NORMAL VALUES – Hematology
Determination
Bleeding Time
Fibrinogen
Activated Partial Thromboplastin
Time
Normal Adult Reference Range
Conventional Units
SI Units
1.5 – 9.5 min
1.5 – 9.5 min
200 – 400 mg/dL
2 – 4 g/dL
Lower limit of normal:
20 – 25 sec
Clinical Significance
Prolonged in thrombocytopenia, defective plt
function and ASA therapy
Prolonged in deficiency of fibrinogen, factors II, V,
VIII, IX, X, XI, and XII, and in heparin therapy
Upper limit of normal:
32 – 39 sec
Lower limit of normal:
10 sec
Prothrombin Consumption
Impaired in deficiency of factors VIII, IX, and X
Upper limit of normal:
14 sec
Prothrombin Time
Prolonged by deficiency in factors I, II, V, VII, and X,
fat malabsorption, severe liver dse, Coumadin
anticoagulant therapy
9.5 – 12 sec
1.0
INR
Erythrocyte Count
(Red Blood Cells)
2–3
(for therapy in AFib, DVT and
pulmo embolism)
2.5 – 3.5
(for therapy in prosthetic heart
valves)
Males:
4.6 – 6.2 million/mm3
Females:
4.2 – 5.4 million/ mm3
Used to standardize the prothrombin time and
anticoagulation therapy
4.6 – 6.2 x 1012/ L
4.2 – 5.4 x 1012/ L
Increased in severe diarrhea and DHN,
polycythemia, acute poisoning, pulmonary fibrosis
Decreased in all anemias, in leukemia and after
hemorrhage when blood volume has been restored
ERYTHROCYTE INDICES
Mean corpuscular volume (MCV)
Mean corpuscular hemoglobin
(MCH)
Mean corpuscular hemoglobin
concentration (MCHC)
Erythrocyte Sedimentation Rate
(ESR) – Westergren method
84 – 96 cu µm
84 – 96 fL
28 – 33 µµg/cell
28 - 33 pg
Males under 50: < 15mm/h
Males over 50: < 20 mm/h
Concentration fraction:
0.33 – 0.35
< 15 mm/h
< 20 mm/h
Females under 50: <25 mm/h
Females over 50: <30 mm/h
< 25 mm/h
< 35 mm/h
33 – 35%
Increased in macrocytic anemias
Decreased in microcytic anemia
Increased in macrocytic anemias
Decreased in microcytic anemia
Decreased in severe hypochromic anemia
Increased in tissue destruction (inflammatory or
degenerative), during menstruation and pregnancy
and in acute febrile disease
Erythrocyte Sedimentation Rate –
Zeta centrifuge
Hematocrit
Hemoglobin
LEUKOCYTE COUNT
< 50 y/o: < 55%
50 – 80 y/o: 40 – 60%
Volume fraction: <0.55
Volume fraction: 0.4 – 0.6
Males: 42 – 52%
Females: 35 – 47%
Volume fraction: 0.42 – 0.52
Volume fraction: 0.35 – 0.47
Males: 13 – 18 g/dL
Females: 12 – 16 g/dL
2.02 – 2.79 mmol/L
1.86 – 2.48 mmol/ L
4,500 – 11,000/ mm3
4.5 – 11 x 109/L
Significance similar to ESR
Decreased in severe anemias, anemia of
pregnancy, acute massive blood loss
Increased in erythrocytosis of any cause, and in
DHN or hemoconcentration associated with shock
Decreased in various anemias, pregnancy, severe
or prolonged hemorrhage and with excessive fluid
intake
Increased in polycythemia, COPD, failure of
oxygenation because of CHF, and normally in
people living at high altitudes
Increased with acute infections, trauma or surgery,
leukemia, malignant disease, necrosis
Neutrophils
45 – 73%
Number fraction: 0.45 – 0.73
Decreased with viral infections, bone marrow
suppression, primary bone marrow disease
Increased in allergy, parasitic disease, collagen
disease, subacute infections
Eosinophils
0 – 4%
Number fraction: 0.00 – 0.004
Decreased with stress, use of some medications
(ACTH, epinephrine, thyroxine)
Increased with acute leukemia and following
surgery or trauma
Basophils
0 – 1%
Number fraction: 0.00 – 0.01
Decreased with allergic reactions, stress, allergy,
parasitic disease, use of corticosteroids
Increased with infectious mononucleosis, viral and
some bacterial infections, hepatitis
Lymphocytes
Monocytes
Platelet count
20 – 40%
2 – 8%
150,000 – 450,000/ mm3
Number fraction: 0.2 – 0.4
Number fraction: 0.02 – 0.08
0.15 – 0.45 x 1012/L
Decreased with aplastic anemia, SLE,
immunodeficiency including AIDS
Increased with viral infections, parasitic disease,
collagen and hemolytic disorders
Decreased with use of corticosteroids, RA, HIV infx
Increased in malignancy, myeloproliferative
disease, RA and post-operatively; about 50% of
patient with unexpected increase of platelet count
will be found to have a malignancy
Decreased in thrombocytopenic purpura, acute
leukemia, aplastic anemia and during cancer
chemotherapy
NORMAL VALUES – Serum, Plasma, and Whole Blood Chemistries
Determination
Acetone
Normal Adult Reference Range
Conventional Units
SI Units
0.3 – 2.0 mg/dL
51.6 – 344.0/ µmol/L
Adenocorticotropic
Hormone (ACTH) (Plasma)
- RIA
< 50 pg/mL
<50 ng/L
Aldosterone (Plasma) - RIA
Supine: 3 – 10 ng/dL
Upright: 5 – 30 ng/dL
Adrenal vein: 200 – 800 ng/dL
0.08 – 0.30 nmol/L
0.14 – 0.90 nmol/L
5.54 – 22.16 nmol/L
Alpha-1-fetoprotein
< 15 ng/mL
< 15 µg/L
Ammonia (Plasma)
15 – 45 µg/dL
(varies with method)
11 – 32/ µmol/L
0.4 – 1.5 mg/dL
23 – 85 µmol/L
Males: 10 – 40 U/mL
Females: 8 – 35 U/mL
0.17 – 0.68 µkat/L
0.14 – 0.60 µkat/L
Males: 10 – 40 U/L
Females: 15 – 30 U/L
0.34 – 0.68 µkat/L
0.25 – 0.51 µkat/L
Total: 0.3 – 1.0 mg/dL
Direct: 0.1 – 0.4 mg/dL
Indirect: 0.1 – 0.4 mg/dL
5 – 17 µmol/L
1.7 – 3.7 µmol/L
3.4 – 11.2 µmol/L
85 – 95 mm Hg
10.64 – 12.64 kPa
95% - 99%
0.95-0.99
Ascorbic Acid
(Vitamin C)
ALT (Alanine
aminotransferase)
Formerly SGPT
AST (Aspartate
aminotransferase)
Formerly SGOT
Bilirubin
Clinical Significance
Increased
DKA
Toxemia of pregnancy
Carbohydrate-free diet
High-fat diet
Pituitary-dependent
Cushing’s syndrome
Ectopic ACTH syndrome
Primary adrenal atropy
Primary aldosteronism
Secondary aldosteronism
Decreased
Adenocortical tunor
Adrenal insufficiency secondary
to hypopituitarism
Addison’s disease
Hepatocarcinoma
Metastatic Carcinoma of liver
Germinal cell carcinoma of the
testicle or ovary
Fetal neural tube defects –
elevation in maternal serum
Severe liver disease
Hepatic decompensation
Large doses of ascorbic acid as a
prophylactic against common
cold
Same conditions as AST (AGOT),
but increase is more marked in
liver disease than AST (SGOT)
Myocardial infarction
Skeletal muscle disease
Liver disease
Hemolytic anemia (indirect)
Biliary obstruction and disease
Hepatocellular damage
(Hepatitis)
Pernicious anemia
Hemolytic disease of newborn
BLOOD GASES
Oxygen
Partial pressure (PaO2)
Saturation (SaO2)
Polycythemia
Anemia
Cardiac or pulmonary disease
Cardiac Decompensation
Chronic obstructive lung disease
Carbon Dioxide
Partial Pressure (PaCO2)
pH (whole blood, arterial)
Calcium
Chloride
35 – 45 mm Hg
4.66 – 5.99 kPa
7.35 – 7.45
7.35 – 7.45
8.6 – 10.2 mg/dL
97 – 107 mEq/L
2.15 – 2.55 mmol/L
97 – 107 mmol/L
Nephrosis
Nephritis
Urinary obstruction
Cardiac decompensaton
Anemia
Lipemia
Obstructive jaundice
Diabetes
Hyperthyroidism
Cholesterol
150 – 200 mg/dL
3.9 – 5.2 mmol/L
Creatinine
0.7 – 1.4 mg/dL
62 – 124 µmol/L
Fasting:
60 – 110 mg/dL
3.3 – 6.05 mmol/L
Postprandial (2h):
65 – 140 mg/dL
3.58 – 7.7 mmol/L
Glucose
Glucose Tolerance (oral)
Normal Response:
1. Normal fasting
between 60-110 mg/dL
2. No sugar in urine
3. Upper limits of normal:
Respiratory Acidosis
Metabolic Alkalosis
Vomiting
Hyperventilation
Fever
Intestinal Obstruction
Tumor or hyperplasia of
parathyroid
Hypervitaminosis D
Multiple myeloma
Nephritis with uremia
Malignant tumours
Sarcoidosis
Hypoparathyroidism
Skeletal immobilization
Excess calcium intake: Milk alkali
syndrome
3.3 – 6.05 mmol/L
Nephritis
Chronic renal disease
Diabetes mellitus
Nephritis
Hypothyroidism
Early hyperpituitarism
Cerebral lesions
Infections
Pregnancy
Uremia
2-hour value >200 mg/dL (11.1
mmol/L) is diagnostic for Diabetes
mellitus
Respiratory Alkalosis
Metabolic Acidosis
Uremia
Diabetic ketoacidosis
Hemorrhage
Nephritis
Hyperthyroidism
Diarrhea
Celiac disease
Vitamin D deficiency
Acute pancreatitis
Nephrosis
After paathyroidectomy
Diabetes mellitus
Diarrhea
Vomiting
Pneumoia
Heavy metal poisoning
Cushing’s syndrome
Intestinal obstruction
Febrile Condition
Pernicious aemia
Hemolytic anemia
Hypothyroidism
Severe infection
Terminal stages of debilitating
disease
Hyperinsulinism
Hyperthyroidism
Late hyperpituitarism
Pernicious vomiting
Addison’s disease
Extensive hepatic damage
Decreased 2- and 3-hour values
may occur with hypoglycemia in
diabetes mellitus
Fasting = 125
1 hour = 190
2 hours = 140
3 hours = 125
Hemoglobin (plasma)
6.88 mmol/L
10.45 mmol/L
7.70 mmol/L
6.88 mmol/L
0.5 – 5 mg/dL
5 – 50 mg/L
High-density lipoprotein
cholesterol (HDL
Cholesterol)
Males: 35 – 70 mg/dL
Females: 35 – 85 mg/dL
0.91 – 1.81 mmol/L
0.91 – 2.20 mmol/L
Low-density lipoprotein
cholesterol (LDL
Cholesterol)
mg/dL
desirable levels:
<160 if no CAD and <2 risk
factors
<130 if no CAD and 2 or more
risk factors
<100 if CAD is present
Anemia
Pregnancy
Chronic renal failure
HDL cholesterol is lower in
patients with risk for coronary
heart disease
LDL cholesterol is higher in patients
with increased risk for coronary
heart disease
Magnesium
1.3 – 2.3 mg/dL
0.62 – 0.95 mmol/L
Phospholipids
125-300 mg/dL
1.25 – 3 g/L
Phosphorous, inorganic
2.5 – 4.5 mg/dL
0.8 – 1.45 mmol/L
Potassium
Transfusion reactions
Paroxysmal nocturnal
hemoglobinuria
Intravascular hemolysis
3.5 – 5 mEq/L
3.5 – 5 mmol/L
6 – 8 gm/dL
60 – 80 g/L
Albumin
3.5 – 5.5 g/dL
40 – 55 g/L
Globulin
1.7 – 3.3 g/dL
17 – 33 g/L
Sodium
135 – 145 mEq/L
135 – 145 mmol/L
Excess ingestion of magnesiumcontaining antacids
Diabetes mellitus
Nephritis
Chronic nephritis
Hypoparathroidism
Renal Failure
Acidosis
Cell lysis
Tissue breakdown or hemolysis
Chronic alcoholism
Severe renal disease
Diarrhea
Defective growth
Hyperparathyroidism
Vitamin D deficiency
GI losses
Diuretic administration
PROTEIN
Total
Thyroid-stimulating
Hormone (TSH)
Triglycerides
0.4 – 4.2 mIU/L
Hemoconcentration
Shock
Globulin fraction increased in
multiple myeloma, chronic
infection, liver disease
Hemoconcentraton
Nephritis
Pyloric obstruction
Hypothyroidism
100 – 200 mg/dL
1.13 – 3.8 mmol/L
Increased risk for atherosclerosis
Troponin I
< 0.35 ng/mL
< 0.35 µg/L
Myocardial infarction
Troponin T
< 0.2 ng/mL
< 0.2 µg/L
Rhabdomyolysis
TROPONIN
Malnutrition
Hemorrhage
Loss of plasma from burns
Proteinuria
Alkali deficit
Addison’s disease
Myxedema
Hyperthyroidism
Severe crushing injuries
Urea Nitrogen (BUN)
10 – 20 mg/dL
3.6 – 7.2 mmol/L
Uric Acid
2.5 – 8 mg/dL
0.15 – 0.5 mmol/L
Zinc
55 – 150 µg/dL
7.65 – 22.95 µmol/L
Obstructive uropathy
Mercury poisoning
Neprotic syndrome
Gouty arthritis
Acute leukemia
Lymphomas treated by
chemotherapy
Toxemia of pregnancy
Coronary artery disease
Arteriosclerosis
Industrial exposure
Pregnancy
Defective tubular reabsorption
Metastatic liver disease
Tuberculosis
Sprue
NORMAL VALUES – Urine Chemistry
Determination
Creatinine
Normal Adult Reference Range
Conventional Units
0 – 270 mg/ 24 h
Glucose
Negative
Hemoglobin and
Myoglobin
Negative
SI Units
0 – 2.05 mmol/ 24 h
Osmolality
250 – 900 mOsm/kg
250 – 900 mmol/kg
Potassium
26 – 123 mEq/24 h
26 – 123 mmol/ 24 h
Protein
< 150 mg/ 24 h
< 150 mg/ 24 h
Sodium
75 – 200 mEq/ 24 h
75 – 200 mmol/ 24h
Clinical Significance
Increased
Typhoid fever
Salmonella infections
Tetanus
Diabetes mellitus
Pituitary disorders
Increased ICP
Lesion in floor of 4th ventricle
Extensive burns
Transfusion of incompatible blood
Myoglobin increased in severe crushing
injuries to muscles
Useful in the study of electrolyte and
water balance
Hemolysis
Chronic renal failure
Acidosis
Cushing’s disease
Corpus luteum cysts
Nephritis
Cardiac failure
Mercury poisoning
Bence-Jones protein in multiple myeloma
Febrile states
Hematuria
Useful in detecting gross changes in
water and salt balance
Decreased
Muscular atrophy
Anemia
Advanced degeneration
of kidneys
Leukemia
Renal disease
Diarrhea
Adrenocortical
insufficiency
Urea Nitrogen
Uric Acid
Urobilinogen
9 – 16 gm/24 h
0.32 – 0.57 mol/L
Excessive protein catabolism
Impaired kidney function
250 – 750 mg/ 24 h
1.48 – 4.43 mmol/24 h
Gout
Nephritis
Random urine: <0.25 mg/dL
24-hr urine: up to 4 mg/ 24 h
<0.42 mol/ 24 h
Up to 6.67 µmol/ 24 h
Liver and biliary tract disease
Hemolytic anemia
Complete or nearly
complete biliary
obstruction
Diarrhea
NORMAL VALUES – Miscellaneous Values
Determination
Normal Values
Clinical Significance
Conventional Units
SI Units
Acetaminophen
Zero
Therapeutic level = 10 – 30 µg/mL
10 – 30 mg/L
Carbamazepine
Zero
Therapeutic level = 4 – 12 µg/mL
34 – 51 µmol/L
Carbon monoxide
0 – 2%
Symptoms with 10 – 30% saturation
Diazepam
Zero
Therapeutic level = 0.2 – 1.0 µg/mL
Digoxin
Zero
Therapeutic level = 0.8 – 2 ng/mL
Ethanol
0 – 0.1%
Lithium
Zero
Therapeutic level = 0.6 – 1.2 mEq/L
Lidocaine
Zero
Toxic (48 h after high dose) 454 mg/mL
Propanolol
Zero
Therapeutic level = 50 – 100 ng/mL
Additional Values:
HCO3
Urine pH
Urine Specific Gravity
Cardiac Enzymes
Creatinine Kinase
Myoglobin
22 – 26 mEq/L
4.6 – 8.0
1.005 – 1.030
Males: 55 – 160 µ/L
Females: 30 – 135 µ/L
< 90 mcg/L
0.2 – 1.0 mg/L
0.8 – 2/µg/L
Legal intoxication level = 0.1% or above
0.3 – 0.4% = marked intoxication
0.4 – 0.5% - alcoholic stupor
0.6 – 1.2 mmol/L
1000 mmol/L
347 – 693 µmol/L