Normal Values Henry's

APPENDIX

5

SI UNITS

The International System of Units (French: Système International d’Unités, SI) consists of seven dimensionally independent base units, which are listed in Table A5-1, along with the symbols to be used to denote these units. Table A5-2 lists a number of derived units of the SI that are used in the clinical laboratory. There are two kinds of derived units: (1) coherent units, which are derived directly from the base units without the use of conversion factors, and (2) noncoherent units, which are constructed from the base units and contain a numerical factor to make the numbers more convenient to use. The prefixes to denote fractions or multiples of base and derived SI units are given in Table A5-3. A complete description of the SI and its application in medicine may be found in the World Health Organization publication The SI for the Health Professions (World Health Organization, 1977). See Tietz (1995) for a comprehensive list of quantities and their internationally recommended SI units. The reference intervals used in this presentation should be considered typical values to illustrate principles of analysis; however, they are not intended to be used for interpretation of laboratory results for specific patients which should be evaluated according to reference ranges established by the laboratory performing those measurements. In making the conversion to recommended SI units (Tables A5-4 through A5-13), the following guidelines were followed: TABLE A5-1

SI Base Units Quantity

Name

Symbol

Length Mass Time Electric current Thermodynamic temperature Luminous intensity Amount of substance

meter kilogram second ampere kelvin candela mole

m kg s A K cd mol

1. All reference intervals have been converted to SI units except in cases in which the measurements are not quantitative. 2. Chemical names have not been changed; for example, urea is retained instead of changing to carbamide. 3. Factors are those published by the American National Metric Council (Lundberg et al, 1986; Beeler, 1987; Young, 1987), based on the Metric Commission of Canada (1981) factors. 4. Factors are calculated to the base unit for volume of 1 L. 5. The order of magnitude of the factors is calculated to make the values in SI units convenient numbers, that is, with prefixes, a number not greater than 1000 or smaller than 0.001. 6. The number in recommended SI units is equal to the number in conventional units times the factor. 7. For compounds for which relative molecular masses are not definitely known (e.g., proteins), reference intervals are converted to mass amounts per liter. 8. For mixtures of indeterminate composition (e.g., phospholipids), reference intervals are converted to mass amounts per liter or are based on a given standard, for example, DHEA for 17-ketosteroids. 9. Quantities of a relative nature that are usually expressed as per centages, for example, fractions of LD isoenzymes, are given as fractions. 10. Enzyme units are given as the international unit per liter (U/L). Although the coherent SI unit for catalytic activity (including enzymes), the katal, has been defined as the number of moles of substrate converted per second under defined conditions, its adoption is limited. 11. The pH scale is retained for measurement of hydrogen ion concentrations. 12. It is recommended that the unit millimeters of mercury (mm Hg) be retained for pressure (Pco2, Po2) at the present time. 13. Percentages are expressed as fractions in the SI, where a fraction is a dimensionless quantity given by the number of defined particles constituting a specified component divided by the total number of defined particles in the system.

TABLE A5-2

SI Derived Units

TABLE A5-3

Quantity

Unit Name

Unit Symbol

Area Volume

square meter* cubic meter* liter†

m2 m3 L = dm3‡

kilogram/liter† mole/liter† mole/kilogram kilogram/liter† kilogram/kilogram mole/mole number/liter degree celsius* pascal* hertz* liter/second† volt* joule*

kg/L mol/L mol/kg kg/L kg/kg mol/mol L−1 ° C = ° K − 273.15 Pa = kg/m2 Hz = 1 cycle/s L/s V = kgm2/s3 J = kgm2/s2

Concentration Mass Substance Molality Density Mass fraction Mole fraction Number concentration Temperature Pressure Frequency Clearance Electrical potential Energy

*Derived coherent unit. † Derived noncoherent unit. ‡ Both “L” and “l” are symbols for the liter.

Prefixes Prefix

Prefix Symbol

exa peta tera giga mega kilo hecto deca deci centi milli micro nano pico femto atto zepto yocto

E P T G M k h da d c m µ n p f a z y

Factor 1018 1015 1012 109 106 103 102 101 10−1 10−2 10−3 10−6 10−9 10−12 10−15 10−18 10−21 10−24

e11 Downloaded from ClinicalKey.com at ATENEO SCHOOL OF MEDICINE AND PUBLIC HEALTH March 09, 2017. For personal use only. No other uses without permission. Copyright ©2017. Elsevier Inc. All rights reserved.

APPENDIX 5

TABLE A5-4

Whole Blood, Serum, and Plasma Chemistry TYPICAL REFERENCE INTERVALS Component Acetoacetic acid Qualitative Quantitative Acetone Qualitative Quantitative Albumin Qualitative

Alcohol, ethyl Aldolase

System

Conventional Units

Factor*

Recommended SI Units†

Serum Serum

Negative 0.2–1 mg/dL

— 97.95

Negative 20–100 µmol/L

Serum Serum


— 172.95

Negative 20–340 µmol/L

Serum

3.2–4.5 g/dL (salt fractionation) 3.2–5.6 g/dL (electrophoresis) 3.8–5 g/dL (eye binding) Negative–but presented as mg/dL

10

32–45 g/L 32–56 g/L 38–50 g/L Negative–but presented as mmol/L

Serum or whole blood Serum Adults Children Newborn Serum Serum Plasma

α-Amino acid nitrogen δ-Aminolevulinic acid Ammonia

Amylase Argininosuccinate lyase Arsenic‡ Ascorbic acid (vitamin C) Barbiturates Base excess

Base, total Bicarbonate Bile acids Bilirubin Direct (conjugated) Indirect (unconjugated) Total Newborns total Blood gases (see Chapter 14) pH

Serum Serum Whole blood Plasma Whole blood Serum, plasma, or whole blood Whole blood Male Female Serum Plasma Serum

1.85 10 0.05055 56.78 —

22–59 mU/L at 37° C Approximately 2× adult levels Approximately 4× adult levels 2.6–5 mmol/L 0.8–2.3 µmol/L 12–70 µmol/L 23–47 µmol/L 7–28 µmol/L 30–220 U/L 0–40 U/L <0.4 µmol/L 34–91 µmol/L 40–114 µmol/L Negative

1

Serum Serum Serum Serum

<0.3 mg/dL 0.1–1 mg/dL 0.1–1.2 mg/dL 1–12 mg/dL

17.10

<5 µmol/L 2–17 µmol/L 2–21 µmol/L 17–205 µol/L

Whole blood

7.38–7.44 (arterial) 7.36–7.41 (venous) 35–40 mm Hg (arterial) 40–45 mm Hg (venous) 95–100 mm Hg (arterial) <5 mg/dL

1

7.38–7.44 7.36–7.41 4.7–5.3 kPa 5.3–6 kPa 12.7–13.3 kPa <0.63 mmol/L

4–4.8 mg/dL 2–2.4 mEq/L 30–58% of total 9.2–11.0 mg/dL 4.6–5.5 mEq/L 19–24 mmol/L 21–28 mmol/L 22–26 mmol/L 24–30 mmol/L 24–30 mmol/L 35–40 mm Hg

0.2500 0.5000 0.01 0.2500 0.5000 1

1.05–1.45 mmol/L 1.15–1.50 mmol/L 1.02–1.38 mmol/L

1

Whole blood

PO2 Bromide Calcium Ionized

Whole blood Serum

Total

Serum

Carbon dioxide (CO2 content)

Whole blood (arterial) Plasma or serum (arterial) Whole blood (venous) Plasma or serum (venous) Plasma or serum (venous) Whole blood (arterial) 40–45 mm Hg Whole blood (arterial) Whole blood (venous) Plasma (venous)

CO2 combining power CO2 partial pressure (PCO2) Whole blood (venous) Carbonic acid (H2CO3)

20–120 µg/dL (diffusion) 40–80 µg/dL (enzymatic method) 12–48 µg/dL (resin method) 16–120 Somogyi units/dL 0–4 U/dL <7 µg/dL 0.6–1.6 mg/dL 0.7–2 mg/dL Negative

7.4 — — 0.7139 76.26 0.5872

−3.3 to +1.2 mEq/L −2.4 to +2.3 mEq/L 145–160 mEq/L 21–28 mmol/L 0.3–3 mg/dL

PCO2

Carbon dioxide

3–8 Sibley-Lehninger U/dL at 37° C Approximately 2× adult levels Approximately 4× adult levels 3.6–7 mg/dL 0.01–0.03 mg/dL

0.2171

Serum

1 1 10

0.1333 0.1333 0.125

1 1 0.1333

−3.3 to +1.2 mmol/L −2.4 to +2.3 mmol/L 145–160 mmol/L 21–28 mmol/L 3–30 mg/L

1–1.2 mmol/L 0.30–1.58 of total 2.30–2.74 mmol/L 19–24 mmol/L 21–28 mmol/L 22–26 mmol/L 24–30 mmol/L 24–30 mmol/L 4.7–5.3 kPa 5.3–6 kPa 1.05–1.45 mmol/L 1.15–1.50 mmol/L 1.02–1.38 mmol/L


APPENDIX 5

TABLE A5-4

Whole Blood, Serum, and Plasma Chemistry—cont’d TYPICAL REFERENCE INTERVALS Component

System

Conventional Units

Factor*


Carboxyhemoglobin (carbon monoxide hemoglobin)

Whole blood suburban Nonsmokers Smokers Heavy smokers Serum Serum Serum

<1.5% saturation of hemoglobin

0.01

1.5%–5% saturation 5%–9% saturation 40–200 µg/dL 23–50 mg/dL 95–103 mEq/L

0.01863 10 1

Fraction hemoglobin saturated: <0.015 0.015–0.050 0.050–0.090 0.7–3.7 µmol/L 230–500 mg/L 95–103 mmol/L

Serum

150–250 mg/dL (varies with diet, sex, and age) 65%–75% of total cholesterol

0.02586

3.88–6.47 mmol/L

0.01

0.65–1.3 pH units 0.5–1.3 pH units 8–18 U/L at 37° C 1.7–3 mg/dL

1 1

Fraction of total cholesterol: 0.65–0.75 0.65–1.3 units§ 0.5–1.3 units

52.05

88–156 µmol/L

70–140 µg/dL 80–155 µg/dL

0.1574

11–22 µmol/L 13–24 µmol/L

5–23 µg/dL 3–13 µg/dL

27.59

138–635 nmol/L 83–359 nmol/L

0.1–0.4 mg/dL 0.2–0.7 mg/dL

76.25

8–31 µmol/L 15–53 µmol/L

55–170 U/L at 37° C 30–135 U/L at 37° C 0.6–1.2 mg/dL (adult) 0.3–0.6 mg/dL (children <2 yr)

1 1 88.40

55–170 U/L at 37° C 30–135 U/L at 37° C 53–106 µmol/L 27–53 µmol/L

0.01667 —

1.78–2.32 mL/sec 1.45–1.78 mL/sec Negative

0.01 0.01 0.01 0.1 0.01

Fraction of total protein: 0.52–0.65 0.025–0.05 0.07–0.13 0.08–0.14 0.12–0.22

10

32–56 g/L 1–4 g/L 4–12 g/L 5–11 g/L 5–16 g/L

1 1

9–15 mmol/L 300–480 µmol/L

1 1 0.01 0.5263

15–200 µg/L 15–150 µg/L 2–4 g/L <0.027 mmol/L 11–57 nmol/L >5 nmol/L 376–1450 nmol/L >317 nmol/L

Carotene, β Ceruloplasmin Chloride Cholesterol Total (see Chapter 17) Esters

Serum

Cholinesterase (pseudocholinesterase)

Erythrocytes Plasma

Citrate Copper

Serum or plasma Serum, plasma Male Female Plasma 8 AM–10 AM 4 PM–6 PM Serum or plasma Male Female Serum Male Female Serum or plasma

Cortisol

Creatine

Creatine kinase (CK)

Creatinine (see Chapter 14)

Creatinine clearance (endogenous) Serum or plasma and urine (see Chapter 14) Male 107–139 mL/min Female 87–107 mL/min Cryoglobulins Serum Negative Electrophoresis, protein Serum Albumin 52%–65% of total protein 2.5%–5% of total protein α-1 7%–13% of total protein α-2 8%–14% of total protein β 12%–22% of total protein γ Serum Concentration Albumin 3.2–5.6 g/dL 0.1–0.4 g/dL α-1 0.4–1.2 g/dL α-2 0.5–1.1 g/dL β 0.5–1.6 g/dL γ Fats, neutral (see Triglycerides) Fatty acids Total (free and esterified) Serum 9–15 mmol/L Free (nonesterified) Plasma 300–480 µEq/L Ferritin Serum Male 15–200 ng/mL Female 12–150 ng/mL 200–400 mg/dL Fibrinogen Plasma Fluoride Whole blood <0.05 mg/dL Folate Serum ≥3.5 ng/mL (radioassay) Erythrocytes 166–640 ng/mL (bioassay) >140 ng/mL (radioassay) Galactose Whole blood Adults None Children <20 mg/dL Gamma globulin Serum 0.5–1.6 g/dL

2.266

— 0.05551 10

None <1.11 mmol/L 5–16 g/L

Continued


APPENDIX 5

TABLE A5-4


System

Conventional Units

Factor*


Globulins, total Glucose, fasting

Serum Serum or plasma Whole blood Serum or plasma Fasting 30 min 60 min 120 min 180 min Serum or plasma Fasting 5 min 60 min 120 min 180 min Erythrocytes

2.3–3.5 g/dL 70–110 mg/dL 60–100 mg/dL

10 0.05551

23–35 g/L 3.9–6.1 mmol/L 3.3–5.6 mmol/L

70–110 mg/dL 30–60 mg/dL above fasting 20–50 mg/dL above fasting 5–15 mg/dL above fasting Fasting level or below

0.05551

3.9–6.1 mmol/L 1.7–3.3 mmol/L above fasting 1.1–2.8 mmol/L above fasting 0.3–0.8 mmol/L above fasting Fasting level or below

Glucose tolerance Oral

Intravenous

Glucose-6-phosphate dehydrogenase (G6PD) γ-Glutamyltransferase Glutathione Growth hormone Guanase Haptoglobin Hemoglobin

α-Hydroxybutyrate dehydrogenase 17-Hydroxycorticosteroids

Immunoglobulins IgG IgA IgM IgD IgE Insulin

Serum Whole blood Serum Serum Serum Serum or plasma Qualitative Quantitative Whole blood Female Male Serum Plasma Male Female After 24 USP units of ACTH intramuscularly Serum

Iron, total Iron-binding capacity Iron saturation

Plasma bioassay Radioimmunoassay Serum Fasting 30 min 90 min Serum Serum Serum

Isocitric dehydrogenase

Serum

Ketone bodies 17-Ketosteroids Lactic acid (as lactate)

Serum Plasma Whole blood Venous Arterial Serum

Insulin tolerance (0.1 unit/kg)

Lactate dehydrogenase (LD)

Lactate dehydrogenase isoenzymes Serum

—

70–110 mg/dL 0.05551 Maximum of 250 mg/dL Significant decrease — Below 120 mg/dL 0.05551 Fasting level — 250–5000 units/106 cells 1 1200–2000 mU/mL packed erythrocytes 1 5–40 U/L 1 24–37 mg/dL 0.03254 1 <10 ng/mL 1 <3 nmol/mL/min 60–270 mg/dL 0.01

3.9–6.1 mmol/L Maximum of 13.9 mmol/L Significant decrease Below 6.7 mmol/L Fasting level 250–5000 µunits/cell 1200–2000 U/L packed erythrocytes 5–40 U/L at 37° C 0.78–1.20 mmol/L <10 µg/L <3 U/L at 37° C 0.6–2.7 g/L


— 10

Negative 5–50 mg/L

12–16 g/dL 13.5–18 g/dL 140–350 U/mL

10

120–160 g/L 135–180 g/L 140–350 kU/L

7–19 µg/dL 9–21 µg/dL 35–55 µg/dL

25.59¶

193–524 mmol/L 248–579 mmol/L 966–1517 nmol/L

800–1801 mg/dL 113–563 mg/dL 54–222 mg/dL 0.5–3 mg/dL 0.01–0.04 mg/dL 11–240 µU/mL 4–24 µU/mL

0.01

8–18 g/L 1.1–5.6 g/L 0.5–2.2 g/L 5–30 mg/L 0.1–0.4 mg/L 79–1722 pmol/L 29–172 pmol/L

Glucose of 70–110 mg/dL Fall to 50% of fasting level Fasting level 60–150 µg/dL 250–400 µg/dL 20–55%

0.05551 0.01 — 0.1791 0.1791 0.01

50–240 U/mL at 25° C (WolfsonWilliams Ashman units) Negative 25–125 µg/dL

0.0166

Glucose of 3.9–6.1 mmol/L Fall to 0.5 of fasting level Fasting level 10.7–26.9 µmol/L 44.8–71.6 µmol/L Fraction of total iron-binding capacity: 0.20–0.55 0.83–4.18 U/L at 25° C

— 34.67**

Negative 866–4334 nmol/L

5–20 mg/dL 3–7 mg/dL (lactate → pyruvate) 80–120 units at 30° C (pyruvate → lactate) 185–640 units at 30° C (lactate → pyruvate) 100–190 U/L at 37° C

0.1110 0.48

0.6–2.2 mmol/L 0.3–0.8 mmol/L 38–62 U/L at 30° C

0.48

90–310 U/L at 30° C

1

100–190 U/L at 37° C

1

10 7.175‖

Fraction of total LD


APPENDIX 5

TABLE A5-4

Whole Blood, Serum, and Plasma Chemistry—cont’d TYPICAL REFERENCE INTERVALS Component LD1 (anode) LD2 LD3 LD4 LD5 (cathode) Lactate dehydrogenase (heat stable) Lactose tolerance

System

Conventional Units

Factor*


0.01

Serum

17%–27% 27%–37% 18%–25% 3%–8% 0%–5% 30%–60% of total

0.17–0.27 0.27–0.37 0.18–0.25 0.03–0.08 0.00–0.05 Fraction of total LD: 0.30–0.6

Serum glucose changes similar to glucose tolerance test <50 µg/dL

—

Serum

Lead Leucine aminopeptidase (LAP)

Lipase Lipids, total Cholesterol (see Chapter 17) Triglycerides (see Chapter 17) Phospholipids Fatty acids (free) Phospholipid phosphorus Lithium Therapeutic interval Long-acting thyroid-stimulating hormone (LATS) Luteinizing hormone (LH)

Whole blood Serum Male Female Serum Serum

Serum Serum Serum Male Female

Macroglobulins, total Magnesium

Serum Serum

Methemoglobin

Whole blood

Mucoprotein Muramidase Myoglobin Nonprotein nitrogen (NPN)

Serum Serum Serum Serum or plasma Whole blood Serum Serum Serum

5′-Nucleotidase Ornithine carbamyl transferase Osmolality Oxygen (see Chapter 14) Pressure (PO2) Content Saturation pH

Phenylalanine

Whole blood (arterial) Whole blood (arterial) Whole blood (arterial) Whole blood (arterial) Whole blood (venous) Serum or plasma (venous) Serum Adults Newborns (term)

Phosphatase Acid phosphatase

Serum

Alkaline phosphatase

Serum

0.01

0.04826

Serum glucose changes similar to glucose tolerance test <2.41 µmol/L

80–200 U/mL (Goldbarg–Rutenberg) 75–185 U/mL (Goldbarg–Rutenberg) 0–1.5 U/mL (Cherry–Crandall) 14–280 mU/mL 400–800 mg/dL 150–250 mg/dL 10–90 mg/dL 150–380 mg/dL 9–15 mmol/L 8–11 mg/dL Negative 0.5–1.4 mEq/L None detected

0.24

19.2–48 U/L 18–44.4 U/L 278 0–417 U/L 1 14–280 U/L 0.01 4–8 g/L 0.02586 3.88–6.47 mmol/L 0.01129†† 0.11–2.15 mmol/L 0.01 1.50–3.80 g/L 1 9–15 mmol/L 0.3229 2.58–3.55 mmol/L — Negative 1 0.5–1.4 mmol/L — None detected

6–30 mU/mL Midcycle peak: 3× baseline value Premenopausal <30 mU/mL Postmenopausal >35 mU/mL 70–430 mg/dL 1.3–2.1 mEq/L 1.8–3 mg/dL <0.24 g/dL <1% of total hemoglobin 80–200 mg/dL 4–13 mg/L <90 µg/L 20–35 mg/dL 25–50 mg/dL 0–1.6 units at 37° C 8–20 mU/mL at 37° C 280–295 mOsm/kg

1 — 1 0.01 0.5000 0.4114 10 0.01 0.01 1 1 0.7139 1 1 1

6–30 U/L Midcycle peak: 3× baseline value Premenopausal <30 U/L Postmenopausal >35 U/L 0.7–4.3 g/L 0.65–1.05 mmol/L 0.74–1.23 mmol/L <2.4 g/L Fraction of total hemoglobin <0.01 0.8–2 g/L 4–13 mg/L <90 µg/L 14.3–25 mmol/L 17.8–35.7 mmol/L 0–1.6 units at 37° C 8–20 U/L at 37° C 280–295 mmol/kg

95–100 mmHg 15–23 volume 94–100% 7.38–7.44 7.36–7.41 7.35–7.45

0.1333 0.01 0.01 1

2.7–13.3 kPa Volume fraction: 0.15–0.23 Fraction saturated: 0.94–1 7.38–7.44 7.36–7.41 7.35–7.45

<3 mg/dL 1.2–3.5 mg/dL

60.54

<182 µmol/L 73–212 µmol/L

0.13–0.63 U/L at 37° C (p-nitrophenylphosphate) 20–130 U/L at 37° C (p-nitrophenylphosphate in AMP buffer)

16.67

2.2–10.5 U/L at 37° C

1

20–130 U/L at 37° C

Phospholipid phosphorus (see Lipids, total)

Continued


APPENDIX 5

TABLE A5-4

Whole Blood, Serum, and Plasma Chemistry—cont’d TYPICAL REFERENCE INTERVALS Conventional Units

Factor*


2.3–4.7 mg/dL 4–7 mg/dL 3.8–5 mEq/L

0.3229

0.74–1.52 mmol/L 1.29–2.26 mmol/L 3.8–5 mmol/L

1–25 ng/mL 1–20 ng/mL

1

1–25 µg/L 1–20 µg/L

6–7.8 g/dL 3.2–4.5 g/dL 2.3–3.5 g/dL

10

60–78 g/L 32–45 g/L 23–35 g/L

15–50 mg/dL 0.3–0.9 mg/dL Negative 15–30 mg/dL 136–142 mEq/L 0.2–1.3 mEq/L 0.9–6 in mg/dL as SO4–2 Negative Negative

0.01777 113.6 — 0.07240 1 0.5 0.1042 — —

0.27–0.89 µmol/L 34–102 µmol/L Negative 1.08–2.17 mmol/L 136–142 mmol/L 0.10–0.65 mmol/L 0.09–0.63 mmol/L as SO4–2 Negative Negative

300–1200 ng/dL 30–95 ng/dL Negative

0.03467 —

10.4–41.6 nmol/L 1–3.3 mmol/L Negative

5.5–12.5 µg/dL 0.9–2.3 ng/dL 25–38 relative % uptake 10–26 µg/dL 0.5–5 µU/mL 80–200 mg/dL

12.87 12.87 0.01 10 1 0.0154

71–161 nmol/L 12–30 pmol/L Relative uptake fraction: 0.25–0.38 100–260 µg/L 0.5–5 µU/L 1.23–3 of nmol/L

Serum

8–33 U/L at 37° C

1

8–33 U/L at 37° C

Serum

4–36 U/L at 37° C

1

4–36 U/L at 37° C

Serum Serum

5–40 U/L at 37° C 10–190 mg/dL <2 mg/mL

1 0.01129††

8–23 mg/dL

0.357

5–40 U/L at 37° C 0.11–2.15 mmol/L 0–0.6 µg/L 0–0.1 µg/L 2.9–8.2 mmol/L

64–99 mL/min 41–65 mL/min, or more than 75% of normal clearance

0.01667

1.07–1.65 L/s 0.68–1.08 L/s or more than 0.75 of normal clearance

4–8.5 mg/dL 2.7–7.3 mg/dL 15–60 µg/dL 15–60 µg/dL 200–600 µg/dL

0.05948 0.03491 0.03491 0.03491

0.24–0.51 mmol/L 0.16–0.43 mmol/L 0.52–2.09 µmol/L 0.52–2.09 µmol/L 6.98–20.95 µmol/L

Fasting values or slightly above 160–950 pg/mL 1000–2000 pg/mL

— 0.7378 0.7378

Fasting values or slightly above 118–701 pmol/L 738–1475 pmol/L

0.6–1.6 mg/dL

56.78

34–91 µmol/L

Component

System

Phospholipids (see Lipids, total) Phosphorus, inorganic

Serum Adults Children Plasma Serum Female Male Serum

Potassium Prolactin

Proteins (see Chapter 19) Total Albumin Globulin Protein fractionation, see Electrophoresis Protoporphyrin Pyruvate Salicylates Therapeutic interval Sodium Sulfate, inorganic

Erythrocytes Whole blood Serum Plasma Serum

Sulfhemoglobin Sulfonamides Testosterone

Thiocyanate Thyroid hormone tests (see Chapter 24) Thyroxine, total (T4) Thyroxine, free (FT4) T3 resin uptake Thyroxine-binding globulin (TBG) Thyrotropin (TSH) Triiodothyronine (T3) Transferases Aspartate amino transferase (AST or SGOT) Alanine amino transferase (ALT or SGPT) γ Glutamyl transferase (GGT) Triglycerides (see Chapter 17) Troponin I

Whole blood Serum or whole blood Serum or plasma Male Female Serum Serum

Serum Serum

Urea nitrogen Urea clearance Maximum clearance Standard clearance

Serum Serum and urine

Uric acid

Serum Male Female Serum Serum Fasting 3 hr or 6 hr after 5000 units vitamin A/kg 24 hr Serum Serum

Vitamin A Vitamin A tolerance

Vitamin B12 Unsaturated vitamin B12-binding capacity Vitamin C

Plasma

1


APPENDIX 5

TABLE A5-4


System

Conventional Units

Factor*


Xylose absorption

Serum normal in malabsorption

0.06661

1.67–2.66 mmol/L 1–2 h Maximum ≈0.67 mmol/L

Zinc

Serum

25–40 mg/dL 1–2 hr Maximum ≈10 mg/dL Dose: adult 25 g D-xylose; children 0.5 g D-xylose/kg 50–150 µg/dL

0.1530

7.7–23 µmol/L

*Factor = number factor (note that units are not presented). † Value in SI units = value in conventional units × factor. ‡ Usually not measured in blood (preferred specimen is urine, hair, or nails except in acute cases, when gastric contents are used). § Unit based on hydrogen ion concentration. ¶ As cortisol. ‖ 1 International unit of insulin corresponds to 0.04167 mg of the 4th International Standard (a mixture of 52% beef insulin and 48% pig insulin). **As DHEA. †† As triolein.

TABLE A5-5

Urine TYPICAL REFERENCE INTERVALS Component

Type of Urine System

Conventional Units

Factor*


Acetoacetic acid Acetone Addis count

Random Random 12 hr collection

Negative Negative WBC and epithelial cells: 1,800,000/12 hr RBC 500,000/12 hr Hyaline casts: <5000/12 hr

— — 1

Negative Negative 1.8 × 106 /12 hr

1 1

0.5 × 106 /12 hr <5 × 103 /12 hr

Negative 15–150 mg/day 2–26 µg/day Negative 100–290 mg/day

— 0.001 2.774 — 0.07139

Negative 0.015–0.150 g/day 6–72 nmol/day Negative 7.1–20.7 mmol/day

0.1–0.6 mg/dL <0.5 mg/dL 1.5–7.5 mg/day 20–70 mEq/day 500–1200 mg/day 35–260 Somogyi units/hr <50 µg/L 1–7 mg/dL >50 mg/day — <0.05 µg/day — — <2 mg/L

76.26 7.626 1 0.07139 0.1850 0.01335 56.78 5.678 Negative 111 Negative Negative 16.44

8–46 µmol/L <38 µmol/L 11–57 µmol/day 20–70 mmol/day 35.6–85.7 mmol/day 6.5–48.1 U/hr <0.67 µmol/L 57–397 µmol/L >284 µmol/day

1 + turbidity

1

1 + turbidity

100–240 mg/day <150 mg/day 240–300 mg/day <14 µg/dL <100 µg/day (varies with activity) <10 ng/day <100 ng/day 4–126 µg/day 0.1–1.6 mg/day 140–250 mEq/day

0.02495

2.5–6 mmol/day <3.7 mmol/day 6–7.5 mmol/day <828 nmol/L <591 nmol/day <55 nmol/day <591 nmol/day 24–745 nmol/day

Albumin Qualitative Quantitative Aldosterone Alkapton bodies α-Amino acid nitrogen δ-Aminolevulinic acid

Random 24 hr 24 hr Random 24 hr Random Adults Children 24 hr 24 hr

Ammonia nitrogen Amylase Arsenic Ascorbic acid

2 hr 24 hr Random 24 hr Negative 24 hr Negative Negative 24 hr

Bence Jones protein Beryllium Bilirubin, qualitative Blood, occult Borate Calcium Qualitative (Sulkowitch) Quantitative

Random 24 hr Average diet Low-calcium diet High-calcium diet Random 24 hr

Catecholamines Epinephrine Norepinephrine Total free catecholamines Total metanephrines Chloride Concentration test (Fishberg)

24 hr Random—after fluid restriction

59.11* 5.911* 5.458 5.911 5.911* 5.458† 1

<5.55 nmol/day

<32 µmol/L

0.5–8.7 µmol/day 140–250 nmol/day

Continued


APPENDIX 5

TABLE A5-5

Urine—cont’d TYPICAL REFERENCE INTERVALS Component


Specific gravity Osmolality Copper Coproporphyrin

24 hr Random Adult 24 hr Adult Children 24 hr Male Female

Creatine

Creatinine

24 hr Male Female

Cystine, qualitative Cystine and cysteine Dehydroepiandrosterone

Diacetic acid Epinephrine Estrogens, total

Estrogens, fractionated Estrone (E1) Estradiol (E2) Estriol (E3) Etiocholanolone

Fat, qualitative FIGLU (N-formiminoglutamic acid) Fluoride Follicle-stimulating hormone (FSH)

Fructose Glucose, qualitative Glucose, quantitative Copper-reducing substances Total sugars Glucose Gonadotropins, pituitary (FSH and LH) 11-Hydroxyandrosterone

11-Hydroxyetiocholanolone

Random 24 hr 24 hr Male Female Random 24 hr 24 hr Male Female Ovulation Luteal peak At menses Pregnancy Postmenopausal 24 hr, nonpregnant, midcycle — — — 24 hr Male Female Random 24 hr After 15 g of l-histidine 24 hr 24 hr Adult Prepubertal Postmenopausal Midcycle 24 hr Random 24 hr

24 hr 24 hr Male Female 24 hr Male Female

Conventional Units

Factor*


>1.025 >850 mOsm/kg <50 µg/day

1 1 0.01574

>1.025 >850 mmol/kg <0.8 µmol/day

3–20 µg/dL

15.27

46–305 nmol/L

50–160 µg/day <80 µg/day

1.527

76–244 nmol/day <122 nmol/day

<40 mg/day <100 mg/day Higher in children and during pregnancy

7.625

<305 µmol/day <763 µmol/day Higher in children and during pregnancy

—

20–26 mg/kg/day 1–2 g/day 14–22 mg/kg/day 0.8–1.8 g/day Negative 10–100 mg/day

8.840 8.840 8.840 8.840 — 4.161‡

177–230 µmol/kg/day 8.8–17.7 mmol/day 124–195 µmol/kg/day 7.1–15.9 mmol/day Negative 42–416 µmol/day

0.2–2 mg/day 0.2–1.8 mg/day Negative <20 µg/day

3.467 — 5.458

0.7–6.9 µmol/day 0.7–6.2 µmol/day Negative <109 nmol/day

5–18 µg/day

3.468§

17–62 nmol/day

28–100 µg/day 22–80 µg/day 4–25 µg/day Up to 45,000 µg/day Up to 10 µg/day

3.468 0.003468 3.468

97–347 nmol/day 76–364 nmol/day 14–87 nmol/day Up to 156 µmol/day Up to 35 nmol/day

2–25 µg/day <10 µg/day 2–30 µg/day

3.699 3.671 3.468

7–93 nmol/day

1.4–5 mg/day 0.8–4 mg/day Negative <3 mg/day 4 mg/8 hr

3.443

<37 nmol/day 7–104 nmol/day

<1 mg/day

52.63

4.8–17.2 µmol/day 2.8–13.8 µmol/day Negative <7.2 µmol/day 23 µmol/8 hr <53 µmol/day

4–25 U/L 4–30 U/L 40–50 U/L 2 × baseline 30–65 mg/day Negative

1 1 1 1 0.005551 —

4–25 U/L 4–30 U/L 40–50 U/L 2 × baseline 0.17–0.36 mmol/day Negative

0.5–1.5 g/day Average 250 mg/day Average 130 mg/day 10–50 U/L

1 1 0.005551 1

0.5–1.5 g/day Average 250 mg/day Average 0.72 mmol/day 10–50 U/day

0.1–0.8 mg/day <0.5 mg/day

3.263

0.3–2.6 µmol/day <1.6 µmol/day

0.2–0.6 mg/day 0.1–1.1 mg/day

3.26

0.7–2 µmol/day 0.3–3.63 µmol/day

— 5.740


APPENDIX 5

TABLE A5-5



Conventional Units

Factor*


11-Ketoandrosterone

24 hr Male Female

0.2–1 mg/day 0.2–0.8 mg/day

3.274

0.7–3.3 µmol/day 0.7–2.6 µmol/day

0.2–1 mg/day 0.2–0.8 mg/day 14–40 mg/day

3.274

0.7–3.3 µmol/day 0.7–2.6 µmol/day 41–117 µmol/day <0.48 µmol/day 3–4.3 mmol/day Negative 100–150 mg/day 1.3–36 mg/day 41–117 µmol/day Negative <4 mg/L 500–800 mmol/kg 2–5 mg/kg/day 4.6–8 Fraction dye excreted:

11-Ketoetiocholanolone

Lactose Lead Magnesium Melanin, qualitative Mucin Muramidase (lysozyme) Myoglobin Qualitative Quantitative Osmolality Pentoses pH Phenolsulfonphthalein (PSP)

Phenylpyruvic acid, qualitative Phosphorus Porphobilinogen Qualitative Quantitative Potassium Pregnancy tests

Pregnanediol

24 hr Male Female 24 hr 24 hr 24 hr Random 24 hr 24 hr 24 hr Random 24 hr Random 24 hr Random Urine timed after 6 mg PSP IV 15 min 30 min 60 min 120 min Random Random Random 24 hr 24 hr Concentrated morning specimen

Reducing substances, total Sodium Solids, total

24 hr Male Female Peak Pregnancy Children 24 hr Male Female Children Random 24 hr 24 hr 24 hr 24 hr

Specific gravity

Random

Pregnanetriol

Protein, qualitative

Sugars (excluding glucose) Titratable acidity Urea nitrogen Uric acid Urobilinogen

Random 24 hr 24 hr 24 hr 2 hr 24 hr

Uropepsin

Random 24 hr

<100 µg/day 6–8.5 mEq/day Negative 100–150 mg/day 1.3–36 mg/day 14–40 mg/day Negative <4 mg/L 500–800 mOsm/kg water 2–5 mg/kg/day 4.6–8

2.291 0.004826 0.5000 — 1 1 2.291 — 1 1 1 1

20%–50% dye excreted 16%–24% dye excreted 9%–17% dye excreted 3%–10% dye excreted Negative 0.9–1.3 g/day

0.01

Negative <1 mg/day 40–80 mEq/day Positive in normal pregnancies or with tumors producing chorionic gonadotropin

— 4.420 1 —

Negative <4.4 µmol/day 40–80 mmol/day Positive in normal pregnancies or with tumors producing chorionic gonadotropin

<1.5 mg/day 1–8 mg/day 1 week after ovulation <50 mg/day Negative

3.120 3.120 — 3.120 —

<4.7 µmol/day 3–25 µmol/day 1 week after ovulation <156 µmol/day Negative

0.4–2.4 mg/day 0.5–2 mg/day Up to 1 mg/day Negative 40–150 mg/day 0.5–1.5 mg/day 75–200 mEq/day 55–70 g/day Decreases with age to 30 g/day

2.972

1.016–1.022 (normal fluid intake) 1.001–1.035 (range) Negative 20–50 mEq/day 6–17 g/day 250–750 mg/day 0.3–1 Ehrlich units 0.05–2.5 mg/day or 0.5–4 Ehrlich units/day 15–45 units/hr (Anson) 1500–5000 units/day (Anson)

1

1.2–7 µmol/day 1.5–5.9 µmol/day Up to 3 µmol/day Negative 40–150 mg/day 0.5–1.5 mg/day 75–200 mmol/day 55–70 g/day Decreases with age to 30 g/day Relative density (U 20° C/water 20° C): 1.016–1.022 (normal fluid intake) 1.001–1.035 (range) Negative 20–50 mmol/day 214–607 mmol/day 1.5–4.5 mmol/day 0.3–1 U 0.1–4.2 µmol/day 0.5–4 U/day 111–332 U/hr 11–37 kU/hr

— 32.29

— 1 1 1 1 —

— 1 35.70 0.005948 1 1.693 1 7.37

0.20–0.50 0.16–0.24 0.09–0.17 0.03–0.10 Negative 29–42 mmol/day

Continued


APPENDIX 5

TABLE A5-5



Conventional Units

Factor*


Uroporphyrins Qualitative Quantitative Vanillylmandelic acid (VMA) Volume, total Zinc

Random 24 hr 24 hr 24 hr 24 hr

Negative 10–30 µg/day 1.5–7.5 mg/day 600–1600 mL/day 0.15–1.2 mg/day

— 1.204 5.046 0.001 15.30

Negative 12–36 nmol/day 7.6–37.9 µmol/day 0.6–1.6 L/day 2.3–18.4 µmol/day

*As norepinephrine. † As normetanephrine. ‡ Based on cystine. § Based on estriol.

TABLE A5-6

Synovial Fluid TYPICAL REFERENCE INTERVALS Component

Conventional Units

Factor

Recommended SI Units

Blood-serum-synovial fluid glucose difference Differential cell count

<10 mg/dL

0.05551

<0.56 mmol/L

Granulocytes <25% of nucleated cells Absent Abundant <200 cells/µL High <3.5 mL

0.01

Granulocyte number fraction: <0.25 of nucleated cells Absent Abundant <200 × 106 cells/L High <0.0035 L

Fibrin clot Mucin clot Nucleated cell count Viscosity Volume

— — 106 — 0.001

TABLE A5-7

Seminal Fluid TYPICAL REFERENCE INTERVALS Component

Conventional Units

Factor


Liquefaction Sperm morphology Sperm motility pH Sperm count Volume

Within 20 min >70% normal, mature spermatozoa >60% >7 (average 7.7) 60–150 × 106/mL 1.5–5 mL

0.01 0.01 1 103 0.001

Within 20 min Number fraction: >0.70 normal, mature spermatozoa Number fraction: >0.60 >7 (average 7.7) 60–150 × 109/L 0.0015–0.005 L

TABLE A5-8

Gastric Fluid TYPICAL REFERENCE INTERVALS Component

Conventional Units

Factor


Fasting residual volume pH Basal acid output (BAO)* Maximum acid output (MAO) (after histamine stimulation) BAO/MAO ratio

20–100 mL <2 0–6 mEq/hr 5–40 mEq/hr

0.001 1 1 1

0.02–0.10 L <2 0–6 mmol/hr 5–40 mmol/hr

<0.4

1

<0.4

*Varies between male and female and ages.


APPENDIX 5

TABLE A5-9

Hematology TYPICAL REFERENCE INTERVALS Component Red cell volume Male Female Plasma volume Male Female Coagulation and hemostatic tests Bleeding time

Activated partial thromboplastin time (APTT) Antithrombin IIII Immunologic Functional Clot lysis time Euglobulin factor Whole blood Clot retraction Coagulation factors Factor XIII (screening test) Fibrinogen Fibrin(ogen) degradation products Serum FDP Plasma D-dimers Plasminogen Immunologic Functional Protein C Protein S (total) Prothrombin time Thrombin time von Willebrand factor Immunologic Ristocetin cofactor activity Complete blood count (CBC) Hematocrit Male Female Hemoglobin Male Female Red cell count Male Female White cell count Erythrocyte indices Mean corpuscular volume (MCV) Mean corpuscular hemoglobin (MCH) Mean corpuscular hemoglobin concentration (MCHC) White blood cell differential (adult) Segmented neutrophils Bands Eosinophils Basophils Lymphocytes Monocytes

Conventional Units

Factor


20–36 mL/kg body weight 19–32 mL/kg body weight

0.001

0.020–0.036 L/kg body weight 0.019–0.032 L/kg body weight

25–43 mL/kg body weight 28–45 mL/kg body weight

0.001

0.025–0.043 L/kg body weight 0.028–0.045 L/kg body weight

10 10

200–300 mg/L 800–1200 U/L

1000

500–1500 U/L

0.01

2–4 g/L

<10 µg/mL <200 ng/mL

1 1

<10 mg/L <200 µg/L

10–20 mg/dL 80–120 U/dL 0.7–1.4 µ/mL 0.7–1.4 µ/mL Depends on thromboplastin reagent used, typically 10–13 s Depends on concentration of thrombin reagent used, typically 17–25 s

10 10 10 10

100–200 mg/L 800–1200 U/L 700–1400 U/L 700–1400 U/L

50–150 U/dL 50–150 U/dL

10

500–1500 U/L 500–1500 U/L

41.5%–50.4% 35.9%–44.6%

0.01

14–17.5 g/dL 12.3–15.3 g/dL

10

140–175 g/L 123–153 g/L

4.5–5.9 × 106/µL 4.5–5.1 × 106/µL 4.4–11 × 103/µL

106 106

4.5–5.9×1012/L 4.1–5.1×1012/L 4.4–11.3×109/L

80–96 µm3 27.5–33.2 pg

1 1

80–96 fL 27.5–33.2 pg

33.4%–35.5%

0.01

Concentration fraction: 0.334–0.355

Depends on location and orientation of cut and on particular device, typically 2–8 min Depends on activator and phospholipid reagents used, typically 25–35 s 20–30 mg/dL 80–120 U/dL 1.5–4 hr at 37° C None by 24 hr at 37° C Complete by 4 hr at 37° C 0.50–1.50 µ/mL Clot insoluble in 5 mol/L urea at 24 hr 200–400 mg/dL

Mean % 56 3 2.7 0.3 34 4

Range of absolute counts 1800–7800/µL 0–700/µL 0–450/µL 0–200/µL 1000–4800/µL 0–800/µL

106

Volume fraction: 0.415–0.504 0.359–0.446

Mean number fraction*

Range of absolute counts

0.56 0.03 0.027 0.003 0.34 0.04

1.8–7.8 × 109/L 0–0.70 × 109/L 0–0.45 × 109/L 0–0.20 × 109/L 1.0–4.8 × 109/L 0–0.80 × 109/L

Continued


APPENDIX 5

TABLE A5-9

Hematology—cont’d TYPICAL REFERENCE INTERVALS Component

Conventional Units

Factor


Hemoglobin A2 Hemoglobin F Osmotic fragility

1.5%–3.5% of total hemoglobin <2% % Lysis

0.01 0.01

Mass fraction: 0.015–0.035 of total hemoglobin Mass fraction: <0.02 Lysed Fraction

% (w/v) NaCl

Fresh

24 hr at 37° C

% NaCl – 171 % Lysis − 0.01

NaCl mmol/L

Fresh

24 hr at 37° C

0.2 0.3 0.35 0.4 0.45 0.5 0.55 0.6 0.65 0.7 0.75

— 97–100 90–99 50–95 5–45 0.6 — — — — —

95–100 85–100 75–100 65–100 55–95 40–85 15–70 0–40 0–10 0–5 95–100

34.2 51.3 59.8 68.4 77.0 85.5 94.1 102.6 111.2 119.7 128.3

— 0.97–1.00 0.90–0.99 0.50–0.95 0.05–0.45 0–0.06 0 — — — —

0.95–1 0.85–1 0.75–1 0.65–1 0.55–0.95 0.40–0.85 0.15–0.70 0–0.40 0–0.10 0–0.05 0

Platelet count Reticulocyte count Sedimentation rate (ESR) (Westergren) Men younger than 50 yr Men 50–85 yr Men older than 85 yr Women younger than 50 yr Women 50–85 yr Women older than 85 yr Viscosity Zeta sedimentation ratio

150,000–450,000/µL 0.5%–1.5% 25,000–75,000 cells/µL

106 0.01 106

150–450×109/L Number fraction: 0.005–0.015 25–75×109/L

<15 mm/hr <20 mm/hr <30 mm/hr <20 mm/hr <30 mm/hr <42 mm/hr 1.4–1.8 times water 41%–54%

1 0.01

1.4–1.8 times water Fraction: 0.41–0.54

*All percentages are multiplied by 0.01 to give fraction.

TABLE A5-10

Amniotic Fluid TYPICAL REFERENCE INTERVALS Component Appearance Early gestation Term Albumin Early gestation Term Bilirubin Early gestation Term Chloride Early gestation Term Creatinine Early gestation Term Estriol Early gestation Term Lecithin: sphingomyelin Early (immature)

Conventional Units

Factor


Clear Clear or slightly opalescent

— —

Clear Clear or slightly opalescent

0.39 g/dL 0.19 g/dL

10

3.9 g/L 1.9 g/L

<0.075 mg/dL <0.025 mg/dL

17.10

<1.3 µmol/L <0.41 µmol/L

Approximately equal to serum chloride Generally 1–3 mEq/L lower than serum chloride

— 1

Approximately equal to serum chloride Generally 1–3 mmol/L lower than serum chloride

0.8–1.1 mg/dL

88.40

71–97 µmol/L 159–354 µmol/L (generally >177 µmol/L)

<10 µg/dL <60 µg/dL

3.468

<347 nmol/L >2081 nmol/L

<1 : 1

1

<1 : 1

1.8–4 mg/dL (generally >2 mg/dL)


APPENDIX 5

TABLE A5-10

Amniotic Fluid—cont’d TYPICAL REFERENCE INTERVALS Component

Conventional Units

Term (mature) Osmolality Early gestation Term PCO2 Early gestation Term pH Early gestation Term Protein, total Early gestation Term Sodium Early gestation Term Staining, cytologic Oil Red O Early gestation Term Nile blue sulfate Early gestation Term Urea Early gestation Term Uric acid Early gestation Term Volume Early gestation Term

>2 : 1

Factor

Recommended SI Units >2 : 1

Approximately equal to serum osmolality 230–270 mOsm/kg

— 1

Approximately equal to serum osmolality 230–270 mmol/kg

33–55 mm Hg 42–55 mm Hg (increases toward term)

0.1333

4.4–7.3 kPa 5.6–7.3 kPa (increases toward term)

7.12–7.38 6.91–7.43 (decreases toward term)

1

7.12–7.38 6.91–7.43

0.60 ± 0.24 g/dL 0.26 ± 0.19 g/dL

10

60 ± 2.4 g/L 2.6 ± 1.9 g/L

Approximately equal to serum sodium 7–10 mEq/L lower than serum sodium

— 1

Approximately equal to serum sodium 7–10 mmol/L lower than serum sodium

Stained fraction: <10% Stained fraction: >50%

0.01

Stained fraction: <0.1 >0.5

Stained fraction: 0

0.01

Stained fraction: <0.0 >0.2

18 ± 5.9 mg/dL 30.3 ± 11.4 mg/dL

0.1665

3.00 ± 0.98 mmol/L 5.04 ± 1.90 mmol/L

3.72 ± 0.96 mg/dL 9.90 ± 2.23 mg/dL

59.48

221 ± 57 µmol/L 589 ± 133 µmol/L

450–1200 mL 500–1400 mL (increases toward term)

0.001

0.45–1.2 L 0.5–1.4 L (increases toward term)

Stained fraction: >20%

TABLE A5-11

Cerebrospinal Fluid TYPICAL REFERENCE INTERVALS Component

Conventional Units

Factor


Albumin Cell count Glucose Lactate dehydrogenase (LD) Proteins Protein electrophoresis Prealbumin Albumin α-1 Globulin α-2 Globulin β Globulin γ Globulin Xanthochromia

<10–30 mg/dL <5 cells/µL 40–80 mg/dL Approximately 10% of serum level 12–60 mg/dL

10 106 0.05551 — 10

100–300 mg/L

2%–7% 56%–76% 2%–7% 4%–12% 8%–18% 3%–12% Negative

0.01

—

<5 × 106/L 2.8–4.4 mmol/L Activity fraction: approximately 0.1 of serum level 120–600 mg/L Fraction: 0.2–0.07 0.56–0.76 0.02–0.07 0.04–0.12 0.08–0.18 0.03–0.12 Negative


APPENDIX 5

TABLE A5-12

Miscellaneous TYPICAL REFERENCE INTERVALS Component

Specimen

Conventional Units

Factor


Bile, qualitative

Random stool

Chloride Clearances

Sweat Serum and urine (timed) Creatinine, endogenous Diodrast Inulin PAH Urine

Negative in adults Positive in children 4–60 mEq/L

— — 1

Negative in adults Positive in children 4–60 mmol/L

115 ± 20 mL/min 600–720 mL/min 100–150 mL/min 600–750 mL/min Free acid present

0.01667

1.92 ± 0.33 mL/s 10–12 mL/s 1.67–2.50 mL/s 10–12.50 mL/s Free acid present

<5 g/24 hr 10%–25% of dry matter 1%–5% of dry matter 5%–13% of dry matter 5%–15% of dry matter 10% of intake 1–2 g/24 hr 10–80 mEq/L Positive (2+ to 4+) 7.5%–25% in 6 hr

1 0.01

71.39 1 — 0.01

<5 g/day Mass fraction: 0.1–0.25 of dry matter 0.01–0.05 of dry matter 0.05–0.13 of dry matter 0.05–0.15 of dry matter Mass fraction: 0.1 of intake 71–143 mmol/day 10–80 mmol/L Positive (2+ to 4+) Fraction uptake: 0.075–0.25 in 6 hr

Positive 40–200 mg/24 hr 80–280 Ehrlich units/24 hr

— 1.693

Positive 68–339 µmol/day

Diagnex blue (tubeless gastric analysis) Fat

Nitrogen, total Sodium Trypsin activity Thyroid iodine-131 uptake Urobilinogen Qualitative Quantitative

Stool, 72 hr Total fat Neutral fat Free fatty acids Combined fatty acids Stool, 24 hr Sweat Random, fresh stool

Random stool Stool, 24 hr

—

TABLE A5-13

Selected Pediatric Reference Values Parameter S-Acid phosphatase Newborn 2–13 yr S-Aldolase Newborn Child S-Alkaline phosphatase Newborn Child S-α-fetoprotein Newborn 1–2 yr S-Amylase Newborn 1 yr S-Aspartate aminotransferase Newborn 1–3 yr S-Bilirubin, newborn 24 hr 48 hr 3–5 day S-Calcium Preterm, first week Full-term, first week 1–2 yr 2–16 yr U-Catecholamines 1 yr 1–5 yr 6–15 yr >15 yr

Value 7.4–19.4 U/L 6.4–15.2 U/L to 4× adult value to 2× adult value 40–300 U/L 60–270 U/L Up to 150 mg/L or higher Up to 87 mg/L Little, if any, amylase activity Adult values 16–74 U/L 6–30 U/L Preterm 17–103 µmol/L (10–60 mg/L) 17–103 µmol/L (10–60 mg/L) 171–257 µmol/L (100–150 mg/L)

Full-term 34–103 µmol/L (20–60 mg/L) 103–120 µmol/L (60–70 mg/L) 68–205 µmol/L (40–120 mg/L)

1.50–2.50 mmol/L (60–100 mg/L) 1.75–3 mmol/L (70–120 mg/L) 2.50–3 mmol/L (100–120 mg/L) 2.25–2.87 mmol/L (90–115 mg/L) Norepinephrine: 30–90 nmol/day (5.4–15.9 µg/day) 50–180 nmol/day (8.1–30.8 µg/day) 110–420 nmol/day (19–71.1 µg/day) 200–510 nmol/day (34.4–87 µg/day)

Epinephrine: 1–23 nmol/day (0.1–4.3 µg/day) 4–50 nmol/day (0.8–9.1 µg/day) 7–339 nmol/day (1.3–10.5 µg/day) 19–72 nmol/day (3.5–13.2 µg/day)


APPENDIX 5

TABLE A5-13

Selected Pediatric Reference Values—cont’d Parameter

Value

U-Chloride (varies with chloride intake) Infant Child S-Cholesterol Cord blood 1–2 yr 2–16 yr U-Cortisol (free) 4 mo–10 yr 11–20 yr S-Creatine kinase Newborn 3 wk–3 mo >1 yr S-Creatinine Up to 5 yr Up to 6 yr Up to 7 yr Up to 8 yr Up to 9 yr Up to 10 yr >10 yr S-Estradiol 0–2 yr 2–4 yr 4–6 yr 6–8 yr 8–10 yr 10–12 yr 12–14 yr 14–16 yr 16–26 yr Fecal fat Preterm newborn Full-term newborn 3 mo–1 yr 1 yr P-Nonesterified fatty acids Newborn 4 mo–10 yr S-Glucose Preterm newborn Full–term newborn Child S-γ-Glutamyltransferase Premature newborn Newborn–3 wk 3 wk–3 mo 1–5 yr 6–15 yr 16 yr–adult S-Haptoglobin Newborn ≥1 yr S-Immunoglobulin G 0–5 wk 6 mo 1 yr 5 yr 10 yr S-Immunoglobulin A 0–5 wk 6 mo 1 yr 5 yr 10 yr 0–5 wk

1.7–8.5 mmol/day 17–34 mmol/day 1.2–2.5 mmol/L (460–980 mg/L) 1.8–4.9 mmol/L (700–1900 mg/L) 3.5–6.5 mmol/L (1350–2500 mg/L) 6–74 nmol/day (2–27 µg/day) 2–152 nmol/day (0.7–55 µg/day) 3× adult values 1.5× adult values Adult values Upper reference value: 44 µmol/L (5 mg/L) 53 µmol/L (6 mg/L) 62 µmol/L (7 mg/L) 71 µmol/L (8 mg/L) 80 µmol/L (9 mg/L) 88 µmol/L (10 mg/L) 106 µmol/L (12 mg/L) 0–26 pmol/L (0–7 pg/mL) 0–26 pmol/L (0–7 pg/mL) 0–51 pmol/L (0–14 pg/mL) 0–37 pmol/L (0–10 pg/mL) 0–367 pmol/L (0–100 pg/mL) 0–367 pmol/L (0–100 pg/mL) 0–367 pmol/L (0–100 pg/mL) 26–385 pmol/L (7–105 pg/mL) 26–1175 pmol/L (7–320 pg/mL) Up Up Up Up

to to to to

0.40 excreted 0.20 excreted 0.15 excreted 0.085 excreted

0–1845 mmol/L 300–1100 mmol/L 1.1–3.6 mmol/L (200–656 mg/L) 1.1–6.1 mmol/L (200–1100 mg/L) 3.3–5.8 mmol/L (600–1050 mg/L) 56–233 U/L 10–103 U/L 4–111 U/L 2–23 U/L 2–23 U/L 2–35 U/L Detectable haptoglobin in only 0.1–0.2 Adult values 7500–15,000 mg/L 1500–7000 mg/L 1400–10,300 mg/L 3700–15,000 mg/L 4400–15,500 mg/L None 200–1300 mg/L 200–1300 mg/L 300–2000 mg/L 500–2300 mg/L None

Continued


APPENDIX 5

TABLE A5-13

Selected Pediatric Reference Values—cont’d Parameter

Value

S-Immunoglobulin M 0–5 wk 6 mo 1 yr 5 yr 10 yr Inulin clearance <1 mo 1–6 mo 6–12 mo >1 yr U-17-Ketosteroids* 0–3 day 1–3 yr 3–6 yr 6–9 yr

<200 mg/L 300–600 mg/L 300–1600 mg/L 200–2200 mg/L 300–1700 mg/L 29–88 mL/min per 1.73 m2 of body surface 40–112 mL/min per 1.73 m2 of body surface 62–121 mL/min per 1.73 m2 of body surface 78–164 mL/min per 1.73 m2 of body surface 0–0.2 µmol/day (0–0.5 mg/day) <7.0 µmol/day (<2.0 mg/day) 2–10 µmol/day (0.5–3.0 mg/day) 3–14 µmol/day (0.8–4.0 mg/day) Male 2–21 µmol/day (0.7–6.0 mg/day) 10–52 µmol/day (3–15 mg/day)

10–12 yr Adolescent S-Lactate dehydrogenase 1–3 day S-Phosphorus (inorganic) Preterm newborn 6–10 day 4 mo 1 yr 2–16 yr S-Potassium Preterm newborn Full-term newborn 2 day–2 wk 2 wk–3 mo 3 mo–1 yr 1–16 yr S-Testosterone 0–2 yr 2–4 yr 4–6 yr 6–8 yr 8–10 yr 10–12 yr 12–14 yr 14–16 yr 16–18 yr 18–20 yr 20–25 yr S-Thyroxine 1–3 day 1 wk–1 mo 1–4 mo 4–12 mo 1–6 yr 6–10 yr

Female 2–17 µmol/day (0.7–5.0 mg/day) 10–42 µmol/day (3–12 mg/day)

Up to 2× → adult values 1.81–2.58 mmol/L 1.97–3.78 mmol/L 1.55–2.62 mmol/L 1.26–1.94 mmol/L 0.84–1.61 mmol/L

(56.0–80.0 mg/L) (61–117 mg/L) (48–81 mg/L) (39–60 mg/L) (26–50 mg/L)

4.5–7.2 mmol/L 5.0–7.7 mmol/L 4.0–6.4 mmol/L 4.0–6.2 mmol/L 3.7–5.6 mmol/L 3.6–5.2 mmol/L Male 0.14–1.28 nmol/L (0–0.4 ng/mL) 0.17–5.55 nmol/L (0–1.6 ng/mL) 0.28–1.39 nmol/L (0.1–0.4 ng/mL) 0.21–9.72 nmol/L (0.1–2.8 ng/mL) 0.31–1.74 nmol/L (0.1–0.5 ng/mL) 0.29–10.06 nmol/L (0.1–2.9 ng/mL) 0.17–26.37 nmol/L (0–7.6 ng/mL) 3.12–19.43 nmol/L (0.9–5.6 ng/mL) 9.02–25.33 nmol/L (2.6–7.3 ng/mL) 13.88–24.98 nmol/L (4.0–7.2 ng/mL) 11.80–38.86 nmol/L (3.4–11.2 ng/mL)

Female 0.24–0.62 nmol/L 0.24–0.69 nmol/L 0.35–0.69 nmol/L 0.52–1.04 nmol/L 0.69–1.39 nmol/L 0.69–1.74 nmol/L 1.04–2.43 nmol/L 1.21–3.30 nmol/L 1.39–3.30 nmol/L 1.39–3.30 nmol/L 1.39–3.30 nmol/L

(0.1–0.2 ng/mL) (0.1–0.2 ng/mL) (0.1–0.2 ng/mL) (0.1–0.3 ng/mL) (0.2–0.4 ng/mL) (0.2–0.5 ng/mL) (0.3–0.7 ng/mL) (0.3–1.0 ng/mL) (0.4–1.0 ng/mL) (0.4–1.0 ng/mL) (0.4–1.0 ng/mL)

142–296 nmol/L (11.0–23.0 µg/dL) 116–232 nmol/L (9.0–18.0 µg/dL) 97–212 nmol/L (7.5–16.5 µg/dL) 71–187 nmol/L (5.5–14.5 µg/dL) 71–174 nmol/L (5.5–13.5 µg/dL) 64–161 nmol/L (5.0–12.5 µg/dL)

Information based on Meites S, editor: Pediatric clinical chemistry, Washington, DC, 1977, American Association for Clinical Chemistry. P, Plasma; S, serum; U, urine. *As DHEA.

REFERENCES Beeler MF: SI units and the AJCP, Am J Clin Pathol 87: 140, 1987. Lundberg GD, Iverson C, Radulescu G: Now read this: the SI units are here, JAMA 255:2329, 1986.

Metric Commission of Canada: The SI manual in healthcare, Ottawa, 1981, Sector 9.10 Health and Welfare, Metric Commission of Canada. Tietz NW, editor: Clinical guide to laboratory tests, ed 3, Philadelphia, 1995, WB Saunders.

World Health Organization: The SI for the health professions, Geneva, 1977, WHO. Young DS: Implementation of SI units for clinical laboratory data: style specifications and conversion tables, Ann Intern Med 106:114, 1987.


Normal Values Henry's

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