Nursing - Normal Lab Values
Comments
Content
APPENDIX
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
µL
fL
=
=
=
=
=
liter
deciliter (10−1 liter)
milliliter (10−3 liter)
microliter (10−6 liter, 10−3 milliliter)
femtoliter (10−15 liter, 10−12 milliliter)
g
mg
mcg
ng
pg
=
=
=
=
=
gram
milligram (10−3 gram)
microgram (10−6 gram)
nanogram (10−9 gram)
picogram (10−12 gram)
U = unit
µU = microunit
IU = international unit
mmol
µmol
nmol
pmol
kPa
µkat
=
=
=
=
=
=
millimole (10−3 mole)
micromole (10−6 mole)
nanomole (10−9 mole)
picomole (10−12 mole)
kilopascal
microkatal
Source: Wu HB: Tietz clinical guide to laboratory tests, ed 4,
Philadelphia, 2006, Saunders.
TABLE C-1
SERUM, PLASMA, AND WHOLE BLOOD CHEMISTRIES
TEST
REFERENCE INTERVALS
CONVENTIONAL UNITS
SI UNITS
Acetone
Quantitative
Qualitative
Albumin
<2.0 mg/dL
Negative
3.5-5.0 g/dL
<344 µmol/L
Negative
35-50 g/L
Aldolase
α1-Antitrypsin
1.5-8.1 U/L
78-200 mg/dL
1.5-8.1 U/L
0.78-2.0 g/L
Skeletal muscle disease
Acute and chronic inflammation, arthritis
α1-Fetoprotein
<10 ng/mL
<10 mcg/L
Ammonia
Amylase
15-45 mcg N/dL
30-122 U/L (method
dependent)
11-32 µmol N/L
0.51-2.07 µkat/L
Bicarbonate
22-26 mEq/L
22-26 mmol/L
b-Type natriuretic
peptide (BNP)
Bilirubin
Total
Indirect
Direct
<100 mcg/L
<100 pmol/L
Cancer of testes, ovaries,
and liver
Severe liver disease
Acute and chronic pancreatitis, mumps (salivary gland
disease), perforated ulcers
Compensated respiratory
acidosis, metabolic alkalosis
Heart failure
0.2-1.2 mg/dL
0.1-1.0 mg/dL
0.1-0.3 mg/dL
3-21 µmol/L
1.7-17.0 µmol/L
1.7-5.1 µmol/L
HIGHER
POSSIBLE ETIOLOGY
LOWER
Diabetic ketoacidosis, high-fat
diet, low-carbohydrate diet,
starvation
Dehydration
Chronic liver disease,
malabsorption, malnutrition,
nephrotic syndrome
Renal disease
Chronic lung disease (early
onset), malnutrition,
nephrotic syndrome
Acute alcoholism, cirrhosis of
liver, extensive destruction
of pancreas
Compensated respiratory
alkalosis, metabolic acidosis
Biliary obstruction, impaired
liver function, hemolytic
anemia, pernicious anemia
Mosby items and derived items © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier, Inc.
1795
1796
APPENDIX C
TABLE C-1
Laboratory Reference Intervals
SERUM, PLASMA, AND WHOLE BLOOD CHEMISTRIES—cont’d
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 µmol/L
Chloride
96-106 mEq/L
96-106 mmol/L
Cholesterol
<200 mg/dL
<5.2 mmol/L
Male: >40 mg/dL
Female: >50 mg/dL
Recommended: <100 mg/dL
>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
High-density lipoproteins (HDLs)
Low-density
lipoproteins
(LDLs)
Copper
Cortisol
Creatine
Near optimal: 100-129 mg/dL
(2.6-3.34 mmol/L)
Moderate risk for CAD:
130-159 mg/dL
(3.37-4.12 mmol/L)
High risk for CAD:
>160 mg/dL (>4.14 mmol/L)
80-155 mcg/dL
8 AM: 5-23 mcg/dL
8 PM: <10 mcg/dL
0.2-1.0 mg/dL
High risk for CAD:
>4.14 mmol/L
12.6-24.3 µmol/L
0.14-0.63 µmol/L
<0.28 µmol/L
15.3-76.3 µmol/L
Creatine kinase (CK)
Male: 20-200 U/L
Female: 20-180 U/L
Male: 20-200 U/L
Female: 20-180 U/L
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 µmol/L
10-250 mcg/L
Folate (folic acid)
5-16 ng/mL
11-36 nmol/L
Gamma-glutamyl
transferase (GGT)
0-30 U/L
0-0.5 µkat/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
deficiency
Same as bicarbonate
Cystic fibrosis, hypothyroidism,
pancreatic insufficiency
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,
inflammation, liver disease)
Hypothyroidism
Liver disease, infectious
mononucleosis, pancreatitis,
hyperthyroidism
Acute stress, Cushing
disease, diabetes mellitus,
hyperthyroidism, pancreatic
insufficiency
Dietary deficiency, malabsorption disorders
Addison’s disease, diarrhea,
metabolic alkalosis, respiratory acidosis, vomiting
Extensive liver disease, hyperthyroidism, malnutrition,
corticosteroid therapy
Wilson’s disease
Adrenal insufficiency,
panhypopituitary states
Diabetes mellitus
Iron-deficiency anemia
Alcoholism, hemolytic anemia,
inadequate diet, malabsorption syndrome, megaloblastic anemia
Hypothyroidism
Addison’s disease, hepatic
disease, hypothyroidism,
insulin overdosage,
pancreatic tumor, pituitary
hypofunction
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 influenced 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
Laboratory Reference Intervals
1797
SERUM, PLASMA, AND WHOLE BLOOD CHEMISTRIES—cont’d
TEST
REFERENCE INTERVALS
CONVENTIONAL UNITS
SI UNITS
Haptoglobin
26-185 mg/dL
260-1850 mg/L
Insulin (fasting)
4-24 µU/mL
29-172 pmol/L
Iron, total
50-175 mcg/dL
9.0-31.3 µmol/L
Iron-binding capacity
250-425 mcg/dL
44.8-76.1 µmol/L
Lactic acid (L-Lactate)
Lactic dehydrogenase (LDH)
6.3-22.5 mcg/dL
140-280 U/L
0.7-2.5 mmol/L
0.83-2.5 µkat/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 µkat/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
See blood gases
0.8-1.8 mg/dL
0-0.6 U/L
48-109 µmol/L
0-90 µkat/L
Phosphatase, alkaline
38-126 U/L
0.65-2.14 µkat/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
Lactic dehydrogenase isoenzymes
LDH1
HIGHER
POSSIBLE ETIOLOGY
LOWER
Infectious and inflammatory
processes, malignant
neoplasms
Acromegaly, adenoma of
pancreatic islet cells,
untreated mild case of type 2
diabetes
Excessive RBC
destruction
Iron-deficient state, polycythemia
Acidosis, heart failure, shock
Heart failure, hemolytic
disorders, hepatitis,
metastatic cancer of liver,
myocardial infarction, pernicious anemia, pulmonary
embolus, skeletal muscle
damage
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
Addison’s disease, hypothyroidism, renal failure
Chronic renal disease, diabetes
mellitus
Polycythemia
Phenylketonuria
Advanced Paget’s disease,
cancer of prostate,
hyperparathyroidism
Bone diseases, marked hyperparathyroidism, obstruction of
biliary system, rickets
Healing fractures, hypoparathyroidism, renal disease, vitamin
D intoxication
Addison’s disease, diabetic
ketosis, massive tissue
destruction, renal failure
Hemolytic anemia, mononucleosis, toxoplasmosis,
chronic liver disease
Inadequately treated type 1
diabetes mellitus
Iron-deficiency anemia, anemia
of chronic disease
Cancer, chronic infections,
pernicious anemia
Chronic alcoholism, severe
malabsorption
Addison’s disease, diuretic
therapy
Anemia, cardiac decompensation, respiratory disorders
Excessive vitamin D ingestion,
hypothyroidism
Diabetes mellitus, hyperparathyroidism, vitamin D
deficiency
Cushing syndrome, diarrhea
(severe), diuretic therapy,
gastrointestinal fistula,
pyloric obstruction,
starvation, vomiting
RBC, Red blood cell; SaO2, arterial oxygen saturation.
Mosby items and derived items © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier, Inc.
Continued
1798
APPENDIX C
TABLE C-1
Laboratory Reference Intervals
SERUM, PLASMA, AND WHOLE BLOOD CHEMISTRIES—cont’d
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
Male: 280-1100 ng/dL
Postmenopause
Prostate-specific
antigen (PSA)
Proteins
Total
Albumin
Globulin
Albumin/globulin
ratio
HIGHER
POSSIBLE ETIOLOGY
LOWER
Adrenal hyperplasia, choriocarcinoma of ovary, pregnancy,
cysts of ovary
Threatened abortion. hypogonadism, amenorrhea, ovarian
tumor
Prostate cancer
Burns, cirrhosis (globulin
fraction), dehydration
Liver disease, malabsorption
Multiple myeloma (globulin
fraction), shock, vomiting
Malnutrition, nephrotic
syndrome, proteinuria, renal
disease, severe burns
Addison’s disease, diabetic
ketoacidosis, diuretic
therapy, excessive loss from
GI tract, excessive perspiration, water intoxication
Hypofunction of testes,
hypogonadism
Dehydration, impaired renal
function, primary aldosteronism, corticosteroid therapy
T4 (thyroxine), total
4.6-11.0 mcg/dL
Male: 10.438.17 nmol/L
Female: 0.522.43 nmol/L
59-142 nmol/L
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 µU/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 µkat/L
Alanine aminotransferase (ALT)
Transferrin
Transferrin
saturation (%)
Triglycerides
10-40 U/L
0.17-0.68 µkat/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
<0.5 ng/mL (<0.5 mcg/L)
<0.1 ng/mL (<0.1 mcg/L)
6-20 mg/dL
2.1-7.1 mmol/L
Malnutrition, severe liver
damage
Uric acid
Male: 4.4-7.6 mg/dL
Female: 2.3-6.6 mg/dL
Male: 262-452 µmol/L
Female:137-393 µmol/L
Vitamin A (retinol)
Vitamin B12
(cobalamin)
30-80 mcg/dL
200-835 pg/mL
1.05-2.80 µmol/L
148-616 pmol/L
Increase in protein catabolism
(fever, stress), renal disease,
urinary tract infection
Gout, gross tissue destruction,
high-protein weight reduction
diet, leukemia, renal failure
Excess ingestion of vitamin A
Chronic myeloid leukemia
Vitamin C
(ascorbic acid)
0.4-2.0 mg/dL
23-114 µmol/L
Zinc
70-120 mcg/dL
10.7-120 µmol/L
Female: 15-70 ng/dL
Polycystic ovary, virilizing
tumors
Hyperthyroidism, thyroiditis
Cretinism, hypothyroidism,
myxedema
Hyperthyroidism
Hyperthyroidism
Hypothyroidism
Hypothyroidism
Myxedema, primary hypothyroidism, Graves’ disease
Secondary hypothyroidism
Liver disease, myocardial
infarction, pulmonary
infarction, acute hepatitis
Liver disease, shock
Excessive ingestion of
vitamin C
Administration of uricosuric
drugs
Vitamin A deficiency
Strict vegetarianism, malabsorption syndrome, pernicious anemia, total or partial
gastrectomy
Connective tissue disorders,
hepatic disease, renal
disease, rheumatic fever,
vitamin C deficiency
Alcoholic cirrhosis
Mosby items and derived items © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier, Inc.
APPENDIX C
TABLE C-2
Laboratory Reference Intervals
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
Fibrin split (degradation) products
D-Dimer
<10 mcg/mL
<10 mg/L
<250 ng/mL
<250 mcg/L
Erythrocyte count†
(altitude dependent)
Mean corpuscular
volume (MCV)
Mean corpuscular
hemoglobin (MCH)
Mean corpuscular
hemoglobin concentration (MCHC)
Erythrocyte sedimentation rate (ESR)
Male: 4.3-5.7 × 106/µL
Female: 3.8-5.1 × 106/µL
80-100 fL
Hematocrit†
(altitude dependent)
Hemoglobin†
(altitude dependent)
Hemoglobin,
glycosylated
Platelet count
(thrombocytes)
POSSIBLE ETIOLOGY
HIGHER
LOWER
Male: 4.3-5.7 × 1012/L
Female: 3.8-5.1 × 1012/L
80-100 fL
Defective platelet function, thrombocytopenia, von Willebrand’s disease,
aspirin ingestion, vascular disease
Deficiency factors I, II, V, VIII, IX and
X, XI, XII; hemophilia, liver disease;
heparin therapy
Warfarin therapy; deficiency of
factors I, II, V, VII, and X; vitamin K
deficiency; liver disease
Burns (after first 36 hr), inflammatory
disease
Acute DIC, massive hemorrhage,
primary fibrinolysis
DIC, myocardial infarction, deep vein
thrombosis, unstable angina
Dehydration, high altitudes,
polycythemia vera
Macrocytic anemia
Anemia, leukemia,
posthemorrhage
Microcytic anemia
27-34 pg
27-34 pg
Macrocytic anemia
Microcytic anemia
32%-37%
0.32-0.37
Spherocytosis
Hypochromic anemia
<30 mm/hr (some
gender variation)
<30 mm/hr (some
gender variation)
Malaria, severe liver
disease, sickle cell
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%
Moderate increase: acute hepatitis,
myocardial infarction; rheumatoid
arthritis
Marked increase: acute and severe
bacterial infections, malignancies,
pelvic inflammatory disease
Dehydration, high altitudes,
polycythemia
COPD, high altitudes, polycythemia
Poorly controlled diabetes mellitus
150-400 × 103/µL
150-400 × 109/L
Sickle cell anemia, chronic
renal failure, pregnancy
Acute leukemia, DIC,
thrombocytopenic
purpura
Reticulocyte count
0.5%-1.5% of RBC
0.5%-1.5% of RBC
White blood cell count†
4.0-11.0 × 103/µL
4.0-11.0 × 109/L
Inflammatory and infectious
processes, leukemia
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
Bacterial infections, collagen diseases,
Hodgkin’s lymphoma
Acute infections
Chronic infections, lymphocytic
leukemia, mononucleosis, viral
infections
Chronic inflammatory disorders,
malaria, monocytic leukemia, acute
infections, Hodgkin’s lymphoma
Allergic reactions, eosinophilic and
chronic granulocytic leukemia,
parasitic disorders, Hodgkin’s
lymphoma
Hypothyroidism, ulcerative colitis,
myeloproliferative diseases
WBC differential
Segmented
neutrophils
Band neutrophils
Lymphocytes
Acute infections, chronic granulocytic
leukemia, chronic pancreatitis,
cirrhosis, collagen disorders, polycythemia, postsplenectomy
Hemolytic anemia, polycythemia vera
Burns (during first 36 hr),
DIC, severe liver disease
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
Laboratory Reference Intervals
SEROLOGY-IMMUNOLOGY
TEST
REFERENCE INTERVALS
CONVENTIONAL UNITS
SI UNITS
Antinuclear antibody (ANA)
Negative at 1:40 dilution
Negative at 1:40 dilution
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)
Nonsmoker: <3 ng/mL
Smoker: <5 ng/mL
Nonsmoker: <3 mcg/L
Smoker: <5 mcg/L
Complement, total
hemolytic (CH50)
75-160 U/mL
75-160 kU/L
Direct Coombs or direct
antihuman globulin test
(DAT)
Fluorescent treponemal
antibody absorption
(FTA-Abs)
Hepatitis A antibody
Hepatitis B surface antigen
(HBsAg)
Hepatitis C antibody
Monospot or monotest
Rheumatoid factor (RF)
Negative
Negative
Acquired hemolytic anemia, drug
reactions, transfusion reactions
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, Sjögren’s
syndrome, systemic lupus
erythematosus
Syphilis, systemic lupus
erythematosus, rheumatoid
arthritis, leprosy, malaria, febrile
diseases, IV drug abuse
Syphilis
HIGHER
POSSIBLE ETIOLOGY
LOWER
Chronic hepatitis, rheumatoid
arthritis, scleroderma, systemic
lupus erythematosus
Systemic lupus erythematosus
Systemic lupus erythematosus
Acute infections, any inflammatory condition, widespread
malignancy
Carcinoma of colon, liver,
pancreas; chronic cigarette
smoking; inflammatory bowel
disease; other cancers
Acute glomerulonephritis, systemic
lupus erythematosus,
rheumatoid arthritis,
subacute bacterial
endocarditis
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
3-30 mcg/day (low
sodium diet
increases threefold
to fivefold)
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
Diabetes mellitus, high-fat
and low-carbohydrate diets,
starvation
Primary aldosteronism:
adrenocortical tumors
Secondary aldosteronism:
cardiac failure, cirrhosis, large
dose of ACTH, salt depletion
Acute pancreatitis
Multiple myeloma
Liver disorders
Bone tumor,
hyperparathyroidism
ACTH deficiency,
Addison’s 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
Laboratory Reference Intervals
1801
URINE CHEMISTRY—cont’d
TEST
SPECIMEN
REFERENCE INTERVALS
UNITS
SI UNITS
Creatine
24 hr
<100 mg/day
<763 µmol/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
5-Hydroxyindoleacetic acid (5-HIAA)
Ketone bodies
24 hr
2-7 mg/day
10.5-36.6 µmol/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
Specific 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 µmol/day
Vanillylmandelic acid
24 hr
1.4-6.5 mg/day
7-33 µmol/day
HIGHER
POSSIBLE ETIOLOGY
LOWER
Liver cancer, hyperthyroidism,
diabetes, Addison’s disease,
infections, burns, muscular
dystrophy, skeletal muscle
atrophy
Anemia, leukemia, muscular
atrophy
Hypothyroidism
Renal disease
Renal disease
Gonadal or adrenal tumor
Endocrine disturbance,
ovarian dysfunction,
menopause
Diabetes mellitus, pituitary
disorders
Extensive burns, glomerulonephritis, hemolytic anemias,
hemolytic transfusion reaction
Malignant carcinoid syndrome
Diabetes mellitus, starvation,
dehydration
Pheochromocytoma
Crushing injuries, electric
injuries, extreme physical
exertion
Dehydration, tubular
dysfunction (kidney lost ability
to dilute urine)
Urinary tract infection, urine
allowed to stand at room
temperature
Acute and chronic renal
disease, especially involving
glomeruli; heart failure
Cardiac failure, inflammatory
processes of urinary tract,
nephritis, nephrosis,
strenuous exercise
Acute tubular necrosis
Albuminuria, dehydration,
glycosuria
Gout, leukemia
Hemolytic disease, hepatic
parenchymal cell damage,
liver disease
Pheochromocytoma
ACTH, Adrenocorticotropic hormone.
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
Laboratory Reference Intervals
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
Chronic pancreatic disease, obstruction of common
bile duct, malabsorption syndrome
Mucous colitis, spastic constipation
Chronic bacillary dysentery, chronic ulcerative colitis,
localized abscesses
Anal fissures, hemorrhoids, malignant tumor, peptic
ulcer, inflammatory bowel disease
Various color depending on diet
Biliary obstruction or presence of barium sulfate
More than 100 mL of blood in gastrointestinal tract
Blood in large intestine
Blood in upper gastrointestinal tract or iron medication
*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
CEREBROSPINAL FLUID ANALYSIS
TEST
REFERENCE INTERVALS
CONVENTIONAL UNITS
SI UNITS
HIGHER
Pressure
60-150 mm H2O
60-150 mm H2O
Hemorrhage, intracranial tumor, meningitis
Blood
Cell count (age
dependent)
WBC
RBC
Chloride
Negative
Negative
Intracranial hemorrhage
Inflammation or infections of CNS
0-5 cells/µL
Negative
118-132 mEq/L
0-5 × 106 cells/L
Negative
118-132 mmol/L
Uremia
Glucose
40-70 mg/dL
2.2-3.9 mmol/L
Diabetes mellitus, viral infections of CNS
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
Guillain-Barré syndrome, poliomyelitis, trauma
Syphilis of CNS
Acute meningitis, brain tumor, chronic CNS
infections, multiple sclerosis
POSSIBLE ETIOLOGY
LOWER
Head injury, spinal tumor,
subdural hematoma
Bacterial infections of CNS
(meningitis, encephalitis)
Bacterial infections and
tuberculosis of CNS
CNS, Central nervous system.
Mosby items and derived items © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier, Inc.
Sponsor Documents