NORMAL VALUES – Hematology

Normal Adult Reference Range

Determination Clinical Significance
Conventional Units SI Units
Prolonged in thrombocytopenia, defective plt
Bleeding Time 1.5 – 9.5 min 1.5 – 9.5 min
function and ASA therapy
Fibrinogen 200 – 400 mg/dL 2 – 4 g/dL
Lower limit of normal:
20 – 25 sec
Activated Partial Thromboplastin Prolonged in deficiency of fibrinogen, factors II, V,
Time 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
Prolonged by deficiency in factors I, II, V, VII, and X,
Prothrombin Time 9.5 – 12 sec fat malabsorption, severe liver dse, Coumadin
anticoagulant therapy
1.0

2–3
(for therapy in AFib, DVT and
Used to standardize the prothrombin time and
INR pulmo embolism)
anticoagulation therapy
2.5 – 3.5
(for therapy in prosthetic heart
valves)
Males:
Increased in severe diarrhea and DHN,
4.6 – 6.2 million/mm3
Erythrocyte Count 4.6 – 6.2 x 1012/ L polycythemia, acute poisoning, pulmonary fibrosis
(Red Blood Cells) 4.2 – 5.4 x 1012/ L Decreased in all anemias, in leukemia and after
Females:
hemorrhage when blood volume has been restored
4.2 – 5.4 million/ mm3
ERYTHROCYTE INDICES
Increased in macrocytic anemias
Mean corpuscular volume (MCV) 84 – 96 cu µm 84 – 96 fL
Decreased in microcytic anemia
Mean corpuscular hemoglobin Increased in macrocytic anemias
28 – 33 µµg/cell 28 - 33 pg
(MCH) Decreased in microcytic anemia
Mean corpuscular hemoglobin Concentration fraction:
33 – 35% Decreased in severe hypochromic anemia
concentration (MCHC) 0.33 – 0.35
Males under 50: < 15mm/h < 15 mm/h
Males over 50: < 20 mm/h < 20 mm/h Increased in tissue destruction (inflammatory or
Erythrocyte Sedimentation Rate
degenerative), during menstruation and pregnancy
(ESR) – Westergren method
Females under 50: <25 mm/h < 25 mm/h and in acute febrile disease
Females over 50: <30 mm/h < 35 mm/h
Erythrocyte Sedimentation Rate – < 50 y/o: < 55% Volume fraction: <0.55
Significance similar to ESR
Zeta centrifuge 50 – 80 y/o: 40 – 60% Volume fraction: 0.4 – 0.6
Decreased in severe anemias, anemia of
pregnancy, acute massive blood loss
Males: 42 – 52% Volume fraction: 0.42 – 0.52
Hematocrit
Females: 35 – 47% Volume fraction: 0.35 – 0.47
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
Males: 13 – 18 g/dL 2.02 – 2.79 mmol/L
Hemoglobin
Females: 12 – 16 g/dL 1.86 – 2.48 mmol/ L
Increased in polycythemia, COPD, failure of
oxygenation because of CHF, and normally in
people living at high altitudes
LEUKOCYTE COUNT 4,500 – 11,000/ mm3 4.5 – 11 x 109/L
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 20 – 40% Number fraction: 0.2 – 0.4
Decreased with aplastic anemia, SLE,
immunodeficiency including AIDS
Increased with viral infections, parasitic disease,
collagen and hemolytic disorders
Monocytes 2 – 8% Number fraction: 0.02 – 0.08
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
Platelet count 150,000 – 450,000/ mm3 0.15 – 0.45 x 1012/L
Decreased in thrombocytopenic purpura, acute
leukemia, aplastic anemia and during cancer
chemotherapy
 NORMAL VALUES – Serum, Plasma, and Whole Blood Chemistries
Normal Adult Reference Range Clinical Significance
Determination
Conventional Units SI Units Increased Decreased
DKA
Toxemia of pregnancy
Acetone 0.3 – 2.0 mg/dL 51.6 – 344.0/ µmol/L
Carbohydrate-free diet
High-fat diet
Pituitary-dependent
Adenocorticotropic Adenocortical tunor
Cushing’s syndrome
Hormone (ACTH) (Plasma) < 50 pg/mL <50 ng/L Adrenal insufficiency secondary
Ectopic ACTH syndrome
- RIA to hypopituitarism
Primary adrenal atropy
Supine: 3 – 10 ng/dL 0.08 – 0.30 nmol/L
Primary aldosteronism
Aldosterone (Plasma) - RIA Upright: 5 – 30 ng/dL 0.14 – 0.90 nmol/L Addison’s disease
Secondary aldosteronism
Adrenal vein: 200 – 800 ng/dL 5.54 – 22.16 nmol/L
Hepatocarcinoma
Metastatic Carcinoma of liver
Germinal cell carcinoma of the
Alpha-1-fetoprotein < 15 ng/mL < 15 µg/L
testicle or ovary
Fetal neural tube defects –
elevation in maternal serum
15 – 45 µg/dL Severe liver disease
Ammonia (Plasma) 11 – 32/ µmol/L
(varies with method) Hepatic decompensation
Large doses of ascorbic acid as a
Ascorbic Acid
0.4 – 1.5 mg/dL 23 – 85 µmol/L prophylactic against common
(Vitamin C)
cold
ALT (Alanine Same conditions as AST (AGOT),
Males: 10 – 40 U/mL 0.17 – 0.68 µkat/L
aminotransferase) but increase is more marked in
Females: 8 – 35 U/mL 0.14 – 0.60 µkat/L
Formerly SGPT liver disease than AST (SGOT)
AST (Aspartate Myocardial infarction
Males: 10 – 40 U/L 0.34 – 0.68 µkat/L
aminotransferase) Skeletal muscle disease
Females: 15 – 30 U/L 0.25 – 0.51 µkat/L
Formerly SGOT Liver disease
Hemolytic anemia (indirect)
Biliary obstruction and disease
Total: 0.3 – 1.0 mg/dL 5 – 17 µmol/L
Hepatocellular damage
Bilirubin Direct: 0.1 – 0.4 mg/dL 1.7 – 3.7 µmol/L
(Hepatitis)
Indirect: 0.1 – 0.4 mg/dL 3.4 – 11.2 µmol/L
Pernicious anemia
Hemolytic disease of newborn
BLOOD GASES

Oxygen
Anemia
Partial pressure (PaO2) 85 – 95 mm Hg 10.64 – 12.64 kPa Polycythemia
Cardiac or pulmonary disease
Cardiac Decompensation
Saturation (SaO2) 95% - 99% 0.95-0.99
Chronic obstructive lung disease
Carbon Dioxide
Respiratory Acidosis Respiratory Alkalosis
Partial Pressure (PaCO2) 35 – 45 mm Hg 4.66 – 5.99 kPa
Metabolic Alkalosis Metabolic Acidosis
Vomiting Uremia
Hyperventilation Diabetic ketoacidosis
pH (whole blood, arterial) 7.35 – 7.45 7.35 – 7.45
Fever Hemorrhage
Intestinal Obstruction Nephritis
Tumor or hyperplasia of
parathyroid
Hypervitaminosis D Hyperthyroidism
Multiple myeloma Diarrhea
Nephritis with uremia Celiac disease
Calcium 8.6 – 10.2 mg/dL 2.15 – 2.55 mmol/L Malignant tumours Vitamin D deficiency
Sarcoidosis Acute pancreatitis
Hypoparathyroidism Nephrosis
Skeletal immobilization After paathyroidectomy
Excess calcium intake: Milk alkali
syndrome
Diabetes mellitus
Diarrhea
Nephrosis
Vomiting
Nephritis
Pneumoia
Chloride 97 – 107 mEq/L 97 – 107 mmol/L Urinary obstruction
Heavy metal poisoning
Cardiac decompensaton
Cushing’s syndrome
Anemia
Intestinal obstruction
Febrile Condition
Pernicious aemia
Lipemia Hemolytic anemia
Obstructive jaundice Hypothyroidism
Cholesterol 150 – 200 mg/dL 3.9 – 5.2 mmol/L
Diabetes Severe infection
Hyperthyroidism Terminal stages of debilitating
disease
Nephritis
Creatinine 0.7 – 1.4 mg/dL 62 – 124 µmol/L
Chronic renal disease
Diabetes mellitus
Nephritis Hyperinsulinism
Fasting:
Hypothyroidism Hyperthyroidism
60 – 110 mg/dL 3.3 – 6.05 mmol/L
Early hyperpituitarism Late hyperpituitarism
Glucose
Cerebral lesions Pernicious vomiting
Postprandial (2h):
Infections Addison’s disease
65 – 140 mg/dL 3.58 – 7.7 mmol/L
Pregnancy Extensive hepatic damage
Uremia
Normal Response:
1. Normal fasting 2-hour value >200 mg/dL (11.1 Decreased 2- and 3-hour values
Glucose Tolerance (oral) between 60-110 mg/dL mmol/L) is diagnostic for Diabetes may occur with hypoglycemia in
2. No sugar in urine 3.3 – 6.05 mmol/L mellitus diabetes mellitus
3. Upper limits of normal:
 Fasting = 125 6.88 mmol/L
1 hour = 190 10.45 mmol/L
2 hours = 140 7.70 mmol/L
3 hours = 125 6.88 mmol/L
Transfusion reactions
Anemia
Paroxysmal nocturnal
Hemoglobin (plasma) 0.5 – 5 mg/dL 5 – 50 mg/L Pregnancy
hemoglobinuria
Chronic renal failure
Intravascular hemolysis
High-density lipoprotein HDL cholesterol is lower in
Males: 35 – 70 mg/dL 0.91 – 1.81 mmol/L
cholesterol (HDL patients with risk for coronary
Females: 35 – 85 mg/dL 0.91 – 2.20 mmol/L
Cholesterol) heart disease
mg/dL
desirable levels:
Low-density lipoprotein <160 if no CAD and <2 risk LDL cholesterol is higher in patients
cholesterol (LDL factors with increased risk for coronary
Cholesterol) <130 if no CAD and 2 or more heart disease
risk factors
<100 if CAD is present
Chronic alcoholism
Excess ingestion of magnesium- Severe renal disease
Magnesium 1.3 – 2.3 mg/dL 0.62 – 0.95 mmol/L
containing antacids Diarrhea
Defective growth
Diabetes mellitus
Phospholipids 125-300 mg/dL 1.25 – 3 g/L
Nephritis
Chronic nephritis
Phosphorous, inorganic 2.5 – 4.5 mg/dL 0.8 – 1.45 mmol/L
Hypoparathroidism
Renal Failure Hyperparathyroidism
Acidosis Vitamin D deficiency
Potassium 3.5 – 5 mEq/L 3.5 – 5 mmol/L
Cell lysis GI losses
Tissue breakdown or hemolysis Diuretic administration
PROTEIN

Total 6 – 8 gm/dL 60 – 80 g/L Hemoconcentration

Malnutrition
Shock
Hemorrhage
Albumin 3.5 – 5.5 g/dL 40 – 55 g/L Globulin fraction increased in
Loss of plasma from burns
multiple myeloma, chronic
Globulin 1.7 – 3.3 g/dL 17 – 33 g/L Proteinuria
infection, liver disease
Hemoconcentraton Alkali deficit
Sodium 135 – 145 mEq/L 135 – 145 mmol/L Nephritis Addison’s disease
Pyloric obstruction Myxedema
Thyroid-stimulating
0.4 – 4.2 mIU/L Hypothyroidism Hyperthyroidism
Hormone (TSH)
Triglycerides 100 – 200 mg/dL 1.13 – 3.8 mmol/L Increased risk for atherosclerosis

TROPONIN

Troponin I < 0.35 ng/mL < 0.35 µg/L Myocardial infarction

Troponin T < 0.2 ng/mL < 0.2 µg/L Rhabdomyolysis

 Severe crushing injuries

Obstructive uropathy
Urea Nitrogen (BUN) 10 – 20 mg/dL 3.6 – 7.2 mmol/L Mercury poisoning Pregnancy
Neprotic syndrome
Gouty arthritis
Acute leukemia
Uric Acid 2.5 – 8 mg/dL 0.15 – 0.5 mmol/L Lymphomas treated by Defective tubular reabsorption
chemotherapy
Toxemia of pregnancy
Coronary artery disease Metastatic liver disease
Zinc 55 – 150 µg/dL 7.65 – 22.95 µmol/L Arteriosclerosis Tuberculosis
Industrial exposure Sprue

NORMAL VALUES – Urine Chemistry

Normal Adult Reference Range Clinical Significance
Determination
Conventional Units SI Units Increased Decreased
Muscular atrophy
Anemia
Typhoid fever
Advanced degeneration
Creatinine 0 – 270 mg/ 24 h 0 – 2.05 mmol/ 24 h Salmonella infections
of kidneys
Tetanus
Leukemia
Renal disease
Diabetes mellitus
Pituitary disorders
Glucose Negative
Increased ICP
Lesion in floor of 4th ventricle
Extensive burns
Hemoglobin and Transfusion of incompatible blood
Negative
Myoglobin Myoglobin increased in severe crushing
injuries to muscles
Useful in the study of electrolyte and
Osmolality 250 – 900 mOsm/kg 250 – 900 mmol/kg
water balance
Hemolysis
Chronic renal failure Diarrhea
Potassium 26 – 123 mEq/24 h 26 – 123 mmol/ 24 h Acidosis Adrenocortical
Cushing’s disease insufficiency
Corpus luteum cysts
Nephritis
Cardiac failure
Mercury poisoning
Protein < 150 mg/ 24 h < 150 mg/ 24 h
Bence-Jones protein in multiple myeloma
Febrile states
Hematuria
Useful in detecting gross changes in
Sodium 75 – 200 mEq/ 24 h 75 – 200 mmol/ 24h
water and salt balance
 Urea Nitrogen 9 – 16 gm/24 h 0.32 – 0.57 mol/L Excessive protein catabolism Impaired kidney function

Uric Acid 250 – 750 mg/ 24 h 1.48 – 4.43 mmol/24 h Gout Nephritis
Complete or nearly
Random urine: <0.25 mg/dL <0.42 mol/ 24 h Liver and biliary tract disease complete biliary
Urobilinogen
24-hr urine: up to 4 mg/ 24 h Up to 6.67 µmol/ 24 h Hemolytic anemia obstruction
Diarrhea

NORMAL VALUES – Miscellaneous Values

Clinical Significance
Determination Normal Values
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 0.2 – 1.0 mg/L

Digoxin Zero Therapeutic level = 0.8 – 2 ng/mL 0.8 – 2/µg/L

Legal intoxication level = 0.1% or above
Ethanol 0 – 0.1% 0.3 – 0.4% = marked intoxication
0.4 – 0.5% - alcoholic stupor
Lithium Zero Therapeutic level = 0.6 – 1.2 mEq/L 0.6 – 1.2 mmol/L

Lidocaine Zero Toxic (48 h after high dose) 454 mg/mL 1000 mmol/L

Propanolol Zero Therapeutic level = 50 – 100 ng/mL 347 – 693 µmol/L

Additional Values:
HCO3 22 – 26 mEq/L

Urine pH 4.6 – 8.0

Urine Specific Gravity 1.005 – 1.030

Cardiac Enzymes
Creatinine Kinase Males: 55 – 160 µ/L
Females: 30 – 135 µ/L
Myoglobin < 90 mcg/L