, hypothyroidism, liver disease
Myocardial infarction
2.1-7.1 mmol/L
Uric acid
Vitamin A (retinol)
Vitamin B12
(cobalamin)
30-80 mcg/dL
200-835 pg/mL
1.05-2.80 mol/L
148-616 pmol/L
Vitamin C
(ascorbic acid)
0.4-2.0 mg/dL
23-114 mol/L
Zinc
70-120 mcg/dL
10.7-120 mol/L
Cretinism, hypothyroidism,
myxedema
Hyperthyroidism
Hyperthyroidism
Hypothyroidism
Hypothyroidism
Secondary hypothyroidism
Excessive ingestion of
vitamin C
Administration of uricosuric
drugs
Vitamin A deciency
Strict vegetarianism, malabsorption syndrome, pernicious anemia, total or partial
gastrectomy
Connective tissue disorders,
hepatic disease, renal
disease, rheumatic fever,
vitamin C deciency
Alcoholic cirrhosis
Mosby items and derived items 2011, 2007 by Mosby, Inc., an affiliate of Elsevier, Inc.
APPENDIX C
TABLE C-2
1799
HEMATOLOGY
TEST
REFERENCE INTERVALS
CONVENTIONAL
SI UNITS
UNITS
Bleeding time
2-7 min
120-420 sec
Activated partial
thromboplastin time
(aPTT)
Prothrombin time
(Protime, PT)
25-35 sec*
25-35 sec*
11-16 sec*
11-16 sec*
Fibrinogen
200-400 mg/dL
2-4 g/L
<10 mcg/mL
<10 mg/L
<250 ng/mL
<250 mcg/L
POSSIBLE ETIOLOGY
HIGHER
LOWER
Anemia, leukemia,
posthemorrhage
Microcytic anemia
27-34 pg
27-34 pg
Macrocytic anemia
Microcytic anemia
32%-37%
0.32-0.37
Spherocytosis
Hypochromic anemia
Male: 39%-50%
Female: 35%-47%
Male: 13.2-17.3 g/dL
Female: 11.7-15.5 g/dL
4.0%-6.0%
Male: 0.39-0.50
Female: 0.35-0.47
Male: 132-173 g/L
Female: 117-155 g/L
4.0%-6.0%
150-400 103/L
150-400 109/L
Reticulocyte count
0.5%-1.5% of RBC
0.5%-1.5% of RBC
4.0-11.0 103/L
4.0-11.0 109/L
50%-70%
0.50-0.70
0%-8%
20%-40%
0-0.08
0.20-0.40
Monocytes
4%-8%
0.04-0.08
Eosinophils
0%-4%
0-0.04
Basophils
0%-2%
0-0.02
Erythrocyte count
(altitude dependent)
Mean corpuscular
volume (MCV)
Mean corpuscular
hemoglobin (MCH)
Mean corpuscular
hemoglobin concentration (MCHC)
Erythrocyte sedimentation rate (ESR)
Hematocrit
(altitude dependent)
Hemoglobin
(altitude dependent)
Hemoglobin,
glycosylated
Platelet count
(thrombocytes)
WBC differential
Segmented
neutrophils
Band neutrophils
Lymphocytes
Anemia, hemorrhage,
overhydration
Anemia, hemorrhage
Hypoproliferative anemia,
macrocytic anemia,
microcytic anemia
Aplastic anemia, side
effects of chemotherapy
and irradiation
Aplastic anemia, viral
infections
Corticosteroid therapy,
whole body irradiation
Corticosteroid therapy
Hyperthyroidism, stress
COPD, Chronic obstructive pulmonary disease; DIC, disseminated intravascular coagulation; RBC, red blood cell; WBC, white blood cell.
*Values depend on reagent and instrumentation used.
Components of complete blood count (CBC).
Mosby items and derived items 2011, 2007 by Mosby, Inc., an affiliate of Elsevier, Inc.
1800
TABLE C-3
APPENDIX C
SEROLOGY-IMMUNOLOGY
TEST
REFERENCE INTERVALS
CONVENTIONAL UNITS
SI UNITS
Anti-DNA antibody
Anti-Sm (Smith)
C-reactive protein (CRP)
<70 IU/mL
Negative
6.8-820 mcg/dL
<70 IU/mL
Negative
68-8200 mcg/L
Carcinoembryonic antigen
(CEA)
Complement, total
hemolytic (CH50)
75-160 U/mL
75-160 kU/L
Negative
Negative
Negative or
nonreactive
Negative or
nonreactive
Syphilis
Negative
Negative
Negative
Negative
Hepatitis A
Hepatitis B
Negative
Negative
Negative or titer <1:17
Negative
Negative
Negative or titer <1:17
RPR
Negative or nonreactive
Negative or nonreactive
VDRL
Negative or nonreactive
Negative or nonreactive
Hepatitis C
Infectious mononucleosis
Rheumatoid arthritis, Sjgrens
syndrome, systemic lupus
erythematosus
Syphilis, systemic lupus
erythematosus, rheumatoid
arthritis, leprosy, malaria, febrile
diseases, IV drug abuse
Syphilis
HIGHER
POSSIBLE ETIOLOGY
LOWER
RPR, Rapid plasma regain test; VDRL, Veneral Disease Research Laboratory test.
TABLE C-4
URINE CHEMISTRY
TEST
SPECIMEN
REFERENCE INTERVALS
UNITS
SI UNITS
Acetone
Random
Negative
Negative
Aldosterone
24 hr
0.08-0.83 nmol/day
Amylase
Bence Jones protein
Bilirubin
Calcium
24 hr
Random
Random
24 hr
1-17 U/hr
Negative
Negative
100-250 mg/day
1-17 U/hr
Negative
Negative
2.5-6.3 mmol/day
Catecholamines
Epinephrine
Norepinephrine
24 hr
<20 mcg/day
15-80 mcg/day
<109 nmol/day
89-473 nmol/day
HIGHER
POSSIBLE ETIOLOGY
LOWER
ACTH deciency,
Addisons disease,
corticosteroid therapy
Hypoparathyroidism,
malabsorption of
calcium and vitamin D
Pheochromocytoma,
progressive muscular
dystrophy, heart failure
Mosby items and derived items 2011, 2007 by Mosby, Inc., an affiliate of Elsevier, Inc.
APPENDIX C
TABLE C-4
1801
URINE CHEMISTRYcontd
TEST
SPECIMEN
REFERENCE INTERVALS
UNITS
SI UNITS
Creatine
24 hr
<100 mg/day
<763 mol/day
Creatinine
24 hr
0.6-2.0 g/day
5.3-17.7 mmol/day
Creatinine clearance
Estrogens
Female
Premenopause
Postmenopause
Male
Glucose
24 hr
24 hr
59-137 mL/min/1.73 m2
0.59-1.37 mL/sec/m2
Random
15-80 mcg/day
<20 mcg/day
15-40 mcg/day
Negative
15-80 mcg/day
<20 mcg/day
15-40 mcg/day
Negative
Hemoglobin
Random
Negative
Negative
24 hr
2-7 mg/day
10.5-36.6 mol/day
24 hr
20-50 mg/day
0.34-0.86 mmol/day
Metanephrine
Myoglobin
24 hr
Random
92-934 mcg/day
Negative
500-5100 nmol/day
Negative
Osmolality
Random
300-1300 mOsm/kg
300-1300 mmol/kg
pH
Random
4.0-8.0
4.0-8.0
Protein (dipstick)
Random
0-trace
0-trace
Protein (quantitative)
24 hr
<150 mg/day
<0.15 g/day
Sodium
Specic gravity
24 hr
Random
40-220 mEq/day
1.003-1.030
Uric acid
Urobilinogen
24 hr
24 hr
250-750 mg/day
0.5-4.0 mg/day
40-220 mmol/day
Same as conventional units
1.5-4.5 mmol/day
0.8-6.8 mol/day
Vanillylmandelic acid
24 hr
1.4-6.5 mg/day
7-33 mol/day
HIGHER
POSSIBLE ETIOLOGY
LOWER
Hypothyroidism
Renal disease
Renal disease
Endocrine disturbance,
ovarian dysfunction,
menopause
Mosby items and derived items 2011, 2007 by Mosby, Inc., an affiliate of Elsevier, Inc.
Tubular dysfunction
(kidney lost ability to
concentrate urine)
Respiratory or
metabolic acidosis
Hyponatremia
Diabetes insipidus
Nephritis
Complete obstruction
of bile duct
1802
APPENDIX C
TABLE C-5
FECAL ANALYSIS
TEST
REFERENCE INTERVALS
CONVENTIONAL UNITS
SI UNITS
Fecal fat
<6 g/24 hr
Mucus
Pus
Negative
Negative
Same as
conventional units
Negative
Negative
Blood*
Negative
Negative
Color
Brown
Clay
Tarry
Red
Black
POSSIBLE ETIOLOGY
HIGHER
LOWER
*Ingestion of meat may produce false-positive results. Patient may be placed on a meat-free diet for 3 days before the test.
TABLE C-6
TEST
REFERENCE INTERVALS
CONVENTIONAL UNITS
SI UNITS
HIGHER
Pressure
60-150 mm H2O
60-150 mm H2O
Blood
Cell count (age
dependent)
WBC
RBC
Chloride
Negative
Negative
Intracranial hemorrhage
Inammation or infections of CNS
0-5 cells/L
Negative
118-132 mEq/L
Uremia
Glucose
40-70 mg/dL
2.2-3.9 mmol/L
Protein
Lumbar
Cisternal
Ventricular
15-45 mg/dL
15-25 mg/dL
5-15 mg/dL
0.15-0.45 g/L
0.15-0.25 g/L
0.05-0.15 g/L
POSSIBLE ETIOLOGY
LOWER
Head injury, spinal tumor,
subdural hematoma
Mosby items and derived items 2011, 2007 by Mosby, Inc., an affiliate of Elsevier, Inc.