Reference ranges for blood tests
From Wikipedia, the free encyclopedia
A reference range is a set of values used by a health professional to interpret a set of medical test results. The range is usually defined as the set of values 95% of the normal population falls within.
The reference range will vary, depending on the age, sex and race of a population, and even the instruments the laboratory uses to perform the tests. Furthermore, by definition, 5% of the normal population will fall outside the reference range.
Contents[hide] |
[edit] Clinical biochemistry
- Items marked with a ** are part of "CHEM-7"[1] and CHEM-20
- Items marked with a * are part of "CHEM-20"[2], but not CHEM-7
[edit] Electrolytes and Metabolites
Electrolytes and Metabolites:
| Test [3] | Patient type | Lower limit [3] | Upper limit[3] | Unit | Comments |
| ** Sodium (Na) | 135[4]-137[5] | 145[5]-147[4] | mmol/L or mEq/L[4] | ||
| ** Potassium (K) | 3.5[4]-3.6[5] | 5.0[5][4]-5.1 | mmol/L or mEq/L[4] | ||
| Chloride (Cl) | 95[4]-98 | 105[4]-107 | mmol/L or mEg/L[4] | ||
| Osmolality | 275[4] | 295[4] | mOsm/kg | ||
| Urea | 1.2[4]-2.5 | 3.0[4]-6.4 | mmol/L | ** BUN - blood urea nitrogen | |
| 7[4] | 18[4]-21[5] | mg/dL | |||
| * Uric acid[5] | 0.18[4] | 0.48[4] | mmol/L | ||
| 3.0[4]3.5 | 8.2[4]-8.5 | mg/dL | |||
| ** Creatinine | male | 62 | 115 | μmol/L | May be complemented with creatinine clearance |
| 0.7 | 1.3 | mg/dL | |||
| female | 53 | 97 | μmol/L | ||
| 0.6 | 1.1 | mg/dL | |||
| ** Glucose (fasting) | 3.8[4]-3.9 | 5.8-6.1[4] | mmol/L | See also glycosylated hemoglobin (in hematology) | |
| 65[5]-70[4] | 105-110[5][4] | mg/dL | |||
| Total serum iron (TSI) | male | 65[6]-76[5] | 176[6]-198[5] | µg/dL | |
| female | 26[5]-50[6] | 170[6][5] | |||
| newborns[6] | 100 | 250 | |||
| children[6] | 50 | 120 | |||
| Total iron-binding capacity (TIBC) | 240[6]-262[5] | 450[6]-474[5] | |||
| Transferrin[5] | 204 | 360 | mg/dL | ||
| Transferrin saturation[6] | 20 | 50 | % | ||
| Ferritin[5] | Male | 18 | 250 | ng/mL | |
| Female | 12 | 160 |
[edit] Acid and base
- Further information: Acid base physiology
- Further information: Arterial blood gas
| Test | Lower limit | Upper limit | Unit | Comments |
| pH | 7.34[5]-7.35[4] | 7.44[5]-7.45[4] | ||
| [H+] | 36[4] | 44[4] | nmol/L | |
| base excess | -3 | +3 | ||
| PO2 | 10[4] | 13-14[4] | kPa | |
| 75[5][4] | 100[5]-105[4] | mmHg | ||
| ** PCO2 | 4.4[4]4.8 | 5.8-5.9[4] | kPa | |
| 33[4]-35[5] | 44[4]-45[5] | mmHg | ||
| Bicarbonate (HCO3-) | 18 | 23 | mmol/L | |
| Standard bicarbonate (SBCe) | 21-22[4] | 27-28[4] | mmol/L or mEq/L[4] |
[edit] Liver function
- Further information: Liver function tests
| Test | Lower limit | Upper limit | Unit | Comments |
| * Total Protein | 60[4]-63[5] | 78[4]-82[5] | g/L | |
| * Albumin | 35[7][4] | 48[5]-55[4] | g/L | |
| 3.5[5] | 4.8[5]-5.5[4] | U/L | ||
| Globulins | 23[4] | 35[4] | g/dL | |
| * Total Bilirubin | 2[4] | 17[4] | μmol/L | |
| 0.1[4]-0.2[5] | 1.0[4]-1.3[5] | mg/dL | ||
| * Direct Bilirubin | 0.0[4] | 5[4] | μmol/L | |
| 0[5][4] | 0.3[5][4] | mg/dL | ||
| * Alanine transaminase (ALT) | 7[5]-8 [4] | 20[4], 40, 56[5] | U/L | Also called serum glutamic pyruvic transaminase (SGPT) |
| * Alkaline phosphatase (ALP) | 20[4]-38[5] | 70[4]-126[5] | U/L | p-NPP at 30 degrees C[4] Higher in children and pregnant women. |
| * Gamma glutamyl transferase (GGT) | 8[5] | 50-78[5] | U/L |
[edit] Cardiac tests
| Test | Lower limit | Upper limit | Unit | Comments |
| Creatine kinase (CK) - male | 24[8]-38[5] | 195 | U/L or ng/mL |
|
| Creatine kinase (CK) - female | 24[9]-38[5] | 170 | U/L | |
| CK-MB[5] | 0 | 3 | ng/mL | |
| Troponin[5] | 0 | 0.4 | ng/mL |
[edit] Other enzymes and proteins
| Test | Lower limit | Upper limit | Unit | Comments |
| * Aspartate transaminase (AST) | 5[5]-8[4] | 20[4]-35[5] | U/L | Also called serum glutamic oxatoacetic transaminase (SGOT) |
| * Lactate dehydrogenase (LDH) | 85 | 285 | U/L | |
| Amylase | 25[4]-30[5] | 110[5], 120[10], 125[4] | U/L | |
| C-reactive protein (CRP) | n/a | 5[11] | mg/L | |
| D-dimer | n/a | 500 | ng/mL | |
| Lipase[5] | 7 | 60 | U/L |
[edit] Other ions and trace metals
- Further information: Trace metals
| Test | Lower limit | Upper limit | Unit | Comments |
| Ionised calcium (Ca) | 1.15 | 1.29 | mmol/L | Some calcium is bound to albumin, thus not measured by certain techniques. |
| * Total calcium (Ca) | 2.1[4] | 2.8[4] | mmol/L | |
| 8.4[4] | 10.2[4] | mg/dL | ||
| Phosphate (HPO42−) | 0.8 | 1.5 [12] | mM | |
| Inorganic phosphorus (serum) | 1.0[4] | 1.5[4] | mmol/L | |
| 3.0[4] | 4.5[4] | mg/dL | ||
| Copper (Cu) | 11[13] | 24 | μmol/L | |
| Zinc (Zn) | 10 | 17 | μmol/L |
[edit] Lipids
- Further information: Blood lipids
| Test | Lower limit | Upper limit | Unit | Comments |
| Triglycerides | 0.4 | 2 | mmol/L | |
| 50[5] | 250[5] | mg/dL | ||
| * Total cholesterol | 3.6[4] | 5.0[14]-6.5[4] | mmol/L | |
| 120[5]-140[4] | 200[5]-250[4] | mg/dL | ||
| HDL cholesterol (male) | 0.7 | 1.9 | mmol/L | |
| HDL cholesterol (female) | 0.9 | 2.4 | mmol/L | |
| LDL cholesterol | 2.4 | 3[14] | mmol/L | Not valid when triglycerides >5.0 mmol/L. |
[edit] Tumour markers
- Further information: Tumour markers
| Test | Lower limit | Upper limit | Unit | Comments |
| Alpha fetoprotein (AFP) | n/a | 10 | kU/l | |
| 0 | 44[5] | ng/mL | ||
| Alpha 1-antitrypsin (AAT) | 20 | 53 | mmol/L | |
| 150 | 350 | mg/dL | ||
| Beta Human chorionic gonadotrophin (bHCG) | n/a | 5[5] | IU/l | in male and non-pregnant female |
| CA-125 (also CA12.5) | n/a | 35 | U/ml | |
| CA15.3 | n/a | 28 | U/ml | |
| CA19.9 | n/a | 40[5] | U/ml | |
| Carcinoembryonic antigen (CEA) - non-smokers | n/a | 3 | μg/l | |
| Carcinoembryonic antigen (CEA) - smokers | n/a | 5 | μg/l | |
| Prostate specific antigen (PSA) | n/a | 4[5] | μg/L |
[edit] Hormones
- Further information: Hormones
| Test | Lower limit | Upper limit | Unit | Comments |
| Thyroid stimulating hormone (TSH) | 0.3 | 3.0 | mIU/L | Also called: Thyrotropin |
| Free thyroxine (FT4) | 9 | 24 | pmol/L | |
| 0.8[5] | 1.5[5] | ng/dL | ||
| Total thyroxine | 60[15] | 140[15] | nmol/L | |
| 5.5[5] | 12.3[5] | ng/mL | ||
| Free triiodothyronine (FT3) | 2.5 | 5.3 | pmol/L | |
| 0.2[15] | 0.5[15] | ng/dL | ||
| Total triiodothyronine | 1.1[15] | 2.7[15] | nmol/L | Values in children may be higher [15] |
| 60[5]-75[15] | 175[15]-181[5] | ng/dL[15] | ||
| Adrenocorticotropic hormone (ACTH) | 1.3 | 15 | pmol/L | |
| 20[5] | 100[5] | pg/mL | ||
| Cortisol (0830 h) | 250 | 850 | nmol/L | Cortisol levels are higher in the morning than at night. |
| Cortisol (1630 h) | 110 | 390 | nmol/L | |
| Growth hormone (fasting) | 0 | 5[4] | ng/mL | |
| Growth hormone (arginine stimulation) | 7[4] | n/a | ng/mL | |
| Prolactin (male) | n/a | 450 | mIU/L | |
| Prolactin (female) | n/a | 580 | mIU/L | |
| Testosterone (male) | 8 | 38 | nmol/L | |
| Testosterone (male prepuberty) | 0.1 | 0.5 | nmol/L | |
| Testosterone (female) | 0.3 | 2.5 | nmol/L |
[edit] Hematology
[edit] Red blood cells
| Test | Patient | Lower limit | Upper limit | Unit | Comments |
| Haemoglobin (Hb) | male | 2.1[4] | 2.7[4] | mmol/L | Higher in neonates, lower in children. |
| 132[5]-135[4] | 162[5]-175[4] | g/L | |||
| female | 1.9[4] | 2.5[4] | mmol/L | Sex difference negligible until adulthood. | |
| 115-120[4][5] | 152[5]-160[4] | g/L | |||
| Glycosylated hemoglobin (HbA1c) | 4[16] | 5.9[16] | % of Hb | ||
| Haematocrit (Hct) | male | 0.38, 0.4[5], 0.41[4] | 0.52-0.53[4] | ||
| female | 0.36[4]-0.37[5] | 0.46[5][4]-0.47 | |||
| Child | 0.31[5] | 0.43[5] | |||
| Hemoglobin in plasma | 0.16[4] | 0.62[4] | μmol/L | ||
| 1 | 4 | mg/dL | |||
| Mean cell volume (MCV) | Male | 82[5] | 102[5] | fL | Cells are larger in neonates, though smaller in other children. |
| Female | 78[5] | 101[5] | fL | ||
| MCV standard deviation | 35[5] | 47[5] | fL | ||
| Mean cell haemoglobin (MCH) | 0.39[4] | 0.54[4] | fmol/cell | ||
| 25[4]-26 | 34-35[4] | pg/cell | |||
| Mean cell haemoglobin concentration (MCHC) | 31[5] | 35[5] | g/dL | ||
| Red cell count (RBC) | male | 4.3[5][4]-4.5 | 5.9[4]-6.2[5] | x1012/L | |
| Female | 3.5[4]-3.8[5] | 5.5[5][4]-5.8 | x1012/L | ||
| Infant/Child | 3.8[5] | 5.5[5] | x1012/L | ||
| Reticulocytes | 10 | 100 | x109/L | ||
| Adult | 0.5[5][4] | 1.5[5] [4] | % of RBC | ||
| Newborn | 1.1[5] | 4.5[5] | % of RBC | ||
| Infant | 0.5[5] | 3.1[5] | % of RBC | ||
| Red blood cell distribution width (RDW) | 11.5[5] | 14.5[5] | % | Coefficient of variation |
[edit] White blood cells
| Test | Lower limit | Upper limit | Unit | Comments |
| White Blood Cell Count (WBC) | 4.1[5]-4.5[4] | 10.9[5]-11[4] |
|
Higher in neonates and infants. |
| Neutrophil granulocytes | 2 | 7.5 | x109/L | Also known as granulocytes (grans), polys, PMNs, or segs. |
| 45-54[4] | 62[4]-74 | % of WBC | ||
| Neutrophilic band forms | 3[4] | 5[4] | % of WBC | |
| Lymphocytes | 1.3 | 4 | x109/L | |
| 16-25[4] | 33[4]-45 | % of WBC | ||
| Monocytes | 0.2 | 0.8 | x109/L | |
| 3[4]-4.0 | 7[4]-10 | % of WBC | ||
| Mononuclear leukocytes | 1.5 | 5 | x109/L | Lymphocytes + monocytes. Mean: 35% of WBC. |
| 20 | 35 | % of WBC | ||
| CD4+ cells | 0.4 [5] | 1.8[5] | x109/L | |
| Eosinophil granulocytes | 0.04 | 0.4 | x109/L | |
| 1[4] | 3[4]-7 | % of WBC | ||
| Basophil granulocytes | 0.01 | 0.1 | x109/L | |
| 0.0 | 0.75[4]-2 | % of WBC |
[edit] Coagulation
| Test | Lower limit | Upper limit | Unit | Comments |
| Platelet count (Plt) | 140[5]-150[4] | 400[4]-450[5] | x109/L | |
| Prothrombin time (PT) | 11[4][17]-12[5] | 13.5[17], 14[5], 15[4] | s | PT reference varies between laboratory kits - INR is standardised |
| INR | 0.9 | 1.2 | The INR is a corrected ratio of a patients PT to normal | |
| Activated partial thromboplastin time (APTT) | 18[5]-29 | 28[5]-41 | s | |
| Thrombin clotting time (TCT) | 11 | 18 | s | |
| Fibrinogen | 1.7[5]-1.8 | 4.2[5] | g/L | |
| Bleeding time | 2 | 9 | minutes |
[edit] Immunology
| Category | Test | Patient | Lower limit | Upper limit | Unit | Comments |
| Acute phase protein markers of Inflammation |
Erythrocyte sedimentation rate (ESR) |
Male | 0 | Age÷2[18] | mm/hr | ESR increases with age and tends to be higher in females.[19] |
| Female | (Age+10)÷2 [18] | |||||
| C-reactive protein (CRP) | 0 | 6 | mg/L | |||
| Autoantibodies | Antinuclear antibodies (ANA) | |||||
| Extractable nuclear antigen (ENA) | ||||||
| Rheumatoid factor (RF) | 0 | 20-30[5] | IU/mL | High levels not specific for Rheumatoid Arthritis alone. | ||
| Serology | Antistreptolysin O titre (ASOT) |
Preschoolers | n/a | 100 | units/mL | |
| School age | 250[5] | |||||
| Adult | 125[5] |
[edit] See also
- Blood test
- Comprehensive metabolic panel
- Medical technologist
- Cardiology diagnostic tests and procedures
[edit] References
- ^ MedlinePlus Encyclopedia 003462
- ^ MedlinePlus Encyclopedia 003468
- ^ a b c Unless else specified in boxes, then ref is: Ashwood, Edward R.; Tietz, Norbert W.; Burtis, Carl A. (1994). Tietz textbook of clinical chemistry, 2nd edition, Philadelphia: Saunders. ISBN 0-7216-4472-4.
- ^ a b c d e f g h i j k l m n o p q r s t u v w x y z aa ab ac ad ae af ag ah ai aj ak al am an ao ap aq ar as at au av aw ax ay az ba bb bc bd be bf bg bh bi bj bk bl bm bn bo bp bq br bs bt bu bv bw bx by bz ca cb cc cd ce cf cg ch ci cj ck cl cm cn co cp cq cr cs ct cu cv cw cx cy cz da db dc dd de df dg dh di dj dk dl dm Last page of Deepak A. Rao; Le, Tao; Bhushan, Vikas (2007). First Aid for the USMLE Step 1 2008 (First Aid for the Usmle Step 1). McGraw-Hill Medical. ISBN 0-07-149868-0.
- ^ a b c d e f g h i j k l m n o p q r s t u v w x y z aa ab ac ad ae af ag ah ai aj ak al am an ao ap aq ar as at au av aw ax ay az ba bb bc bd be bf bg bh bi bj bk bl bm bn bo bp bq br bs bt bu bv bw bx by bz ca cb cc cd ce cf cg ch ci cj ck cl cm cn co cp cq cr cs ct cu cv cw cx cy cz da db dc dd Normal Reference Range Table from The University of Texas Southwestern Medical Center at Dallas. Used in Interactive Case Study Companion to PATHOLOGIC BASIS of DISEASE.
- ^ a b c d e f g h i Slon S (2006-09-22). "Serum Iron". University of Illinois Medical Center. Retrieved on 2006-07-06.
- ^ 288686147 at GPnotebook
- ^ 1436155929 at GPnotebook
- ^ 1436155929 at GPnotebook
- ^ 309002307 at GPnotebook
- ^ 946536472 at GPnotebook
- ^ Walter F., PhD. Boron. Medical Physiology: A Cellular And Molecular Approaoch. Elsevier/Saunders. ISBN 1-4160-2328-3. Page 849
- ^ 1040580630 at GPnotebook
- ^ a b -214630397 at GPnotebook
- ^ a b c d e f g h i j Table 4: Typical reference ranges for serum assays - Thyroid Disease Manager
- ^ a b "Hemoglobin A1c Test". MedicineNet.com. Retrieved on 2007-12-26.
- ^ a b MedlinePlus Encyclopedia 003652
- ^ a b Miller A, Green M, Robinson D (1983). "Simple rule for calculating normal erythrocyte sedimentation rate". Br Med J (Clin Res Ed) 286 (6361): 266. PMID 6402065. Full text at PMC: 6402065.
- ^ Böttiger LE, Svedberg CA (1967). "Normal erythrocyte sedimentation rate and age". Br Med J 2 (5544): 85–7. PMID 6020854. Full text at PMC: 6020854.
