Reference Ranges for Adults and Children

Reference Ranges for Adults and Children Heil/Ehrhardt Reference Ranges for Adults and Children 2008
Pre-Analytical Considerations 2008
11322524001 0110 2. CD
www.roche.de Roche Diagnostics Ltd. Forrenstrasse CH-6343 Rotkreuz Switzerland
W. Heil V. Ehrhardt
Preface, 9th Edition
In order to fulfill increased regulatory standards the contents of this brochure are now to orientate closer by the information included in the package inserts of Roche Diagnostics test kits. As a consequence a number of changes and modifications concerning the indicated reference ranges as well as the citated literature turned out to be necessary. The resulting number changes compared to the 8th edition of this brochure necessitated the publication of a revised 9th edition. As a result of differing printing dates, it is possible that differences may occur between the information given here and that appears in the package inserts. In such cases the data given in the insert, enclosed with the kit, applies. The reference ranges listed in this brochure are guide values which may depend on the specific method used. Therefore, each laboratory should investigate the transferability of the expected values to its own patient population and if necessary determine its own reference ranges. PD Dr. W. Heil, Wuppertal Dr. V. Ehrhardt, Mannheim Mannheim, March 2008
Authors Dr. Wolfgang Heil, Wuppertal Dr. Volker Ehrhardt, Roche Diagnostics GmbH, Mannheim Roche Diagnostics GmbH Status: July 2008
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68519 Viernheim Max-Planck-Strae 13 Tel. 0 62 04 50 21 Fax: 0 62 04 60 08 66 email: info@hagedornkommunikation.de
Hagedorn Kommunikation
Roche / Frau Schu tz, Herr Dr. Ehrhardt Reference Range Pra analytik 2009 (11. Auflage)
JANUAR_2010_ENGLISCH SEITE 0
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Contents
Page List of abbreviations 1 1.1 1.2 1.3 1.4 2 2.1 2.2 2.3 2.4 2.5 2.6.1 2.6.2 2.7 2.8 2.9 2.10 2.11 2.12 2.13 3 3.1 3.2 3.3 3.4 3.5 Pre-analytical considerations Factors affecting blood collection Sample collection Transport and storage of sample material Assessment of sample material Reference ranges Clinical chemistry and immunological tests, serum/plasma Hematology Coagulation Blood gases Therapeutic drug monitoring Urinalysis, urinary sediment and status Clinical chemical urinalysis Urinary calculi, gallstones CSF Stool Spermiogram Extravascular body fluids Function tests Characteristic analytes for identification of body fluids Decision supports Enzyme patterns Lipids Electrophoretic patterns of plasma proteins Schematic representation of blood coagulation Thrombophilia, risk factors 4 7 8 9 10 12 14 14 76 86 100 102 108 112 120 122 124 126 128 137 144 145 145 146 147 149 150 3.6 3.7 Age dependence of immunoglobulin synthesis Complement system, classical and alternative mechanism 3.8 Tumor markers 3.9 Serological diagnosis of hepatitis A and B 3.10 Urinary sediment 3.11 Nomogram for diagnosing acid-base disorders 4 4.1 4.2 5 6 7 Conversion tables Conversion table from conventional units to SI units and vice versa (/U refers to urinalysis) Conversion factors for enzyme activities: U/L mkat/L and nkat/L Sample stability References List of key words
Page 152 153 154 155 156 158 159 159 171 172 189 225
COBAS; CARDIAC M; INTEGRA; ELECSYS; REFLOTRON; Roche CARDIAC and TINA-QUANT are trademarks of Roche.
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Roche / Frau Schu tz, Herr Dr. Ehrhardt Reference Range Pra analytik 2009 (11. Auflage) 18.2.10 17:45 3. Autorkorrektur hgd / muckel Version: 9.1 M110 H:/3B2/Roche/19816_ReferenceRanges/3B2/januar_2010_englisch.3d Tiefe Cyan Magenta Yellow
List of abbreviations
BSA C4bBP CA CO2 CSF CTAD d DGKC EDTA EGTA ELISA Eq f g
h H2 Hb Hct (PCV) HPLC IFCC INR kat
Body surface area C4-binding Protein Tumour-related carbohydrate antigen Carbon dioxide Cerebrospinal fluid Citrate, theophylline, adenosine, dipyridamole Day German Society of Clinical Chemistry Ethylene diamine tetraacetic acid 1,2-bis (2-amino ethoxyethane)tetraacetic acid Enzyme-linked immuno-sorbent assay Equivalent mEq milliequivalent Female Gram mg Milligram (103 g) mg Microgram (106 g) ng Nanogram (109 g) pg Picogram (1012 g) Hour Hydrogen Hemoglobin Hematocrit (packed cell volume) High pressure liquid chromatography International Federation of Clinical Chemistry International Normalized Ratio Katal mkat Millikatal (103 kat) mkat Microkatal (106 kat) nkat Nanokatal (109 kat) pkat Picokatal (1012 kat)
m m
MCH MCHC MCV mil min mol
mosmol mth NACB NCEP NGSP O2 Pa pCO2
Liter dL Deciliter (101 L) mL Milliliter (103 L) mL Microliter (106 L) nL Nanoliter (109 L) pL Picoliter (1012 L) fL Femtoliter (1015 L) Male Meter mm Millimeter (103 m) mm Micrometer (106 m) m2 Square meter mm3 Cubic micrometer Mean corpuscular hemoglobin Hb/RBC (hemoglobin content of one red cell) Mean corpuscular hemoglobin concentration Mean corpuscular volume Million Minute Mole mmol Millimole (103 mol) mmol Micromole (106 mol) nmol Nanomole (109 mol) pmol Picomole (1012 mol) fmol Femtomole (1015 mol) Milliosmole (103 osmole) Month National Academy of Clinical Biochemistry National Cholesterol Education Program National Glycohemoglobin Standardization Program Oxygen Pascal kPa (103 pascal) Partial pressure of carbon dioxide
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pH pO2 ppm pt
s U UV w yr
Negative decimal logarithm of the hydrogen ion activity Partial pressure of oxygen Parts per million Particle Mpt Megaparticle (106 particle) Gpt Gigaparticle (109 particle) Tpt Teraparticle (1012 particle) Second Unit (international) kU Kilo unit (103 units) Ultraviolet Week Year
1 Pre-analytical considerations
Assay findings in the field of clinical chemistry can be divided into the following categories: preanalytical phase analytical phase analytical evaluation postanalytical phase.
The following chart illustrates details of the preanalytical and analytical phases as well as analytical and medical evaluation and how the individual steps are related to one another. The accuracy of a laboratory analysis greatly depends on the preanalytical phase.
PATIENT
Patient preparation Influence factors Sample transport Identity check Sample evaluation Sample collection Patient data
FINDINGS
Medical evaluation
Clinical questions Plausibility check Interferences
Sample material
Quality control
Analytical evaluation
Sample preparation
Analysis
Value measured
Result
Method
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1.1 Influence factors
The following should be taken into account during sample collection: After food intake glucose, cholesterol, triglycerides, iron, inorganic phosphate and amino acids are present in elevated concentrations in blood (103). If the patient is moved from a recumbent to an upright position, the concentration of corpuscular and macromolecular substances such as leucocytes, erythrocytes, hemoglobin, hematocrit, total protein, enzymes, lipoproteins and protein-bound ions (e. g. calcium, iron) increase by up to 10 %. Some drugs may affect the test performed. Compress vein for maximum 1 min. Large quantities of alcohol over an extended period of time cause an increase in g-GT activity, CDT and MCV. Smokers have elevated CO-Hb- and CEAconcentrations. Substantial diurnal variations can be observed in the case of some analytes, e. g. hormones (epinephrine, aldosterone, corticotropin, cortisol, norepinephrine, prolactin, somatotropin, testosterone), electrolyte excretion in urine, serum hemoglobin and iron. Therefore it is recommended to collect samples between 7 and 9 a.m. Patients undergoing tolerance tests should be prepared as described in section 2.12 Function tests. If possible, sample collection should always take place under standardized conditions, i. e. when the patient is fasting, always with the patient in the same position (seated or recumbent), around the same time of day and following brief venous stasis.
1.2 Sample collection
Clinical chemistry: Clinical chemical assays are almost exclusively performed on serum or plasma. Serum is obtained from spontaneously coagulated whole blood, plasma via the addition of anticoagulants (EDTA, citrate, oxalate or heparinate). Differences between serum and plasma are generally observed in the determination of potassium, inorganic phosphate and LDH, and in electrophoresis of fibrinogen (281). In thrombocytosis patients with thrombocyte values above 500 q 103/mL (500 Gpt/L) a potassium determination cannot be performed in serum; it is necessary to use heparinized plasma instead. Glucose: Since the rate of glycolysis is around 7 % per hour, a glycolysis inhibitor, e.g. sodium fluoride, mannose or iodoacetate must be added to the blood sample prior to determination of the glucose concentration. Hematology: In the vast majority of hematological analyses, venous blood treated with EDTA is used. In isolated cases, EDTA-induced pseudothrombocytopenia can develop, which is of no significance clinically. Use of citrated blood returns cell numbers to normal. Coagulation: In coagulation tests, citrated plasma (one part 3.2 % [0.11 mol/L]* sodium citrate solution and nine parts blood) is used for assay purposes. It is essential to mix the sodium citrate solution and the blood exactly in the relationship 1 + 9. Blood treated with EDTA or oxalate cannot be used for coagulation assays, since these substances may cause more rapid
* sometimes one part 3.9 % [0.129 mol/L] is used
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inactivation of factors V and VIII, for example. Hemolytic samples or samples which have started to coagulate should be discarded. Urine: In urinalysis it must be noted that there are considerable diurnal variations in the excretion of some substances, that urine must be pretreated for stabilization of catecholamines, for example, and that it is essential to collect all the urine excreted during the specified period. For the determination of calcium, the entire amount of urine excreted over 24 hours must be acidified and heated. CSF: CSF collected for the assay of clinical chemistry analytes should be treated with EDTA to preclude fibrin clot formation since an accurate cell count can otherwise not be obtained. 1.3 Transport and storage of sample material Centrifugation should generally take place no more than 1 hour after sample collection. If samples are to be despatched, only serum or plasma should be used unless whole blood is absolutely necessary for the analysis. With regard to clinical chemical determinations, the use of a separator gel in the collection tube has proved advantageous in preventing cellular constituents from entering the serum. Clinical chemistry (102): Electrolytes, substrates and enzymes in the sample (serum, plasma) are usually stable for 4 days when stored in the refrigerator at + 4 C (exceptions: acid phosphatase, ammonium, lactate) and are stable for at least one day at room temperature. If long-term storage is necessary, it is advisable to freeze the sample at 20 C unless it is to be used for determina-
tion of LDH, Lp[a] or a-HBDH. Repeated thawing should be avoided. Plasma glucose determinations: Plasma should be separated from cellular constituents (centrifuged) no later than 30 minutes after collection of the blood sample. Avoid hemolysis. Sample material which has been separated from cellular constituents or in which glycolysis has been prevented via the addition of a glycolysis inhibitor, e. g. sodium fluoride (NaF), can be refrigerated for up to 7 days. Hematology (96): When kept in the closed tube, the cellular constituents and hemoglobin are stable for one day. It should, however, be noted that the blood smear must be prepared within 3 hours (93). Coagulation (95, 101): In coagulation analysis, determination of the analytes should always take place as soon as possible. If this is not feasible, platelet-poor plasma must be frozen immediately at 20 C or 40 C. Plasma for Quick, PTT, thrombin time and fibrinogen can be stored for about 4 h at room temperature or in a refrigerator. Fibrinogen, protein C and AT III are stable for 7 days, protein S and factors V and VIII for 4 hours only. Urine: Urine sediment should be evaluated within 2 to 3 hours at the latest. Freezing or refrigeration of the specimen is not recommended because of salt precipitation. CSF (214): CSF cells must be counted within the period of one hour.
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Blood gases (184): Blood gas determinations should be performed immediately. If this is not possible, the blood specimens collected in glass containers can be placed in iced water for up to 2 hours. 1.4 Assessment of sample material Hemolysis (102): Determination of potassium, magnesium or LDH is not possible even in slightly hemolytic serum. Considerable hemolysis also affects other tests. Bilirubinemia: To avoid interference by icteric samples, the visual recognition of hyperbilirubinemia is often not sufficiently sensitive. This is particularly true when samples are simultaneously colorized by other pigments (e.g., hemoglobin). Spectral bilirubin interferences can be removed by blanking, such as with the kinetic Jaff methods. Chemical bilirubin interference of H2O2 - forming enzymatic methods based on the Trinder reaction can be avoided by selection and choice of optimal concentrations of test components. (84). Serum Indices: On the Roche/Hitachi, COBAS INTEGRA and cobas modular platforms Serum Indices (icterus, lipemia, hemolysis) are measured. The package inserts of Roches clinical chemistry reagents indicate for every test the Serum Index (I, L, H) limit above which the method is significantly interfered. On the cobas platforms the Serum Index limits are electronically deposed and a Serum Index flag only appears if the respective test is actually significantly affected by the present interferent concentration.
Lipemia: Lipemic sera may interfere with photometric determinations. In this case, it is necessary to remove the lipoproteins.
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2 Reference ranges
2.1 Clinical chemistry and immunological tests, serum/plasma
Analyte Group Acetoacetate
a1-Acid glycoprotein
Reference Ranges Conventional Adults 0.20.4 mg/dL 50120 mg/dL f m < 6.5 U/L < 6.6 U/L < 3.5 U/L < 7.3 U/L < 1.9 U/L 4.37.6 ng/mL 4.68.6 ng/mL 7.263.6 pg/mL
SI 2040 mmol/L 0.51.2 g/L <0.108 mkat/L <0.110 mkat/L <0.058 mkat/L <0.120 mkat/L <0.030 mkat/L 1323 nmol/L 1426 nmol/L 1.613.9 pmol/L
References 16 237 218
Notes
CRM 470 standardization Roche Diagnostics, a-naphthyl phosphate, pentandiole-activated, Roche/Hitachi, cobas instruments COBAS INTEGRA instruments EDTA plasma
Acid phosphatase (ACP), total prostatic total prostatic Adenosine monophosphate, 3l-5l, cycl. (cAMP) Adrenocorticothrophic hormone, Corticotropin (ACTH) Alanine aminotransferase, glutamate pyruvate transaminase (GPT, ALAT, ALT) Adults
m f m Adults
218 43
218
Roche Diagnostics, ACTH Elecsys, samples drawn 710 a.m.
Newborns, children, adolescents 1d 25 d 6 d6 mth 712 mth 13 yr 46 yr 712 yr 1317 yr f m Children, adolescents <1 13 46 712 1317 Adults, >17 yr Adults yr yr yr yr yr f m f m f m w/o pyp <56 U/L <29 U/L <29 U/L <37 U/L <37 U/L
<31 U/L <52 U/L <60 U/L <57 U/L <39 U/L <39 U/L <39 U/L <23 U/L <26 U/L with pyp <71 U/L <31 U/L <36 U/L <44 U/L <45 U/L <33 U/L <41 U/L <35 U/L <50 U/L <34 U/L <45 U/L w/o pyp <0.93 mkat/L <0.48 mkat/L <0.48 mkat/L <0.62 mkat/L <0.62 mkat/L
<0.50 <0.85 <1.00 < 0.95 <0.65 <0.65 <0.65 <0.40 <0.45
mkat/L mkat/L mkat/L mkat/L mkat/L mkat/L mkat/L mkat/L mkat/L
68
IFCC, without pyridoxal phosphate
with pyp <1.18 mkat/L <0.52 mkat/L <0.60 mkat/L <0.73 mkat/L <0.75 mkat/L
94
IFCC, with and without pyridoxal phosphate
<0.52 mkat/L 218, 260 according to IFCC, without pyridoxal <0.68 mkat/L phosphate <0.60 mkat/L 137, 218, IFCC, with pyridoxal phosphate, <0.85 mkat/L 270 consensus values <0.56 mkat/L <0.74 mkat/L 238 IFCC, with pyridoxal phosphate, hospital patients
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Analyte Group Alanine aminotransferase, glutamate pyruvate transaminase (GPT, ALAT, ALT) Newborn12 mth 13 mth60 yr 61 a90 yr >90 yr Adults, 18 yr Adults Albumin f m f m f m f m f m f m Adults Reference Ranges Conventional <45 U/L <45 U/L <35 U/L <40 U/L <28 U/L <40 U/L <24 U/L <38 U/L <46 U/L <45 U/L <32 U/L <41 U/L 3.974.94 g/dL 3.564.61 g/dL SI <0.77 <0.77 <0.60 <0.68 <0.48 <0.68 <0.41 <0.65 References Notes
mkat/L 218, 299 IFCC, with pyridoxal phosphate mkat/L mkat/L mkat/L mkat/L mkat/L mkat/L mkat/L
<0.77 mkat/L <0.75 mkat/L <0.53 mkat/L <0.68 mkat/L 39.749.4 g/L 35.646.1 g/L
227 218 218 218
Nordic Reference Interval Project (NORIP), methods traceable to IFCC Reflotron, blood, serum, plasma Roche Diagnostics, bromocresol-green method, CRM 470 standardization. Roche Diagnostics, immunoturbidimetric method, CRM 470 standardization. Roche Diagnostics, bromocresol-purplemethod, CRM 470 standardization.
3.494.75 g/dL Adults 4 d 5 d14 yr 1518 yr Aldosterone Recumbent Standing 3.55.2 g/dL 2.84.4 g/dL 3.85.4 g/dL 3.24.5 g/dL 29145 ng/L 65285 ng/L
34.947.5 g/L
218
3552 g/L 218, 237 CRM 470 standardization, consensus values 2844 g/L 218, 299 Bromocresol-green/bromocresol3854 g/L purple/immunoturbidimetric/nephelo3245 g/L metric methods, CRM 470 standardization. 80400 pmol/L 180790 pmol/L 116 RIA, method-dependent
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Analyte Group Alkaline phosphatase (AP), total Children, adolescents 1d 25 d 6 d6 mth 712 mth 13 yr 46 yr 712 yr f m f m <1 yr 13 yr 46 yr f m f m f m f m f m 1d 25 d 6 d6 mth 712 mth 13 yr 46 yr 712 yr f m f m Adults Reference Ranges Conventional <600 U/L <553 U/L <1076 U/L <1107 U/L <673 U/L <644 U/L <720 U/L <448 U/L <936 U/L <240 U/L <270 U/L <390 U/L <409 U/L <347 U/L <312 U/L <316 U/L <329 U/L <381 U/L <98 U/L <128 U/L <141 U/L <119 U/L <105 U/L <130 U/L <250 U/L <231 U/L <449 U/L <462 U/L <281 U/L <269 U/L <300 U/L <187 U/L <390 U/L <120 U/L <150 U/L <3 mg/L SI <10.00 <9.20 <17.95 <18.45 <11.20 <10.75 <12.00 <7.45 <15.60
References 68
Notes DGKC, optimized, recommendations 1972, calculated with a conversion factor of 1.52 (25 C 37 C)
1317 yr Adults Children, adolescents 712 yr 1317 yr 2050 yr > 60 yr Adults Children, adolescents
<4.00 mkat/L <4.50 mkat/L <6.50 <6.82 <5.78 <5.20 <5.27 <5.48 <6.35 <1.65 <2.15 <2.35 <2.00
mkat/L mkat/L mkat/L mkat/L mkat/L mkat/L mkat/L mkat/L mkat/L mkat/L mkat/L
224 94
DGKC (calculated for 37 C) IFCC
272
IFCC
<1.75 mkat/L <2.20 mkat/L <4.17 <3.84 <7.49 <7.69 <4.67 <4.48 <5.00 <3.11 <6.51
270 218, 68
Consensus values of DGKC and VDGH Calculated from data published for the ALP opt. method (DGKC) using a factor of 0.417.
1317 yr
bone Aluminium
Adults
<2.00 mkat/L <2.50 mkat/L <0.11 mmol/L
224 67
DGKC (calculated for 37 C) Use only tubes specifically designed for determination of trace elements
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Analyte Group Ammonia Adults f m f m
a-Amylase, total a-Amylase, pancreatic
Reference Ranges Conventional <82 mg/dL <94 mg/dL <87 mg/dL <102 mg/dL <100 U/L <8 U/L <31 U/L <39 U/L <53 U/L 0.89.7 mg/L 816 mmol/L 17 U/mL
SI <48 mmol/L <55 mmol/L <51 mmol/L <60 mmol/L <1.67 mkat/L <0.13 mkat/L <0.52 mkat/L <0.65 mkat/L <0.90 mkat/L 0.89.7 mg/L 816 mmol/L 17 U/mL
References 218 218 218 2
Notes Roche/Hitachi instruments COBAS INTEGRA/cobas instruments IFCC, Reflotron, COBAS INTEGRA, cobas, Roche/Hitachi instruments IFCC
Adults <1 yr 19 yr 1018 yr Adults
218 155 194 218
Reflotron, COBAS INTEGRA, cobas, Roche/Hitachi instruments
Amyloid A Anion gap Antibody to cyclic citrullinated peptide (Anti-CCP) Anti-DNAse B Children 2 yr 3 yr 4 yr 5 yr 6 yr 710 yr 11 yr 12 yr Adults 2 34 5 69 1012 yr yr yr yr yr
Anti-CCP Elecsys Optimum cut-off (sensitivity: 67.7 %; specificity: 97.0 %)
<240 <60 <240 <320 <480 <640 <800 <480 <480 <160 <120 <160 <240 <320
U/mL U/mL U/mL U/mL U/mL U/mL U/mL U/mL U/mL U/mL U/mL U/mL U/mL U/mL
<240 < 60 <240 <320 <480 <640 <800 <480 <480 <160 <120 <160 <240 <320
kU/L kU/L kU/L kU/L kU/L kU/L kU/L kU/L kU/L kU/L kU/L kU/L kU/L kU/L
131
Antistreptolysin O (ASLO)
Children
131
Reference ranges vary with season and geographical area.
Adults Children Anti-thyreoglobulin, thyreoglobulin autoantibodies (Anti-TG)
<6 yr 618 yr
<200 U/mL <150 U/mL 200240 U/mL <134 <146 <130 <38 <37 <64 U/mL U/mL U/mL U/mL U/mL U/mL
<200 kU/L 218, 292 Immunoturbidimetric method, COBAS INTEGRA, cobas, Roche/Hitachi instruments <150 kU/L 200240 kU/L <134 <146 <130 <38 <37 <64 kU/L kU/L kU/L kU/L kU/L kU/L 219 Anti-TG Elecsys, reference range study
Children, adolescents Newborn 6 d3 mth 412 mth 16 yr 711 yr 1220 yr Healthy subjects
<115 U/mL
<115 kU/L
218
Anti-TG Elecsys
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Analyte Group Anti-thyroidea peroxidase, thyroid peroxidase antibodies (Anti-TPO) Children, adolescents Newborn 6 d3 mth 412 mth 16 yr 711 yr 1220 yr Healthy subjects
a1-Antitrypsin
Reference Ranges Conventional <117 <47 <32 <13 <18 <26 124348 111297 95251 110280 90200 U/mL U/mL U/mL U/mL U/mL U/mL mg/dL mg/dL mg/dL mg/dL mg/dL
SI <117 <47 <32 <13 <18 <26 kU/L kU/L kU/L kU/L kU/L kU/L
References 219
Notes
Anti-TPO Elecsys
<34 IU/mL
<34 kIU/L
218
<1 mth 26 mth 7 mth2 yr 3 yr19 yr Adults Healthy subjects
23.265.1 mmol/L 54 Immunonephelometric assay, 20.855.5 mmol/L CRM 470 standardization 17.846.9 mmol/L 20.652.4 mmol/L 16.636.8 mmol/L 218, 237 Immunoturbidimetric assay, CRM 470 standardization Negative: <1.5 U/L Indeterminate: 1.51.75 U/L Positive: >1.75 U/L 1.042.02 g/L 1.082.25 g/L 2.274.43 mmol/L 2.505.04 mmol/L <2.05 <1.85 <1.40 <1.50 <0.95 <0.85 <0.85 <0.45 <0.60 w/o pyp <0.97 mkat/L <0.98 mkat/L <0.80 mkat/L <0.73 mkat/L <0.65 mkat/L
Anti-TSHR (antibodies to TSH receptor) Apolipoprotein A-I Apolipoprotein B Aspartate aminotransferase, glutamate oxaloacetate aminotransaminase (GOT, ASAT, AST) Adults Adults
Negative: <1.5 U/L Indeterminate: 1.51.75 U/L Positive: >1.75 U/L 104202 mg/dL 108225 mg/dL 0.601.17 g/L 0.661.33 g/L <122 U/L <110 U/L <84 U/L <89 U/L <56 U/L <52 U/L <51 U/L <27 U/L <33 U/L w/o pyp <58 U/L <59 U/L <48 U/L <44 U/L <39 U/L with pyp <96 U/L <71 U/L <53 U/L <50 U/L <46 U/L
218
Anti-TSHR Elecsys
f m f m 1d 25 d 6 d6 mth 712 mth 13 yr 46 yr 712 yr f m yr yr yr yr yr
218 218
Children, adolescents 68 IFCC, without pyridoxal phosphate
1317 yr
Children, adolescents <1 13 46 712 1317
with pyp <1,60 mkat/L <1.18 mkat/L <0.88 mkat/L <0.83 mkat/L <0.77 mkat/L
94
IFCC, with and without pyridoxal phosphate
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Analyte Group Aspartate aminotransferase, glutamate oxaloacetate aminotransaminase (GOT, ASAT, AST) Adults f m f m f m f m Reference Ranges Conventional <35 U/L <50 U/L <31 U/L <35 U/L <35 U/L <45 U/L 32 U/L 40 U/L SI References Notes
<0.60 mkat/L 137, 218, IFCC, with pyridoxal phosphate <0.85 mkat/L 270 <0.52 mkat/L <0.58 mkat/L <0.58 mkat/L <0.75 mkat/L 238 227 IFCC, with pyridoxal phosphate, hospitalized patients Nordic Reference Interval Project (NORIP), methods traceable to IFCC
0.53 mkat/L 218, 260 Acc. to the optimized standard 0.67 mkat/L method (comparable to the IFCC method without pyridoxal phosphate activation), calculated values (25 C 37 C). <0.55 mkat/L <0.67 mkat/L < 140 < 205 < 410 < 26 <150 <193 <217 <216 <17
mmol/L mmol/L mmol/L mmol/L mmol/L mmol/L mmol/L mmol/L mmol/L
f m Bilirubin, total Neonates (premature) 1d 2d 35 d 4 w Newborns (full term), children 1d 2d 3d 46 d >1 mth Adults Bilirubin, direct (conjugated) Neonates CA 153 CA 199 CA 724 CA 125 C3C-complement C4-complement Cadmium Calcitonin Adults f m
<33 U/L <40 U/L < 8.2 mg/dL < 12 mg/dL < 24 mg/dL < 1.5 mg/dL <8.7 <11.3 <12.7 <12.6 <1.0 mg/dL mg/dL mg/dL mg/dL mg/dL
218 134
Reflotron, blood, serum, plasma
264
<1.1 mg/dL <0.2 mg/dL <0.1 mg/dL <0.6 mg/dL <25 U/mL <27 U/mL <6.9 U/mL <35 U/mL 90180 mg/dL 1040 mg/dL <2.7 mg/L 14 ng/L 19 ng/L
<18.7 mmol/L <3.4 mmol/L <1.7 mmol/L <10 mmol/L <25 kU/L <27 kU/L <6.9 kU/L <35 kU/L 0.91.8 g/L 0.10.4 g/L <24 nmol/L 3.9 pmol/L 5.3 pmol/L
285 299 264 247 218 218 218 218 237 237 82 299 CA 153 Elecsys CA 199 Elecsys CA 724 Elecsys CA 125 II Elecsys CRM 470 standardization CRM 470 standardization Whole blood, AAS
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Analyte Group Calcium, total Adults Cord blood Newborns, premature Children <10 d 11 d2 yr 312 yr 1318 yr Adults 1860 yr 6190 yr >90 yr Reference Ranges Conventional 8.610.3 mg/dL 8.810.2 mg/dL 8.211.2 mg/dL 6.211.0 mg/dL 7.610.4 mg/dL 9.011.0 mg/dL 8.810.8 mg/dL 8.410.2 mg/dL 8.610.0 mg/dL 8.810.2 mg/dL 8.29.6 mg/dL 8.610.2 mg/dL Calcium, free, ionized Carcinoembryonic antigen (CEA) Adults Non-smokers 2069 40 Smokers 2069 70 yr yr yr yr 4.75.2 mg/dL 4.65.3 mg/dL 3.8 5.0 5.5 6.5 ng/mL ng/mL ng/mL ng/mL SI 2.152.58 mmol/L 2.202.54 mmol/L 2.052.80 1.552.75 1.902.60 2.252.75 2.202.70 2.102.55 2.152.50 2.202.55 2.052.40 mmol/L mmol/L mmol/L mmol/L mmol/L mmol/L mmol/L mmol/L mmol/L References 266 266 299 Photometric assay AAS Notes
2.152.55 mmol/L 1.171.29 mmol/L 1.161.32 mmol/L 3.8 5.0 5.5 6.5
mg/L mg/L mg/L mg/L
218 244 266 218
Roche/Hitachi, COBAS INTEGRA, cobas systems.
CEA Elecsys
Carnitin, free
112 mth 17 yr 815 yr Adults f m
0.711.83 mg/dL 0.851.74 mg/dL 1.462.02 mg/dL 0.852.16 mg/dL 1.182.40 mg/dL 185275 ng/L 3085 ng/L 3085 ng/L 2060 mg/dL
1539 mmol/L 1837 mmol/L 3143 mmol/L 17.945.5 mmol/L 24.651.0 mmol/L 11001600 pmol/L 170470 pmol/L 200550 pmol/L
31
242
Catecholamines Norepinephrine Epinephrine Dopamine Ceruloplasmin Chloride Children 17 d 8 d1 mth 26 mth 7 mth1 yr >1 yr Adults
206
Plasma with addition of glutathione and EGTA
1.494.40 mmol/L 218, 237 Immunoturbidimetric method, CRM 470 standardization 97108 97108 97108 97106 97107 mmol/L mmol/L mmol/L mmol/L mmol/L 247 ISE
97108 97108 97108 97106 97107
mEq/L mEq/L mEq/L mEq/L mEq/L
98107 mEq/L 101110 mEq/L
98107 mmol/L 218, 299 Indirect ISE, coulometry 101110 mmol/L 218 Direct ISE
26
27

Analyte Group Cholesterol, total 130 d 31182 d 183365 d 13 yr 46 yr 79 yr 1012 yr 1315 yr 1618 yr f m f m f m f m f m f m f m f m f m No risk Moderate risk High risk Cholesterol, HDL Major risk Negative risk No risk Moderate risk High risk Cholesterol, LDL f m f m f m Adults Adult levels Optimum Near/above optimum Borderline high High Very high Reference Ranges Conventional 62155 54151 62141 81147 76216 76179 108193 85182 106193 110217 104210 110211 105218 105223 108205 91204 92234 82192 mg/dL mg/dL mg/dL mg/dL mg/dL mg/dL mg/dL mg/dL mg/dL mg/dL mg/dL mg/dL mg/dL mg/dL mg/dL mg/dL mg/dL mg/dL SI 1.604.01 1.403.90 1.603.65 2.093.80 1.975.59 1.974.63 2.794.99 2.204.71 2.744.99 2.845.61 2.695.43 2.845.46 2.725.64 2.725.77 2.795.30 2.355.28 2.386.05 2.124.97 mmol/L mmol/L mmol/L mmol/L mmol/L mmol/L mmol/L mmol/L mmol/L mmol/L mmol/L mmol/L mmol/L mmol/L mmol/L mmol/L mmol/L mmol/L References 247 Notes EDTA plasma yields 36 % lower values than serum.
<200 mg/dL 200239 mg/dL 240 mg/dL 40 mg/dL 60 mg/dL >65 mg/dL >55 mg/dL 4565 3555 <45 <35 mg/dL mg/dL mg/dL mg/dL
<5.2 mmol/L 5.26.2 mmol/L 6.2 mmol/L <1.0 mmol/L <1.6 mmol/L >1.68 mmol/L >1.45 mmol/L 1.151.68 0.91.45 <1.15 <0.90 mmol/L mmol/L mmol/L mmol/L
46
Classification acc. to NCEP ATP III
46 261
Classification acc. to NCEP ATP III European guidelines
<155 mg/dL <100 100129 130159 160189 190 mg/dL mg/dL mg/dL mg/dL mg/dL
<4.0 mmol/L <2.59 2.593.34 3.354.12 4.134.92 4.92 mmol/L mmol/L mmol/L mmol/L mmol/L
65 46, 218 Classification acc. to NCEP ATP III
28
29

Analyte Group Cholinesterase (CHE) m, w >41 yr w, 1640 yr, not pregnant, not taking oral contraceptives w, 1840 yr, pregnant or taking oral contraceptives Dibucaine inhibition test Chromium Copper Normal individuals Fasting volunteers <4 mth 56 mth 712 mth 15 yr 69 yr 1013 yr f m f m 710 h 1620 h Adults Neonates Children f m <3 w 2 mth15 yr Adults 5064 >65 5064 >65 yr yr yr yr Reference Ranges Conventional 5.3212.92 kU/L 4.2611.25 kU/L 3.659.120 kU/L SI 89215 mkat/L 71188 mkat/L 61152 mkat/L References 29, 218 Notes Pseudocholinesterase, butyrylthiocholine iodide, Roche Diagnostics. Calculated with a temperature conversion factor of 1.52 (25 37 C)
Inhibition: >75 % 1.01.5 mg/L 8.946 mg/dL 25108 mg/dL 51133 mg/dL 83152 mg/dL 83133 mg/dL 83121 mg/dL 70159 mg/dL 64114 mg/dL 76152 mg/dL 70140 mg/dL 6.219.4 mg/dL 2.311.9 mg/dL 1.14.4 ng/mL <0.50 mg/dL <0.41 mg/dL <0.28 mg/dL <0.50 mg/dL <0.85 <0.66 <0.79 <0.68 mg/dL mg/dL mg/dL mg/dL
Inhibition: >0.75 2030 nmol/L 1.47.2 mmol/L 417 mmol/L 821 mmol/L 1324 mmol/L 1321 mmol/L 1319 mmol/L 1125 mmol/L 1018 mmol/L 1224 mmol/L 1122 mmol/L 171536 nmol/L 64327 nmol/L 0.371.47 nmol/L <47.6 nmol/L
200 241 159 Special tubes required
1419 yr Adults Cortisol C-peptide of insulin C-reactive Protein (CRP) high sensitive
171 218 218 89, 218 Cortisol Elecsys C-peptide Elecsys Immunoturbidimetric method, CRM 470 standardization, consensus value for adults
<39.0 nmol/L 218, 233 Immunoturbidimetric method, <26.7 nmol/L CRM 470 standardization <47.6 nmol/L <80.9 <62.8 <75.2 <64.7 nmol/L nmol/L nmol/L nmol/L 105 Immunonephelometric method, CRM 470 standardization
30
31

Analyte Group Creatine kinase (CK), total 1d 25 d 6 d6 mth 712 mth 13 yr 46 yr f m f m f m f m f m f m f m Creatine kinase MB (CK-MB) mass Adults Creatinine Adults f m Reference Ranges Conventional <712 U/L <652 U/L <295 U/L <203 U/L <228 U/L <149 U/L <154 U/L <247 U/L <123 U/L <270 U/L <180 U/L <200 U/L <170 U/L <190 U/L <192 U/L <308 U/L <145 U/L <171 U/L <170 U/L <195 U/L <25 U/L <2.88 ng/mL <4.94 ng/mL <1.04 <0.85 <0.42 <0.41 <0.47 <0.59 <0.60 <0.73 <0.79 <0.87 mg/dL mg/dL mg/dL mg/dL mg/dL mg/dL mg/dL mg/dL mg/dL mg/dL SI <11.9 <10.9 <4.90 <3.40 <3.80 <2.50 <2.55 <4.10 <2.05 <4.50 <2.01 <3.34 References Notes
712 yr 1317 yr Adults Adults
mkat/L 68 NAC activated, DGKC, optimized, mkat/L recommendations 1972 mkat/L mkat/L mkat/L mkat/L mkat/L mkat/L mkat/L mkat/L mkat/L 218, 299 mkat/L
<2.85 mkat/L 137, 218 Consensus values <3.20 mkat/L <3.21 mkat/L 138, 218 <5.14 mkat/L <2.41 mkat/L 217, 238 IFCC, hospital patients <2.85 mkat/L <2.84 mkat/L <3.26 mkat/L 218 Roche Diagnostics, Reflotron
<0.42 mkat/L 269, 218 Consensus values <2.88 mg/L <4.94 mg/L <91 <75 <37 <36 <42 <52 <53 <65 <70 <77 218 CK-MB Elecsys
Neonates, premature Neonates, full term Children 212 mth 12 yr 34 yr 56 yr 78 yr 910 yr 1112 yr 1314 yr Adults f m
mmol/L 218, 233 Jaff method, Roche Diagnostics mmol/L mmol/L mmol/L mmol/L mmol/L mmol/L mmol/L mmol/L mmol/L
<0.90 mg/dL <1.20 mg/dL
<80 mmol/L 172, 218 Jaff method, Roche Diagnostics <106 mmol/L
32
33

Analyte Group Creatinine Neonates, premature Neonates, full term Children 212 mth 12 yr 34 yr 56 yr 78 yr 910 yr 1112 yr 1314 yr Adults
b-CrossLaps
Reference Ranges Conventional <0.98 <0.88 <0.39 <0.35 <0.42 <0.47 <0.53 <0.64 <0.68 <0.77 mg/dL mg/dL mg/dL mg/dL mg/dL mg/dL mg/dL mg/dL mg/dL mg/dL
SI <87 <77 <34 <31 <37 <42 <47 <56 <60 <68
References
Notes
mmol/L 218, 233 Enzymatic method, Roche Diagnostics mmol/L mmol/L mmol/L mmol/L mmol/L mmol/L mmol/L mmol/L mmol/L
f m premenopausal postmenopausal 3050 yr 5170 yr >70 yr <1 mth 112 mth >12 mth 2050 yr >50 yr 2070 yr f m f m f m f m f m f m f m f m f m
<0.95 mg/dL <1.17 mg/dL <573 <1008 <584 <704 <854 pg/mL pg/mL pg/mL pg/mL pg/mL
<84 mmol/L 172, 218 Enzymatic method, Roche Diagnostics <104 mmol/L <573 <1008 <584 <704 <854 ng/L ng/L ng/L ng/L ng/L 218
b-Cross Laps Elecsys For postmenopausal women on hormon replacement therapy the ref. values of premenopausal women are valid.
w m
CYFRA 211 Cystatin C Children
< 3.3 ng/mL 1.12.2 mg/L 0.51.4 mg/L 0.51.0 mg/L 0.71.2 mg/L 0.81.6 mg/L 0.471.09 mg/L 33.9280 mg/dL 24.4247 mg/dL 65.1368 mg/dL 70.2492 mg/dL 148407 mg/dL 211492 mg/dL 98.8340 mg/dL 160449 mg/dL 60.9337 mg/dL 88.9427 mg/dL 35.4256 mg/dL 44.3331 mg/dL 18.9205 mg/dL 51.7295 mg/dL 9.40246 mg/dL 33.6249 mg/dL 12.0154 mg/dL 16.2123 mg/dL
<3.3 mg/L 1.12.2 mg/L 0.51.4 mg/L 0.51.0 mg/L 0.71.2 mg/L 0.81.6 mg/L 0.471.09 mg/L 0.927.60 mmol/L 0.666.70 mmol/L 1.779.99 mmol/L 1.9113.4 mmol/L 4.0211.0 mmol/L 5.7313.4 mmol/L 2.689.23 mmol/L 4.3412.2 mmol/L 1.659.15 mmol/L 2.4111.6 mmol/L 0.966.95 mmol/L 1.208.98 mmol/L 0.515.56 mmol/L 1.408.01 mmol/L 0.266.68 mmol/L 0.916.76 mmol/L 0.334.18 mmol/L 0.443.34 mmol/L
218 205
CYFRA 211 Elecsys
Adults Adults Dehydroepiandrosterone sulfate (DHEA-S) 1014 yr 1519 yr 2024 yr 2534 yr 3544 yr 4554 yr 5564 yr 6574 yr 75 yr
190 218 218 Roche Diagnostics, Roche/Hitachi, COBAS INTEGRA, cobas systems. DHEA-S Elecsys
34
35

Analyte Group Dehydroepiandrosterone sulfate (DHEA-S) Children <1 w 14 w 112 m 14 yr 59 yr f m f m f m f m f m f m Adults Reference Ranges Conventional 2.9316.5 mmol/L 0.8611.7 mmol/L 0.093.35 mmol/L 0.01.0.53 mmol/L 0.082.31 mmol/L <160 mg/L <15.9 <17.9 <8.5 <21.9 <8.2 <13.5 <9.1 <14.0 <20.5 <14.4 <14.2 <15.2 525 U/L U/L U/L U/L U/L U/L U/L U/L U/L U/L U/L U/L U/L SI 108607 mg/dL 31.6431 mg/dL 3.4124 mg/dL 0.4719.4 mg/dL 2.885.2 mg/dL <160 mg/L <15.9 <17.9 <8.5 <21.9 <8.2 <13.5 <9.1 <14.0 <20.5 <14.4 <14.2 <15.2 525 U/L U/L U/L U/L U/L U/L U/L U/L U/L U/L U/L U/L U/L References 218 DHEA-S Elecsys Notes
Elastase Erythropoietin
Healthy lab. workers 13 yr 46 yr 79 yr 1012 yr 1315 yr 1618 yr
186 143
ELISA, reference range depends on test used. Serum
Estradiol (E2)
110 yr
f m f Follicular phase Ovulatory phase Luteal phase Postmenopause Pregnancy, 1st trimester m 2830 3132 3336 3740 w w w w
6.027 pg/mL 5.020 pg/mL 12.5166 pg/mL 85.5498 pg/mL 43.8211 pg/mL 5.054.7 pg/mL 2154300 pg/mL 7.643 pg/mL 38140 35330 48350 95460 ng/mL ng/mL ng/mL ng/mL
22.099 pmol/L 18.473 pmol/L 46607 pmol/L 3151828 pmol/L 161774 pmol/L 18.4201 pmol/L 78915780 pmol/L 28156 pmol/L 132486 1211145 1671215 3301596 nmol/L nmol/L nmol/L nmol/L
218
Estradiol II Elecsys
Estriol (E3)
Pregnants
299
Fatty acids, free Ferritin
Adults Children, adolescents <1 yr 13 yr 46 yr 712 yr f m 1317 yr f m 1760 yr 2060 yr f m
<20 mg/dL 12327 667 467 784 14124 1368 14152 ng/mL ng/mL ng/mL ng/mL ng/mL ng/mL ng/mL
<0.7 mmol/L 12327 667 467 784 14124 1368 14152

mg/L mg/L mg/L mg/L mg/L mg/L mg/L
16 94
15150 ng/mL 30400 ng/mL
15150 mg/L 164, 218 Elecsys Ferritin 30400 mg/L
36
37

Analyte Group
a1-Fetoprotein (AFP)
Reference Ranges Conventional 50,0100,000 ng/mL 40.01000 ng/mL <12.0 ng/mL <27.9 <30.9 <36.1 <40.4 <48.3 <54.8 7.0 6.223 7.123 1.716 2.515 2.714 0.513 2.413 2.312 1.010 1.511 1.27.1 1.28.8 3.117.5 2.23.0 <2.2 >17.5 ng/mL ng/mL ng/mL ng/mL ng/mL ng/mL ng/mL ng/mL ng/mL ng/mL ng/mL ng/mL ng/mL ng/mL ng/mL ng/mL ng/mL ng/mL ng/mL ng/mL ng/mL ng/mL ng/mL
SI 41.583,000 U/mL 33.2830 U/mL <9.96 U/mL <23.2 U/mL <25.6 U/mL <30.0 U/mL <33.5 U/mL <40.1 U/mL <45.5 U/mL 5.8 U/mL 1.05.9 mmol/L 1452 1651 3.936 5.734 6.132 1.129 5.430 5.227 2.323 3.425 2.716 2.720 nmol/L nmol/L nmol/L nmol/L nmol/L nmol/L nmol/L nmol/L nmol/L nmol/L nmol/L nmol/L
References 247
Notes
Children, adolescents <30 d 13 mth 4 mth18 yr Pregnancy (median) w 14 w 15 w 16 w 17 w 18 w 19 Adults f m f m f m f m f m f m
218
AFP Elecsys
Fluoride Folic acid, serum
Adults 1 yr 23 yr 46 yr 79 yr 1012 yr 1318 yr
0.019112 mg/L
196 109
Heparin plasma
Normal Borderline deficient Deficient Excessive
7.039.7 nmol/L 5.06.8 nmol/L <5.0 nmol/L >39.7 nmol/L 10.442.4 nmol/L 5972334 nmol/L 9443103 nmol/L 3.512.5 U/L 4.721.5 U/L 1.77.7 U/L 25.8134.8 U/L 1.512.4 U/L
145
4.618.7 ng/mL Folic acid, red blood cells (RBC Folate) Follicle stimulating hormone (FSH) f Follicular phase Ovulatory phase Luteal phase Postmenopause m 2631028 ng/mL 4161367 ng/mL 3.512.5 4.721.5 1.77.7 25.8134.8 1.512.4 mU/mL mU/mL mU/mL mU/mL mU/mL
218 218
Folate III Elecsys; European study (USA: see package insert) RBC Folate II Elecsys; European study, MODULAR ANALYTICS E 170, cobas e 601 (USA, Australia: see package insert) Elecsys 2010, cobas e 411 FSH Elecsys
218
38
39

Analyte Group free PSA/total PSA ratio (fPSA/tPSA) m 5059 yr 6069 yr 70 yr m f 1st trimester 2nd trimester 3rd trimester Reference Ranges Conventional 0.10 49.2 % 57.5 % 64.5 % 0.110.18 26.9 % 33.9 % 40.8 % 1.01.7 ng/dL 1.01.6 ng/dL 0.91.5 ng/dL 0.81.3 ng/dL 0.71.2 ng/dL 0.862.49 0.892.20 0.921.99 0.961.77 0.971.67 0.981.63 ng/dL ng/dL ng/dL ng/dL ng/dL ng/dL SI 0.190.25 18.3 % 23.9 % 29.7 % > 0.25 9.1 % 12.2 % 15.8 % References 218 Notes Free PSA Elecsys, probability of finding prostate cancer by age in years.
Free thyroxine (FT4)
Adults Pregnants
13.121.3 pmol/L 12.320.2 pmol/L 12.119.6 pmol/L 9.617.0 pmol/L 8.415.6 pmol/L 11.032.0 pmol/L 11.528.3 pmol/L 11.925.6 pmol/L 12.322.8 pmol/L 12.521.5 pmol/L 12.621.0 pmol/L 12.022.0 pmol/L 12.820.4 pmol/L 4.16.7 pmol/L 3.96.9 pmol/L 3.66.4 pmol/L 3.86.0 pmol/L 3.25.5 pmol/L 3.15.0 pmol/L 2.659.68 pmol/L 3.009.28 pmol/L 3.308.95 pmol/L 3.698.46 pmol/L 3.888.02 pmol/L 3.937.70 pmol/L 3.16.8 pmol/L 3.96.7 pmol/L 4.06.8 pmol/L 205285 mmol/L <0.03 mmol/L 4.611.7
219
FT4 Elecsys
Children, adolescents Newborn 6 d3 mth 412 mth 16 yr 711 yr 1220 yr Adults Free triiodothyronine (FT3) Adults m f On contraceptiva Not on contraceptiva Pregnants 1st trimester 2nd trimester 3rd trimester
0.931.7 ng/dL 1.01.6 ng/dL 2.74.3 pg/mL 2.64.5 pg/mL 2.34.2 pg/mL 2.53.9 pg/mL 2.13.6 pg/mL 2.03.3 pg/mL 1.736.30 1.956.04 2.155.83 2.415.50 2.535.22 2.565.01 pg/mL pg/mL pg/mL pg/mL pg/mL pg/mL
218 146 219
FT4 Elecsys FT4 Elecsys, healthy blood donors, selected acc. to NACB recommendations FT3 Elecsys
Children, adolescents Newborn 6 d3 mth 412 mth 16 yr 711 yr 1220 yr Adults, euthyroid
2.04.4 pg/mL 2.54.3 pg/mL
218
FT3 Elecsys, routine samples from commercial laboratory FT3 Elecsys, apparently healthy blood donors FT3 Elecsys, healthy blood donors, selected acc. to NACB recommendations
Adults Fructosamine Fructose FTI Adults Adults
2.64.4 pg/mL 205285 mmol/L <0.6 mg/dL 4.611.7
295 123 218 CEDIA T-uptake
40
41

Analyte Group FT4I Euthyroid subjects Germany, Japan USA Adults m f On contraceptiva Not on contraceptiva Children, adolescents Newborn 6 d3 mth 412 mth 16 yr 711 yr 1220 yr Galactose Gastrin Glucose Newborns Cord blood 1h 2h 514 h 2028 h 4052 h Children (fasting) Adults 6090 yr >90 yr Children Newborns 1d >1 d Adults Reference Ranges Conventional 4.812.7 mg/dL 4.411.4 mg/dL 5.610.7 mg/dL 6.212.1 mg/dL 5.111.5 mg/dL 5.0820.8 mg/dL 5.4818.0 mg/dL 5.6816.8 mg/dL 5.9315.0 mg/dL 5.9713.9 mg/dL 5.9113.2 mg/dL <0.5 mg/dL 4059 pg/mL 63158 3699 3989 3477 4681 4879 60100 74106 82115 75121 60100 mg/dL mg/dL mg/dL mg/dL mg/dL mg/dL mg/dL mg/dL mg/dL mg/dL mg/dL SI References Notes
62164 nmol/L 218, 219 T4 Elecsys and T-uptake Elecsys 57147 nmol/L 72.2138 nmol/L 79.7156 nmol/L 66.1148 nmol/L 65.3268 70.5232 73.1216 76.3193 76.1170 74.4162 nmol/L nmol/L nmol/L nmol/L nmol/L nmol/L 123 252 265 Fasting, deep-freeze immediately, RIA Criteria for diagnosing diabetes mellitus (67): 1. Incidental glucose concentration >200 mg/dL (11.1 mmol/L) or 2. Fasting glucose >126 mg/dL (7 mmol/L) or 3. Glucose concentration 2 hours after oGTT >200 mg/dL (11.1 mmol/L) Plasma is recommended. 219 T4 Elecsys and T-uptake Elecsys
<0.03 mmol/L 2028 pmol/L 3.58.8 2.05.5 2.24.9 1.94.3 2.64.5 2.74.4 3.35.6 4.15.9 4.66.4 4.26.7 3.35.6 mmol/L mmol/L mmol/L mmol/L mmol/L mmol/L mmol/L mmol/L mmol/L mmol/L mmol/L
299
4060 mg/dL 5080 mg/dL
2.223.33 mmol/L 2.784.44 mmol/L
298
42
43

Analyte Group Glucose Adults Venous plasma Venous whole blood Capillary whole blood Capillary plasma Pregnants Venous plasma Venous whole blood Capillary whole blood Capillary plasma Preprandial 1 h postprandial 2 h postprandial 7495 6585 6585 74105 mg/dL mg/dL mg/dL mg/dL 4.55.3 3.54.7 3.54.7 4.56.0 mmol/L mmol/L mmol/L mmol/L 265 Following the recommendations of the Deutsche Diabetesgesellschaft and the Deutsche Gesellschaft fr Gynkologie und Geburtshilfe Plasma (venous, capillary) 74109 65100 65100 74109 mg/dL mg/dL mg/dL mg/dL 4.56.0 3.55.5 3.55.5 4.56.0 mmol/L 218, 265 Following the recommendations of the ADA mmol/L reagarding Impaired Fasting Glucose, mmol/L non-pregnants mmol/L Fetal Infants Adults Reference Ranges Conventional 54103 mg/dL 50180 mg/dL 65110 mg/dL SI 3.05.7 mmol/L 2.810.0 mmol/L 3.66.1 mmol/L References 78 Plasma Notes
70100 mg/dL <140 mg/dL <120 mg/dL <126 mg/dL
3.95.6 mmol/L <7.8 mmol/L <6.7 mmol/L <7.0 mmol/L
265
259
Fasting plasma glucose, Expert Committee on the Diagnosis and Classification of Diabetes mellitus/ADA Reflotron system, blood, serum, plasma
Adults Glutamate dehydrogenase (GLDH) Children Newborns 130 d 16 mth 712 mth 1324 mth 23 yr 1315 yr f m f m
60109 mg/dL <11.7 <10.6 <6.8 <5.6 <4.5 <4.2 <5.1 U/L U/L U/L U/L U/L U/L U/L
3.36.1 mmol/L <195 <177 <113 <93 <75 <70 <85
218
nkat/L 218, 278, DGKC, optimized, recommendations 1972, nkat/L 300 calculated values (25 37 C) nkat/L nkat/L nkat/L nkat/L nkat/L 218 DGKC, optimized, calculated values (25 37 C)
Adults
<4.8 U/L <6.4 U/L <5 U/L <7 U/L
<80 nkat/L <110 nkat/L
<80 nkat/L 218, 270 Consensus values <120 nkat/L
44
45

Analyte Group
g-Glutamyl transferase (g-GT)
Reference Ranges Conventional <151 U/L <185 U/L <204 U/L <34 U/L <18 U/L <23 U/L <17 U/L <33 U/L <45 U/L <203 U/L <87 U/L <26 U/L <31 U/L <29 U/L <36 U/L <61 U/L <42 U/L <71 U/L <40 U/L <60 U/L <38 U/L <55 U/L 0.51.6 mg/dL <5 mg/L 30200 mg/dL 91160 87142 82123 74124 5899 52101 mg/dL mg/dL mg/dL mg/dL mg/dL mg/dL
SI <2.50 <3.10 <3.40 <0.55 <0.30 <0.40 <0.30 <0.55 <0.75 <3.38 <1.45 <0.43 <0.52 <0.48
mkat/L mkat/L mkat/L mkat/L mkat/L mkat/L mkat/L mkat/L mkat/L mkat/L mkat/L mkat/L mkat/L mkat/L
References 68
Notes
Newborns, children, adolescents 1d 25 d 6 d6 mth 712 mth 13 yr 46 yr 712 yr 1317 yr f m Children, adolescents <1 13 46 712 1317 Adults yr yr yr yr yr f m f m f m f m
Method according to Szasz
94
IFCC
<0.60 mkat/L <1.02 mkat/L <0.70 mkat/L <1.19 mkat/L <0.67 mkat/L <1.00 mkat/L <0.63 mkat/L <0.92 mkat/L 60180 mmol/L <5 mg/L
1, 218 218 270 238 16 161
Standardized according to Szasz Standardized according to IFCC IFCC, consensus values IFCC, hospital patients
Glycerol, free Growth hormone (STH, somatotropin) Haptoglobin Hp 11 Hp 21 Hp 22 HbA1c Hemoglobin (free Hb in plasma) Hemopexin Adults
Adults Adults Adults f m f m f m Healthy metabolism Outpatients f m
Fasting, RIA
3.020.0 mmol/L 218, 237 Immunoturbidimetry, CRM 470 standardization 9.116.0 mmol/L 8.714.2 mmol/L 8.212.3 mmol/L 7.412.4 mmol/L 5.89.9 mmol/L 5.210.1 mmol/L 153 Immunonephelometric assay
2.94.2 % 4.85.9 % <6 mg/dL 58131 mg/dL 56111 mg/dL
0.0290.042 129, 218 Immunoturbidimetric assay, IFCC values 0.0480.059 DCCT/NGSP values <60 mg/L 0.581.31 g/L 0.561.11 g/L 24 173 EDTA tubes, method according to Harboe
46
47

Analyte Group Homocysteic acid f m <30 yr 3059 yr >60 yr <30 yr 3059 yr 6084 yr >85 yr Human chorionic gonadotropin (hCG) f Premenopause, non-pregnant Postmenopause m Premenopause, non-pregnant Postmenopause m Adults Reference Ranges Conventional 0.81.9 mg/L 0.71.8 mg/L 0.91.9 mg/L 0.81.9 mg/L 0.82.2 mg/L 0.82.3 mg/L 2.04.0 mg/L <1 mU/mL <7 mU/mL <2 mU/mL <1 mU/mL <7 mU/mL <3 mU/mL <182 U/L SI 614 513 714 614 616 617
mmol/L mmol/L mmol/L mmol/L mmol/L mmol/L
References 236
Notes
1530 mmol/L <1 U/L <7 U/L <2 U/L <1 U/L <7 U/L <3 U/L <3.03 mkat/L
106 218 hCG + b Elecsys, pregnant women: see package insert.
218
hCG STAT Elecsys
a-Hydroxybutyrate dehydrogenase (a-HBDH) b-Hydroxybutyrate
64, 218
DGKC, opt., recommendations 1972, calculated with a conversion factor (25 37 C)
Adults Adults <1 13 46 79 1011 1213 1415 1619 f m yr yr yr yr yr yr yr yr
0.31.2 mg/dL 0.23.4 ng/mL 1.02.4 ng/mL <81 1698 27190 33298 52199 57350 46243 60339 mg/dL mg/dL mg/dL mg/dL mg/dL mg/dL mg/dL mg/dL
30120 mmol/L 0.610.3 nmol/L 3.07.3 nmol/L
16 286
17-Hydroxyprogesterone Immunoglobulin A, IgA
<5.06 mmol/L 160, 218 Values recalculated (WHO, CRM 470 1.006.13 mmol/L standardization) 1.6911.9 mmol/L 2.0618.6 mmol/L 3.2512.4 mmol/L 3.5621.9 mmol/L 2.8815.2 mmol/L 3.7521.9 mmol/L 4.3825 mmol/L 0.0030.14 g/L <1.5 <15 <60 <90 <200 <100 U/mL U/mL U/mL U/mL U/mL U/mL 89, 218 299 53, 218 Immunoturbidimetric method, CRM 470 standardization
Adults Immunoglobulin D, IgD Adults
70400 mg/dL 0.314 mg/dL <0.36 mg/dL <3.6 mg/dL <14.4 mg/dL <21.6 mg/dL <48 mg/dL <24 mg/dL
Immunoglobulin E, Neonates IgE Children, adolescents 1 yr 25 yr 69 yr 1015 yr Adults
48
49

Analyte Group Immunoglobulin G, IgG Neonates 13 yr 46 yr 79 yr 1011 yr 1213 yr 1415 yr 1619 yr Adults IgG subclasses 5 yr 6 yr 7 yr 8 yr 9 yr 10 yr 11 yr 12 yr 13 yr Adults 5 yr 6 yr 7 yr 8 yr 9 yr 10 yr 11 yr 12 yr 13 yr Adults Immunoglobulin M, Children, adolescents IgM <1 13 46 79 1011 1213 1415 1619 yr yr yr yr yr yr yr yr IgG1 5601270 6201130 5401050 5601050 3901140 4401080 6401090 6001150 6101150 480 950 IgG3 30100 30 80 30110 20110 40120 30120 30 90 40100 20110 30 80 Reference Ranges Conventional 2271378 442895 4921430 5591439 6811523 7411513 6991671 5361547 mg/dL mg/dL mg/dL mg/dL mg/dL mg/dL mg/dL mg/dL SI 15.191.9 29.559.7 32.895.4 37.396.0 45.4101.6 49.4100.9 46.6111.5 35.8103.2
mmol/L mmol/L mmol/L mmol/L mmol/L mmol/L mmol/L mmol/L
References 160
Notes Immunonephelometric method, values recalculated (WHO, CRM 470 standardization)
7001600 mg/dL IgG2 40440 50400 90350 70450 70470 60400 90430 90480 90790 170690 IgG4 10 80 20 90 20110 10 80 20100 10 90 20100 20 90 10 80 20110 IgG1 5.612.7 6.211.3 5.410.5 5.610.5 3.911.4 4.410.8 6.410.9 6.011.5 6.111.5 4.8 9.5 IgG3 0.31.0 0.30.8 0.31.1 0.21.1 0.41.2 0.31.2 0.30.9 0.41.0 0.21.1 0.30.8
7.016 g/L IgG2 0.44.4 0.54.0 0.93.5 0.74.5 0.74.7 0.64.0 0.94.3 0.94.8 0.97.9 1.76.9 IgG4 0.10.8 0.20.9 0.21.1 0.10.8 0.21.0 0.10.9 0.21.0 0.20.9 0.10.8 0.21.1
89, 218
Immunoturbidimetric method, CRM 470 standardization
mg/dL mg/dL mg/dL mg/dL mg/dL mg/dL mg/dL mg/dL mg/dL mg/dL mg/dL mg/dL mg/dL mg/dL mg/dL mg/dL mg/dL mg/dL mg/dL mg/dL g/L g/L g/L g/L g/L g/L g/L g/L
g/L g/L g/L g/L g/L g/L g/L g/L g/L g/L g/L g/L g/L g/L g/L g/L g/L g/L g/L g/L
180
<1.21 0.161.22 0.201.76 0.261.74 0.261.50 0.292.00 0.191.57 0.202.17
<1.24 mmol/L 0.161.26 mmol/L 0.211.81 mmol/L 0.271.79 mmol/L 0.271.55 mmol/L 0.302.06 mmol/L 0.201.62 mmol/L 0.212.24 mmol/L 0.42.4 mmo/L
160
Immunonephelometric method, values recalculated (WHO, CRM 470 standardization)
Adults
0.42.3 g/L
89, 218
Immunoturbidimetry, CRM 470 standardization
50
51

Analyte Group Immunoglobulin light chains kappa lambda kappa/lambda ratio Insulin Iron Healthy individuals 130 d 112 mth 13 yr 46 yr 79 yr 1012 yr 1315 yr 1618 yr Adults Iron-binding capacity, total (TIBC) Unsaturated (UIBC) Lactate Adults f m f m f m f m f m f m f m f m f m Adults Reference Ranges Conventional SI References Notes
138375 mg/dL 93242 mg/dL 1.172.93 2.624.9 mU/mL 29127 mg/dL 32112 mg/dL 25126 mg/dL 27109 mg/dL 25101 mg/dL 2991 mg/dL 2893 mg/dL 25115 mg/dL 30104 mg/dL 2796 mg/dL 32104 mg/dL 28112 mg/dL 30109 mg/dL 26110 mg/dL 33102 mg/dL 27138 mg/dL 37145 mg/dL 59158 mg/dL 228428 mg/dL 110370 mg/dL 112346 mg/dL 4.519.8 mg/dL 4.514.4 mg/dL <15.3 mg/dL <11.3 mg/dL
1.383.75 g/L 0.932.42 g/L 1.172.93 17.8173 pmol/L 5.222.7 mmol/L 5.720.0 mmol/L 4.522.6 mmol/L 4.819.5 mmol/L 4.518.1 mmol/L 5.216.3 mmol/L 5.016.7 mmol/L 4.520.6 mmol/L 5.418.6 mmol/L 4.817.2 mmol/L 5.718.6 mmol/L 5.020.0 mmol/L 5.419.5 mmol/L 4.719.7 mmol/L 5.918.3 mmol/L 4.824.7 mmol/L 6.626 mmol/L 1128 mmol/L 4177 mmol/L 2066 mmol/L 2062 mmol/L 0.52.2 0.51.6 <1.7 <1.3 mmol/L mmol/L mmol/L mmol/L
218
Immunoturbidimetric assay, CRM 470 standardization Insulin Elecsys, fasting
218 246
288
218 218 218 299
Roche/Hitachi systems Roche/Hitachi systems COBAS INTEGRA, cobas systems Venous plasma, fluoride/oxalate tubes Arterial plasma, fluoride/oxalate tubes Venous blood, deproteinized Arterial blood, deproteinized
52
53

Analyte Group Lactate dehydrogenase (LDH) 1d 25 d 6 d6 mth 712 mth 13 yr 46 yr 712 yr f m 1317 yr f m Children, adolescents <1 yr 13 yr 46 yr 712 yr 1317 yr Adults Adults >60 yr f m f m Neonates Children Adults 420 d 215 yr f m 60 yr >60 yr Neonates 12 yr 1618 yr Adults Lp [a] Adults Reference Ranges Conventional <1327 U/L <1732 U/L <975 U/L <1100 U/L <850 U/L < 615 U/L <580 U/L <764 U/L <436 U/L <683 U/L <451 U/L <344 U/L <314 U/L <332 U/L <279 U/L <480 U/L <509 U/L <223 U/L <232 U/L <247 U/L <248 U/L <600 U/L <300 U/L <214 U/L <225 U/L <250 U/L Lead Lipase Children Juveniles Adults <250 mg/L <320 mg/L <34 U/L <31 U/L <55 U/ L <60 U/L <30 mg/dL SI <22.1 <28.9 <16.3 <18.3 <14.2 <10.3 <9.65 <12.7 <7.25 <11.4 <7.52 <5.73 <5.23 <5.53 <4.65
mkat/L mkat/L mkat/L mkat/L mkat/L mkat/L mkat/L mkat/L mkat/L mkat/L mkat/L mkat/L mkat/L mkat/L mkat/L
References 68 DGKC, optimized
Notes
94
IFCC
<8.00 mkat/L 218, 289 DGKC, optimized, calculated with conversion factor (25 C 37 C) <8.48 mkat/L <3.72 mkat/L <3.72 mkat/L <4.12 mkat/L <4.13 mkat/L <10.0 <5.00 <3.55 <3.75
mkat/L mkat/L mkat/L mkat/L
33 138 238 163
SFBC method IFCC, liquid IFCC, hospitalized patients Standard method, 1994
<4.2 mkat/L <1.21 mmol/L <1.54 mmol/L <0.57 mkat/L <0.52 mkat/L <0.92 mkat/L <0.30 g/L
270 271 2
Consensus values Whole blood, AAS Colorimetric assay
<1.00 mkat/L 125, 218 Colorimetric assay 218 Immunoturbidimetric assay. Lp [a] serum concentrations in healthy persons exhibit an asymmetric distribution and may exceed 100 mg/dL (1.00 g/L). Values >30 mg/dL (0.3 g/L) are associated with higher risk of atherosclerosis.
54
55

Analyte Group Luteinizing hormone (LH) f Follicular phase Ovulatory phase Luteal phase Postmenopause m Lysozyme
a2-Macroglobulin
Reference Ranges Conventional 2.412.6 1496 1.011.4 7.759 mU/mL mU/mL mU/mL mU/mL
SI 2.412.6 U/L 1496 U/L 1.011.4 U/L 7.759 U/L 1.78.6 IU/L 3.09.0 mg/L 1.33.0 g/L 0.620.91 0.700.95 0.700.86 0.700.91
References 218 LH Elecsys
Notes
1.78.6 mU/mL 3.09.0 mg/L 130300 mg/dL 1.52.2 mg/dL 1.72.3 mg/dL 1.72.1 mg/dL 1.72.2 mg/dL 1.62.6 mg/dL 1.62.4 mg/dL 1.72.3 mg/dL 1.121.46 mg/dL 4.016.44 mg/dL
Adults Adults Children, adolescents, newborns 5 mth6 yr 712 yr 1320 yr Adults 6090 yr >90 yr
183 237 Consensus values, CRM 470 standardization
Magnesium, total
mmol/L 218, 299 AAS mmol/L mmol/L mmol/L
0.661.07 mmol/L 0.660.99 mmol/L 0.700.95 mmol/L 0.460.60 mmol/L 1.652.65 mmol/L 0.34.1 mg/L <36 nmol/L 68186 nmol/L 118 299 155 230 218 Whole blood, AAS Immunoturbidimetric assay Ion-selective electrode AAS
ionized erythrocytes Mannose binding protein (MBP) Mercury

b2-Microglobulin
Adults Adults, children Adults Adults f m f m f m f m
0.34.1 mg/L <7.2 mg/L 0.82.2 mg/L 1951 ng/mL 2372 ng/mL 764 ng/mL 1676 ng/mL 2558 ng/mL 2872 ng/mL 764 ng/mL 1676 ng/mL <16.3 ng/mL
Myoglobin
1951 mg/L 130, 218 Roche/Hitachi systems, 2372 mg/L immunoturbidimetric assay 764 mg/L 1676 mg/L 2558 mg/L 2872 mg/L 764 mg/L 1676 mg/L <16.3 mg/L 218 218 218 218 COBAS INTEGRA instruments, immunoturbidimetric assay Myoglobin Elecsys Roche CARDIAC M, heparinized venous blood NSE Elecsys
Neuron specific enolase (NSE)
Healthy subjects
56
57

Analyte Group N-terminal pro brain natriuretic peptide (NT-proBNP) Children 116 yr Adults Adults <45yr 4554 yr 5564 yr 6574 yr 75 yr Osmolality Adults Osteocalcin f m f m <75 yr 75 yr f m f m f m f m f m Neonates 60 yr >60 yr Premenopausal Postmenopausal <30 yr 3050 yr >50 yr Postmenopausal on HRT no HRT Premenopausal Adults Reference Ranges Conventional <83 pg/mL <62 pg/mL 125 pg/mL 450 pg/mL <177.6 <92.6 <192.0 <137.5 <225.7 <176.8 <352.7 <229.1 <624.0 <851.9 pg/mL pg/mL pg/mL pg/mL pg/mL pg/mL pg/mL pg/mL pg/mL pg/mL SI <9.8 pmol/L <7.3 pmol/L 14.8 pmol/L 53.1 pmol/L <21.0 pmol/L <10.9 pmol/L <22.7 pmol/L <16.2 pmol/L <26.6 pmol/L <20.9 pmol/L <41.6 pmol/L <27.0 pmol/L <73.6 pmol/L <100.5 pmol/L 265275 mmol/kg 275295 mmol/kg 280300 mmol/kg <43 <46 <70 <42 <46
mg/L mg/L mg/L mg/L mg/L
References 208 85, 218
Notes Reference range shialy, proBNP Elecsys Recommended cut-off values to discriminate normal and abnormal cardiac function. Reference ranges, proBNP Elecsys
218
265275 mosmol/kg 275295 mosmol/kg 280300 mosmol/kg <43 <46 <70 <42 <46 ng/mL ng/mL ng/mL ng/mL ng/mL
134
218
N-MID Osteocalcin Elecsys, for postmenopausal women under hormone replacement therapy the ref. values for premenopausal women are valid.
P1NP
14.358.9 ng/mL 20.376.3 ng/mL 15.158.6 ng/mL <3.8 ng/mL
14.358.9 mg/L 20.376.3 mg/L 15.158.6 mg/L <3.8 ng/mL
218
P1NP Elecsys
Pancreatic elastase
36
58
59

Analyte Group Parathyrin, Parathyroid hormone (PTH) 24 yr 56 yr 78 yr 910 yr 1112 yr 1314 yr 1516 yr f m f m f m f m f m f m f m Adults Phosphate, inorganic Children, adolescents 130 d 112 mth 13 yr 46 yr 79 yr 1012 yr 1315 yr 1618 yr Adults Phosphohexose isomerase (PHI) Potassium Adults f m Children 17 d 831 d 16 mth 7 mth1 yr >1 yr Adults Reference Ranges Conventional 3.632 5.734 1.013 4.416 2.725 2.527 2.030 4.634 4.334 2.525 1.637 1.426 1.239 4.536 ng/L ng/L ng/L ng/L ng/L ng/L ng/L ng/L ng/L ng/L ng/L ng/L ng/L ng/L SI 0.383.4 pmol/L 0.603.6 pmol/L 0.101.4 pmol/L 0.461.7 pmol/L 0.282.6 pmol/L 0.262.8 pmol/L 0.213.2 pmol/L 0.483.6 pmol/L 0.453.6 pmol/L 0.262.6 pmol/L 0.173.9 pmol/L 0.152.7 pmol/L 0.134.1 pmol/L 0.473.8 pmol/L 0.325.4 pmol/L 1.265.3 pmol/L 1.66.9 pmol/L 1.252.50 1.152.15 1.001.95 1.051.80 0.951.75 1.051.85 0.951.75 0.951.60 mmol/L mmol/L mmol/L mmol/L mmol/L mmol/L mmol/L mmol/L References 45 Notes
351 ng/L 1250 ng/L 1565 ng/L 3.97.7 mg/dL 3.56.6 mg/dL 3.16.0 mg/dL 3.35.6 mg/dL 3.05.4 mg/dL 3.25.7 mg/dL 2.95.1 mg/dL 2.74.9 mg/dL 2.64.5 mg/dL 2.74.5 mg/dL 2090 U/L 3.55.1 mEq/L 3.44.4 mEq/L 3.54.5 mEq/L 3.25.5 mEq/L 3.46.0 mEq/L 3.55.6 mEq/L 3.56.1 mEq/L 3.34.6 mEq/L 3.75.5 mEq/L 3.64.5 mEq/L 3.65.0 mEq/L 3.54.6 mEq/L
250 149 218 263
Chemiluminescence immunoassay PTH Elecsys
0.841.45 mmol/L 0.871.45 mmol/L 0.351.50 mkat/L 218 239
3.55.1 mmol/L 218, 299 Roche Diagnostics, indirect ISE, serum 3.44.4 mmol/L flame photometry, plasma 3.54.5 mmol/L 3.25.5 3.46.0 3.55.6 3.56.1 3.34.6 mmol/L mmol/L mmol/L mmol/L mmol/L 247 Plasma, dry slide technology
3.75.5 mmol/L 3.64.5 mmol/L 3.65.0 mmol/L 3.54.6 mmol/L
218 218
COBAS INTEGRA, direct ISE, serum COBAS INTEGRA, direct ISE, plasma Reflotron, serum Reflotron, plasma
60
61

Analyte Group Prealbumin (Transthyretin) Children <1 mth 16 mth 7 mth6 yr Adults Pregnancy-associated plasma protein A (PAPP-A) Procalcitonin Progesterone w Follicular phase Ovulatory phase Luteal phase Postmenopause m f m f m f m f m f m f m f m f m f m <40 4050 5160 6170 >70 yr yr yr yr yr 0.10 49.2 % 57.5 % 64.5 % Healthy non-pregnant donors Reference Ranges Conventional 739 mg/dL 834 mg/dL 1236 mg/dL 2040 mg/dL <7.15 mIU/L SI 0.070.39 g/L 0.080.34 g/L 0.120.36 g/L 0.200.40 g/L <7.15 mIU/L References 54 Notes Immunonephelometry, CRM 470 standardization
237 218 PAPP-A Elecsys, Roche study no. R04P026
<0.5 ng/mL 0.21.5 0.83.0 1.727 0.10.8 0.21.4 0.395.0 3.781.2 0.229.9 0.328.9 1.017.1 2.313.2 1.613.1 0.816.9 0.312.9 1.911.6 1.99.6 0.912.9 3.014.4 1.616.6 2.118.4 2.715.2 ng/mL ng/mL ng/mL ng/mL ng/mL ng/mL ng/mL ng/mL ng/mL ng/mL ng/mL ng/mL ng/mL ng/mL ng/mL ng/mL ng/mL ng/mL ng/mL ng/mL ng/mL
<0.5 mg/L 0.64.7 nmol/L 2.49.4 nmol/L 5.386 nmol/L 0.32.5 nmol/L 0.74.3 nmol/L 0.395.0 3.781.2 0.229.9 0.328.9 1.017.1 2.313.2 1.613.1 0.816.9 0.312.9 1.911.6 1.99.6 0.912.9 3.014.4 1.616.6 2.118.4 2.715.2
mg/L mg/L mg/L mg/L mg/L mg/L mg/L mg/L mg/L mg/L mg/L mg/L mg/L mg/L mg/L mg/L
176 218 Progesterone II Elecsys
Prolactin
Children, adolescents 49 Chemiluminescence immunoassay 112 mth 13 yr 46 yr 79 yr 1012 yr 1315 yr 1618 yr Adults
Conversion of ng/mL to mU/L depends on the type of standard used
6.029.9 ng/mL 4.621.4 ng/mL <1.4 <2.0 <3.1 <4.1 <4.4 ng/mL ng/mL ng/mL ng/mL ng/mL 0.190.25 18.3 % 23.9 % 29.7 %
127637 mU/L 98456 mU/L <1.4 <2.0 <3.1 <4.1 <4.4

mg/L mg/L mg/L mg/L mg/L
218 218
Prolactin Elecsys PSA Elecsys
Prostate specific antigen, total (tPSA)
free PSA/total PSA ratio (fPSA/tPSA)
5059 yr 6069 yr 70 yr
0.110.18 26.9 % 33.9 % 40.8 %
>0.25 9.1 % 12.2 % 15.8 %
218
Free PSA Elecsys, probability of finding prostate cancer by age in years.
62
63

Analyte Group Protein, total Children, adolescents 1w 7 mth12 mth 12 yr >3 yr Newborns Premature Umbilical cord Adults Electrophoresis Albumin a1-Globulin a2-Globulin b-Globulin g-Globulin Pyruvate Rheumatoid factor (RF) S100 Selenium Sexual hormone binding globulin (SHBG) Sodium f m 1750 yr Postmenopausal, untreated 1765 yr <7 d 8 d1 mth 26 mth 7 m1 yr >1 yr 90 yr >90 yr Adults Sorbitol Squamous cell carcinoma antigen (SCC) Adults Adults Apparently healthy adults Reference Ranges Conventional 4.47.6 g/dL 5.17.3 g/dL 5.67.5 g/dL 6.08.0 g/dL 4.67.0 g/dL 3.66.0 g/dL 4.88.0 g/dL 6.48.3 g/dL 5569 % 1.65.8 % 5.911 % 7.914 % 1118 % 0.360.59 mg/dL <14 IU/mL 0.105 mg/L 67105 mg/L 4583 mg/L 26.1110 nmol/L 14.168.9 nmol/L 14.548.4 nmol/L 131144 132142 132140 131140 132141 mEq/L mEq/L mEq/L mEq/L mEq/L SI 4476 5173 5675 6080 4670 3660 4880 References g/L 218, 299 g/L g/L g/L g/L g/L g/L Notes
6483 g/L 0.550.69 0.020.06 0.060.11 0.080.14 0.110.18 4167 mmol/L <14 kIU/L 0.105 mg/L 0.851.33 mmol/L 0.571.05 mmol/L 26.1110 nmol/L 14.168.9 nmol/L 14.548.4 nmol/L 131144 132142 132140 131140 132141 mmol/L mmol/L mmol/L mmol/L mmol/L 247 Indirect ISE 79 Ponceau Red S
152 218 218 150 218
Whole blood, deproteinize immediately using ice-cold perchloric acid. Immunoturbidimetric method, Roche Diagnostics S100 Elecsys Whole blood Plasma SHBG Elecsys, free testosterone/androgen index: see package insert.
Children
Adults
136145 mEq/L 132146 mEq/L 146157 mEq/L 0.50.9 mg/dL <2.0 ng/mL
136145 mmol/L 132146 mmol/L 146157 mmol/L 2749 mmol/L <20 mg/L
299 218 28 299
Flame emission photometry, indirect ISE COBAS INTEGRA, direct ISE Plasma, deproteinize immediately. Freeze sample immediately.
64
65

Analyte Group Testosterone Children, adolescents, <1 16 712 1317 Adults Thallium Thyroglobulin Children, adolescents Newborns 6 d3 mth 412 mth 16 yr 711 yr 1220 yr Healthy subjects Thyroid stimulating Children, adolescents hormone (TSH) Newborns 6 d3 mth 412 mth 16 yr 711 yr 1220 yr Healthy blood donors m yr yr yr yr f m Reference Ranges Conventional 0.120.21 0.030.32 0.030.68 0.2811.1 ng/mL ng/mL ng/mL ng/mL SI 0.420.72 nmol/L 0.101.12 nmol/L 0.102.37 nmol/L 0.9838.5 nmol/L 0.222.9 nmol/L 9.927.8 nmol/L <24 nmol/L 25307 20228 18125 9.067 5.143 2.636
mg/L mg/L mg/L mg/L mg/L mg/L
References 218
Notes
Testosterone Elecsys
0.060.82 ng/mL 2.88.0 ng/mL <5 mg/L 25307 20228 18125 9.067 5.143 2.636 ng/mL ng/mL ng/mL ng/mL ng/mL ng/mL
299 219
Whole blood, AAS Thyroglobulin Elecsys*, reference range study
1.478 ng/mL 0.7015.2 mU/mL 0.7211.0 mU/mL 0.738.35 mU/mL 0.705.97 mU/mL 0.604.84 mU/mL 0.514.30 mU/mL 0.403.77 mU/mL
1.478 mg/L 0.7015.2 mU/L 0.7211.0 mU/L 0.738.35 mU/L 0.705.97 mU/L 0.604.84 mU/L 0.514.30 mU/L 0.403.77 mU/L
218 219
Thyroglobulin Elecsys TSH Elecsys, reference range study
146
TSH Elecsys, group selected acc. to National Academy of Clinical Biochemistry (NACB) recommendations TSH Elecsys T4 Elecsys, reference range study
Healthy subjects Thyroxine (T4) Children, adolescents Newborns 6 d3 mth 412 mth 16 yr 711 yr 1220 yr Adults Healthy blood donors Adults Adults
0.274.2 mU/mL 5.0418.5 mg/dL 5.4117.0 mg/dL 5.6716.0 mg/dL 5.9514.7 mg/dL 5.9913.8 mg/dL 5.9113.2 mg/dL 5.114.1 mg/dL 5.512.2 mg/dL 412 mg/dL 4.512 mg/dL
0.274.2 mU/L 64.9239 69.6219 73.0206 76.6189 77.1178 76.1170 nmol/L nmol/L nmol/L nmol/L nmol/L nmol/L
218 219
66181 nmol/L 70.5157 nmol/L 51.6154.8 nmol/L 58.1154.8 nmol/L
218 146 218 218
T4 Elecsys T4 Elecsys, group selected acc. to NACB recommendations Roche Diagnostics, fluorescence polarization immunoassay Roche Diagnostics, homogeneous enzyme immunoassay
66
67

Analyte Group Thyroxine-binding capacity (as TBI) Transferrin Transferrin, carbohydrate deficient (as % CDT) Transferrin receptor, soluble (sTfR) Adults f m Transferrin saturation (TS) Triglycerides Adults Premature 65 yr >65 yr Triiodothyronine (T3) Children, adolescents Newborns 6 d3 mth 412 mth 16 yr 711 yr 1220 yr Adults, euthyroid Adults Neonates Troponin T Children <7 d 830 d 31120 d 121 d1 yr Adults Adults Reference Ranges Conventional 0.81.3 2.03.6 g/L 3.0 % SI References 0.81.30 218, 219 T-uptake Elecsys 25.245.4 mmol/L 3.0 % 89, 218, 237 218 Immunoturbidimetric assay, CRM 470 standardization Roche Diagnostics, immunoturbidimetric assay, elevated values indicate alcohol misuse. Enzyme immunoassay Notes
624 mth 26 yr 712 yr 18 yr 1845 yr 1860 yr
1.372.85 mg/L 1.053.05 mg/L 1.162.72 mg/L 0.842.32 mg/L 1.94.4 mg/L 2.25.0 mg/L 1645 % <62 mg/dL <200 mg/dL <325 mg/dL <150 mg/dL 0.732.88 0.802.75 0.862.65 0.922.48 0.932.31 0.912.18 0.802.0 ng/mL ng/mL ng/mL ng/mL ng/mL ng/mL ng/mL
1.372.85 mg/L 1.053.05 mg/L 1.162.72 mg/L 0.842.32 mg/L 2252 nmol/L 2659 nmol/L 1645 % <0.7 mmol/L <2.3 mmol/L <3.7 mmol/L <1.7 mmol/L 1.124.43 nmol/L 1.234.22 nmol/L 1.324.07 nmol/L 1.423.80 nmol/L 1.433.55 nmol/L 1.403.34 nmol/L 1.23.1 nmol/L 0.16 mg/L 0.183 mg/L 0.35 0.20 0.1 0.03
mg/L mg/L mg/L mg/L
144
141 262 78 65, 218 33 46 219
Roche Diagnostics, immunoturbidimetric assay TS [%] = Fe [mg/dL] q 70.9/Transferrin [mg/dL]
Cutpoint acc. to NECP ATP III T3 Elecsys, reference range study
218 15, 22 22 165
T3 Elecsys Chemiluminescence immunoassay, Troponin I Elecsys Enzyme immunoassay Troponin T Elecsys
Troponin I
0.16 ng/mL 0.183 ng/mL 0.35 0.20 0.1 0.03 ng/mL ng/mL ng/mL ng/mL
Neonates Healthy volunteers
0.097 ng/mL <0.01 ng/mL 0.1 ng/mL <0.03 ng/mL
0.097 mg/L <0.01 mg/L 0.1 mg/L < 0.03 mg/L
22 218 218 132
Troponin T Elecsys Troponin T Elecsys Cut-off acc. to WHO criteria Roche CARDIAC T
Adults
68
69

Analyte Group T-uptake (free thyroxine binding capacity) Urea Children Adults f, <50 f, >50 m, <50 m, >50 Adults f m Uric acid Children f 1849 50 1849 50 yr yr yr yr yr yr yr yr Blood donors Reference Ranges Conventional 24.339.0 % SI 0.2430.390 References 218 Notes Roche Diagnostics, homogeneous enzyme immunoassay
13 yr 413 yr 1419 yr
1136 1536 1845 1743 1540 2143 1944 1855 1638 1947 1949 2149
mg/dL mg/dL mg/dL mg/dL mg/dL mg/dL mg/dL mg/dL mg/dL mg/dL mg/dL mg/dL
1.86.0 2.56.0 2.97.5 2.87.2 2.66.7 3.57.2 3.27.3 3.09.2 2.66.4 3.17.9 3.28.1 3.58.1 59271 65319 106295 118301 106325 148348 130378 142389 71230 71330 124330 106325 106319 130342 183413 124448 137363 214488
mmol/L mmol/L mmol/L mmol/L mmol/L mmol/L mmol/L mmol/L mmol/L mmol/L mmol/L mmol/L
mmol/L mmol/L mmol/L mmol/L mmol/L mmol/L mmol/L mmol/L mmol/L mmol/L mmol/L mmol/L mmol/L mmol/L mmol/L mmol/L mmol/L mmol/L
268
227
NORIP
Adults
130 d 31365 d 13 yr 46 yr 79 yr 1012 yr 1315 yr 1618 yr 130 d 31365 d 13 yr 46 yr 79 yr 1012 yr 1315 yr 1618 yr f m f m
1.04.6 mg/dL 1.15.4 mg/dL 1.85.0 mg/dL 2.05.1 mg/dL 1.85.5 mg/dL 2.55.9 mg/dL 2.26.4 mg/dL 2.46.6 mg/dL 1.23.9 mg/dL 1.25.6 mg/dL 2.15.6 mg/dL 1.85.5 mg/dL 1.85.4 mg/dL 2.25.8 mg/dL 3.17.0 mg/dL 2.17.6 mg/dL 2.36.1 mg/dL 3.68.2 mg/dL 2.45.7 mg/dL 3.47.0 mg/dL 2.65.8 mg/dL 2.66.7 mg/dL 3.98.1 mg/dL
267
Recommended upper limit of males: 7 mg/dL (416 mmol/L) 218 227 Roche/Hitachi, COBAS INTEGRA, cobas, Reflotron systems NORIP
142.8339.2 mmol/L 202.3416.5 mmol/L 155350 mmol/L 155400 mmol/L 230480 mmol/L
Adults f m
1849 yr 50 yr 18 yr
70
71

Analyte Group Vitamin A (Retinol) 15 yr 1635 yr 3660 yr >60 yr Vitamin B1 (Thiamine) Vitamin B2 (Riboflavin) Vitamin B6 (Pyridoxal phosphate) Vitamin B12 <1 yr 23 yr 46 yr 79 yr 1012 yr 1318 yr Adults Vitamin C Vitamin D3, 25-OH f m f m f m f m f m f m Europe USA Adults Children, adults Healthy individuals Adults f m f m f m f m Reference Ranges Conventional 185841 mg/dL 113805 mg/dL 3311079 mg/dL 4601240 mg/dL 6191119 mg/dL 6261322 mg/dL 3801116 mg/dL 6001275 mg/dL 0.130.75 mg/dL 1.94.9 mg/dL 1050 mg/dL 1.02.4 mg/dL 2281515 2931210 4161210 2641215 3131410 2451075 2471175 2711170 1961020 1831090 182820 214864 pg/mL pg/mL pg/mL pg/mL pg/mL pg/mL pg/mL pg/mL pg/mL pg/mL pg/mL pg/mL SI 6.529.4 mmol/L 3.928.1 mmol/L 11.637.7 mmol/L 16.143.3 mmol/L 21.639.1 mmol/L 21.846.1 mmol/L 13.338.9 mmol/L 20.944.5 mmol/L 528 nmol/L 71185 nmol/L 0.271.33 mmol/L 3998 nmol/L 1681115 pmol/L 216891 pmol/L 307892 pmol/L 195897 pmol/L 2311040 pmol/L 181795 pmol/L 182866 pmol/L 200863 pmol/L 145752 pmol/L 135803 pmol/L 134605 pmol/L 158638 pmol/L 141489 pmol/L 156698 pmol/L 20100 mmol/L 25110 nmol/L 13151 nmol/L 27.7107 nmol/L References 110 HPLC Notes
293 299 21 109
HPLC, serum HPLC, whole blood HPLC, fluorimetry HPLC RIA
191663 pg/mL 211946 pg/mL 0.41.8 mg/dL 1044 ng/mL 5.260.4 ng/mL 11.142.9 ng/mL
218 57 21 250 218
Vitamin B12 Elecsys
Approximate reference range based on three studies. Chemiluminescence assay Vitamin D3 Elecsys, Roche Diagnostics, population-based reference range, Germany, summer time Health-based reference range
Children. adults
>30 ng/mL
>75 nmol/L
280
72
73

Analyte Group Vitamin E (a-Tocopherol) <15 yr 1635 yr 3660 yr >60 yr Vitamin K Zinc f m f m f m f m Adults <4 mth 412 mth 15 yr 69 yr f m f m Adults Zinc protoporphyrin Reference Ranges Conventional 0.41.2 mg/dL 0.51.1 mg/dL 0.51.2 mg/dL 0.41.3 mg/dL 0.71.5 mg/dL 0.71.6 mg/dL 0.71.6 mg/dL 0.81.6 mg/dL 0.170.68 mg/L 65137 mg/dL 65130 mg/dL 65118 mg/dL 78105 mg/dL 78118 mg/dL 7898 mg/dL 5998 mg/dL 65118 mg/dL 46150 mg/dL 425560 mg/dL 1777 mg/L SI 9.328 1226 1227 9.331 1634 1636 1636 1938 1021 1020 1018 1216 1218 1215 915 1018
References 110
Notes EDTA plasma, HPLC
0.381.51 nmol/L
21 159
HPLC, fasting
1013 yr 1419 yr
723 mmol/L 6586 mmol/L 0.271.23 mmol/L
150 299
Plasma Whole blood Whole blood (heparine EDTA), hematofluorimetric test.
74
75
2.2 Hematology
Analyte Goup CO-Hb Differential leucocyte count Band neutrophils Non-smokers Smokers Reference Ranges Conventional <2.2 % <10.5 % SI <0.022 <0.105 References 55 Notes
Infants Children Adults Infants Children Adults Infants Children Adults Infants Children Adults Infants Children Adults Infants Children Adults 1d 26 d 1423 d 2437 d 4050 d 22.5 mth 33.5 mth 57 mth 8 mth-3 yr 5 yr 10 yr Adults f m f m f m
<8 % 36 % 35 % 1760 % 2560 % 5070 % 15 % 15 % 24 % <1 % <1 % <1 % 111 % 16 % 28 % 2070 % 2550 % 2540 % 80360 mil/mL 4.36.3 4.06.8 3.76.1 3.25.6 3.15.1 2.84.8 3.14.7 3.25.2 3.65.2 3.75.7 3.85.8 mil/mL mil/mL mil/mL mil/mL mil/mL mil/mL mil/mL mil/mL mil/mL mil/mL mil/mL
<0.08 0.030.06 0.030.05 0.170.60 0.250.60 0.500.70 0.010.05 0.010.05 0.020.04 <0.01 <0.01 <0.01 0.010.11 0.010.06 0.020.08 0.200.70 0.250.50 0.250.40 80360 mpt/L 4.36.3 4.06.8 3.76.1 3.25.6 3.15.1 2.84.8 3.14.7 3.25.2 3.65.2 3.75.7 3.85.8 tpt/L tpt/L tpt/L tpt/L tpt/L tpt/L tpt/L tpt/L tpt/L tpt/L tpt/L
214
Blood must be smeared within 3 hours (93)
Segmented neutrophils Eosinophils
Basophils
Monocytes
Lymphocytes
Eosinophiles Erythrocytes
25 122
4.15.1 mil/mL 4.55.9 mil/mL <25 <15 <30 <20 mm/1 mm/1 mm/1 mm/1 h h h h
4.15.1 tpt/L 4.55.9 tpt/L <25 <15 <30 <20 mm/1 mm/1 mm/1 mm/1 h h h h
294 56 Citrated blood
Erythrocyte sedimentation rate (ESR)
Adults 50 yr Adults >50 yr
76
77
2.2 Hematology
Analyte Group Glucose-6-phosphate dehydrogenase (G-6-P-DH) Hematocrit (Hct, PCV) 1d 26 d 1423 d 2437 d 4050 d 22.5 mth 3 -3.5 mth 57 mth 8 mth3 yr 5 yr 10 yr Adults Hemoglobin (Hb) in blood f m 1d 26 d 1423 d 2437 d 4050 d 22.5 mth 33.5 mth 57 mth 810 mth 1113.5 mth 1.53 yr 5 yr 10 yr Adults >70 yr >75 yr >81 yr Hb composition HbA0 HbA1 HbA2 HbF f m f m f m f m Reference Ranges Conventional 7.916.3 U/g Hb SI 0.521.04 mU/mol Hb References 299 Notes Blood treated with heparinate or EDTA, 37 C
4472 % 5082 % 4262 % 3159 % 3054 % 3046 % 3143 % 3244 % 3543 % 3143 % 3345 % 3547 % 4052 % 15.223.6 g/dL 15.024.6 g/dL 12.718.7 g/dL 10.317.9 g/dL 9.016.6 g/dL 9.213.6 g/dL 9.612.8 g/dL 10.112.9 g/dL 10.512.9 g/dL 10.713.1 g/dL 10.812.8 g/dL 10.714.7 g/dL 10.815.6 g/dL 12.315.3 g/dL 14.017.5 g/dL 11.716.2 g/dL 12.117.6 g/dL 11.616.1 g/dL 11.817.5 g/dL 10.915.5 g/dL 11.616.3 g/dL 9094 % 48 % 1.43.0 % 0.31.0 %
0.440.72 0.500.82 0.420.62 0.310.59 0.300.54 0.300.46 0.310.43 0.320.44 0.350.43 0.310.43 0.330.45 0.350.47 0.400.52 9.414.7 9.315.3 7.911.6 6.411.1 5.610.3 5.78.4 6.07.9 6.38.0 6.58.0 6.68.1 6.77.9 6.69.1 6.79.7 mmol/L mmol/L mmol/L mmol/L mmol/L mmol/L mmol/L mmol/L mmol/L mmol/L mmol/L mmol/L mmol/L
122
122
7.69.5 mmol/L 8.710.9 mmol/L 7.310.1 7.510.9 7.210.0 7.310.9 6.89.6 7.210.1 mmol/L mmol/L mmol/L mmol/L mmol/L mmol/L
294 189
0.900.94 0.040.08 0.0140.03 0.0030.01
294
78
79
2.2 Hematology
Analyte Group Leucocytes 12 h 1d 1w 2w 4w 2 mth 412 mth 2 yr 4 yr 6 yr 812 yr 1416 yr 18 yr 20 yr Adults MCH (Hb/RBC) 1d 26 d 1437 d 4050 d 22.5 mth 33.5 mth 510 mth 11 mth5 yr 10 yr Adults MCHC 1d 26 d 1423 d 2437 d 40 d7 mth 813.5 mth 1.53 yr 510 yr Adults Reference Ranges Conventional 13,00038,000/mL 9,40034,000/mL 5,00021,000/mL 5,00020,000/mL 5,00019,500/mL 5,50018,000/mL 6,00017,500/mL 6,00017,000/mL 5,50015,500/mL 5,00014,500/mL 4,50013,500/mL 4,50013,000/mL 4,50012,500/mL 4,50011,500/mL 4,40011,300/mL 3341 2945 2638 2537 2436 2336 2133 2331 2234 pg/cell pg/cell pg/cell pg/cell pg/cell pg/cell pg/cell pg/cell pg/cell SI 13.038.0 gpt/L 9.434.0 gpt/L 5.021.0 gpt/L 5.020.0 gpt/L 5.019.5 gpt/L 5.518.0 gpt/L 6.017.5 gpt/L 6.017.0 gpt/L 5.515.5 gpt/L 5.014.5 gpt/L 4.513.5 gpt/L 4.513.0 gpt/L 4.512.5 gpt/L 4.511.5 gpt/L 4.411.3 gpt/L 2.02.5 fmol/cell 1.82.8 fmol/cell 1.62.4 fmol/cell 1.62.3 fmol/cell 1.52.2 fmol/cell 1.42.2 fmol/cell 1.32.0 fmol/cell 1.41.9 fmol/cell 1.42.1 fmol/cell 1.72.0 fmol/cell 1922 1522 1621 1623 1621 1720 1621 2022 mmol/L mmol/L mmol/L mmol/L mmol/L mmol/L mmol/L mmol/L References 56 Notes
294 122
2833 pg/cell 3135 2436 2634 2537 2634 2832 2634 3236 g/dL g/dL g/dL g/dL g/dL g/dL g/dL g/dL
294 122
3336 g/dL
2022 mmol/L
294
80
81
2.2 Hematology
Analyte Group MCV 1d 26 d 1423 d 2437 d 22.5 mth 33.5 mth 57 mth 810 mth 1113.5 mth 1.53 yr 5 yr 10 yr Adults Methemoglobin Osmotic resistance of erythrocytes Pyruvate kinase in erythrocytes Reticulocytes 1d 3d 7d 1 mth 1.5 mth 2 mth 2.5 mth 3 mth >4 mth Adults Reticulocyte hemoglobin equivalent (RET-He) Adults Non-smokers/smokers No hemolysis Complete hemolysis Reference Ranges Conventional 98122 94150 84128 82126 81121 77113 73109 74106 74102 73101 7288 6993
mm3 mm3 mm3 mm3 mm3 mm3 mm3 mm3 mm3 mm3 mm3 mm3
SI 98122 94150 84128 82126 81121 77113 73109 74106 74102 73101 7288 6993 fL fL fL fL fL fL fL fL fL fL fL fL
References 122
Notes
8096 mm3 <1.2 % >0.5 % NaCl <0.3 % NaCl 1116 U/g Hb 3070 1030 <10 220 335 448 342 336 228 515 28.235.7 pg
8096 fL <0.012 >0.005 NaCl <0.003 NaCl 0.71.1 mU/mol Hb 3070 q 1030 q <10 q 220 q 335 q 448 q 342 q 336 q 228 q 10 3 10 3 10 3 10 3 10 3 10 3 10 3 10 3 10 3
294 55 56 71 294 Heparinized blood Heparinized or EDTA blood
515 q 10 3 28.235.7 pg
56 269 Derived from Ret-Y as determined on a Sysmex XE 2100 hematology analyzer
82
83
2.2 Hematology
Analyte Group Thrombocytes 15 yr 610 yr 1115 yr 1620 yr 2130 yr 3140 yr 4150 yr 5160 yr 6170 yr >70 yr Volume Blood Erythrocytes Plasma f m f m f m 4969 4479 1929 2037 2841 2344 mL/kg mL/kg mL/kg mL/kg mL/kg mL/kg 0.0490.069 L/kg 0.0440.079 L/kg 0.0190.029 L/kg 0.0200.037 L/kg 0.0280.041 L/kg 0.0230.044 L/kg 56 f m f m f m f m f m f m f m f m f m f m Reference Ranges Conventional 229553 217497 184488 181521 154442 156408 154386 140392 154386 140336 170394 132356 149409 139403 177393 136380 152396 150362 149409 139335 q 103/mL q 103/mL q 103/mL q 103/mL q 103/mL q 103/mL q 103/mL q 103/mL q 103/mL q 103/mL q 103/mL q 103/mL q 103/mL q 103/mL q 103/mL q 103/mL q 103/mL q 103/mL q 103/mL q 103/mL SI 229553 217497 184488 181521 154442 156408 154386 140392 154386 140336 170394 132356 149409 139403 177393 136380 152396 150362 149409 139335 Gpt/L Gpt/L Gpt/L Gpt/L Gpt/L Gpt/L Gpt/L Gpt/L Gpt/L Gpt/L Gpt/L Gpt/L Gpt/L Gpt/L Gpt/L Gpt/L Gpt/L Gpt/L Gpt/L Gpt/L References 80 Notes
84
85
2.3 Coagulation
Analyte Group Antiphospholipid antibodies (APA)
a2-Antiplasmin
Reference Ranges Conventional No antibodies
SI No antibodies 1.081.55 0.791.61 0.801.2 0.551.15 U/mL 0.701.30 U/mL 0.761.24 U/mL 0.761.40 U/mL 0.831.39 U/mL 0.681.36 U/mL 0.200.51 0.210.51 0.400.54 0.440.84 0.340.70 >0.67 >0.81 >0.80 <10 <13 <8 <7 min min min min
References 273 191 218 4 Photometric assay
Notes ELISA, Asserachrom* APA
210 yr 1118 yr Adults Full-term infants 1d 5d 30 d 90 d 180 d Adults 1 4 7 1 7 d d d d d
108155 % 79161 % 80120 % 0.551.15 U/mL 0.701.30 U/mL 0.761.24 U/mL 0.761.40 U/mL 0.831.39 U/mL 0.681.36 U/mL 2051 % 2151 % 4054 % 4484 % 3470 % >67 % >81 % >80 % <10 <13 <8 <7 min min min min
Antithrombin III
Infants, premature Infants, full-term Children
199
210 yr 1118 yr Adults 15 yr 610 yr 1116 yr Adults 1d 1 w2 mth 34 mth 56 mth 712 mth Adults 16 yr 712 yr 1318 yr
191 108 13 Activity test, chromogenic substrate Modification of the method according to Mielke
Bleeding time
C4bBP
<66 % 2574 % 4375 % 4595 % 50110 % 74140 % < 0.6 mg/mL < 0.5 mg/mL < 0.7 mg/mL <2.2 mg/mL <4.3 mg/mL <0.5 mg/mL <0.5 mg/mL
<0.66 0.250.74 0.430.75 0.450.95 0.501.10 0.741.40 < 0.6 mg/L < 0.5 mg/L < 0.7 mg/L <2.2 mg/L <4.3mg/L <0.5 mg/L < 0.5 mg/L
253
D-Dimer
215
ELISA
Pregnancy
<20 w 2140 w Adults
179 218 218 Enzyme immunoassay Immunoturbidimetric assays, Roche CARDIAC D-Dimer
* Asserachrom is a trademark of Diagnostica STAGO
86
87
2.3 Coagulation
Analyte Group Factor II Factor V Factor VII 10 yr 13 yr Neonates Adults Neonates Adults Neonates f m f m Adults Reference Ranges Conventional 3159% >70% 42182% >70% 3495 % 60122 % 56140 % 69131 % 68125 % >70 % 55170 % Factor VIII 210 yr 1118 yr Adults Adults Factor IX Neonates 210 yr Adults Factor X Neonates Adults Factor XI 116 yr Adults Adults Factor XII 116 yr Adults Factor XIII Fibrin monomers Adults Adults 52300 % 54170 % >70 % 60150 % 1155% 6098% >60% 2445% >70% 56156% >70 % 60150 % 52192 % >60 % >60 % <20 mg/mL SI 0.310.59 >0.70 0.421.82 > 0.70 0.340.95 0.601.22 0.561.40 0.691.31 0.681.25 >0.70 0.551.70 0.523.00 0.541.70 >0.70 0.601.50 0.110.55 0.600.98 >0.60 0.240.45 >0.70 0.561.56 >0.70 0.601.50 0.521.92 >0.60 >0.60 <20 mg/L References 202 20 202 20 228 Notes
20 218 192 20 218 192 283 191 20, 218 72 20 218 72 20, 218 20 154 Agglutination test Newborns have approx. 50 % of the adult value
88
89
2.3 Coagulation
Analyte Group Fibrinogen Infants, premature 1d 5d 1 mth 3 mth 6 mth 1d 5d 1 mth 3 mth 6 mth Reference Ranges Conventional 150370 160420 150410 150350 150360 160400 160460 160380 150380 160390 mg/dL mg/dL mg/dL mg/dL mg/dL mg/dL mg/dL mg/dL mg/dL mg/dL SI 1.53.7 1.64.2 1.54.1 1.53.5 1.53.6 1.64.0 1.64.6 1.63.8 1.53.8 1.63.9 g/L g/L g/L g/L g/L g/L g/L g/L g/L g/L References 12 Notes
Infants, full-term
11
210 yr 1118 yr Adults Fibrin(ogen) degradation products (FDP) Fibrinopeptide A Fibronectin Heparin cofactor II Hepato Quick High molecular weight kininogen (HMWKG) International normalized ratio (INR) Adults Adults Children Adults 116 yr Adults Atrial fibrillation/flutter Valvular defects Valve replacements a) Mechanical valves Bileaflet valves/tilting disc valves in aortic position in mitral position Caged Ball valves Mechanical valve + embolism b) Bioprosthetic valves Deep vein thrombosis/pulmonary embolism Adults
140360 mg/dL 160390 mg/dL 200400 mg/dL <10 mg/mL
1.43.6 g/L 1.63.9 g/L 2.04.0 g/L <10 mg/L
191 218 251 Fibrinogen levels increase during pregnancy
<3 mg/mL <300 mg/L >60 % >50 % >70 % 47123 % >70 %
<3 mg/L <0.3 g/L >0.60 >0.50 >0.70 0.471.23 >0.70 INR 2.03.0 INR 2.03.0 INR 2.03.0 INR 2.53.5 INR 2.53.5 INR 2.53.5 INR 2.03.0 INR 2.03.0
7 20 20 69 72 20 182
Enzyme immunoassay
Citrated plasma, citrated blood, whole blood
When determining the INR the bleeding and thrombosis risk has to be considered individually for each patient.
For 3 months
90
91
2.3 Coagulation
Analyte Group
a2-Macroglobulin
Reference Ranges Conventional 1d 5d 1 mth 3 mth 6 mth Adults 1d 5d mth mth mth 0.951.83 U/mL 0.981.98 U/mL 1.061.94 U/mL 1.262.26 U/mL 1.492.33 U/mL 0.521.20 U/mL <79 <74 <63 <51 <53 <55 <60 <55 <50 <43 <43 <38 <42 <40 s s s s s s s s s s s s s s
SI 0.951.83 U/mL 0.981.98 U/mL 1.061.94 U/mL 1.262.26 U/mL 1.492.33 U/mL 0.521.20 U/mL <79 <74 <63 <51 <53 <55 <60 <55 <50 <43 <43 <38 <42 <40 s s s s s s s s s s s s s s
References 4
Notes
Full-term infants
(Activated) Partial Premature infants thromboplastin time (PTT, APTT) 1 3 6 Full-term infants
12
Values are reagent- and age-dependent.
1d 5d 1 mth 3 mth 6 mth 210 yr Adults 210 yr Adults Adults
11
283
Neothromtin Actin FS
2433 s 95420 80370 90450 90365

mg/L mg/L mg/L mg/L
2433 s 95420 80370 90450 90365

mg/L mg/L mg/L mg/L
218 215
Kaolin-activated APTT
Plasmin-a2-antiplasmin complex
16 yr 712 yr 1318 yr Adults Neonates 2 10 yr 1118 yr Adults Full-term infants 1d 5d 1 mth 3 mth 6 mth Adults
Plasminogen
4266 % 55127 % 64133 % >70 % 1.252.65 U/mL 1.412.93 U/mL 1.262.70 U/mL 1.743.22 U/mL 2.213.81 U/mL 2.484.24 U/mL
0.420.66 0.551.27 0.641.33 >0.70 1.252.65 U/mL 1.412.93 U/mL 1.262.70 U/mL 1.743.22 U/mL 2.213.81 U/mL 2.484.24 U/mL
166 192 191 4 Colorimetric test
92
93
2.3 Coagulation
Analyte Group Plasminogen activator inhibitor (PAI) Full-term infants 1d 5d 1 mth 3 mth 6 mth Adults Reference Ranges Conventional <10 AU/mL 2.015.1 U/mL <8.1 U/mL <8.8 U/mL 1.015.3 U/mL 6.013.0 U/mL < 11.0 U/mL <5 U/mL 116 yr Adults Protein C Neonates 210 yr 1118 yr Adults Adults Activity/antigen concentration ratio 1d 2d 3d 4d 1 mth 1 w2 34 56 712 1d mth mth mth mth 47171 % >50 % 0.200.44 U/mL 64150 % 63130 % 70140 % 70130 % 0.631.35 0.291.37 0.661.30 0.571.45 0.761.20 1753 % 3564 % 5086 % 64105 % 66120 % 70140 % 32 84 % 50100 % 6498 % 60125 % 70140 % 50120 % 65145 % SI <10 kAU/L 2.015.1 U/mL <8.1 U/mL <8.8 U/mL 1.015.3 U/mL 6.013.0 U/mL < 11.0 U/mL <5 kU/L 0.471.71 >0.50 0.200.44 kU/L 0.641.50 0.631.30 0.701.40 0.701.30 0.631.35 0.291.37 0.661.30 0.571.45 0.761.20 0.170.53 0.350.64 0.500.86 0.641.05 0.661.20 0.701.40 0.320.84 0.501.00 0.640.98 0.601.25 0.701.40 0.501.20 0.651.45 References 48 4 Notes Colorimetric test, AU = arbitrary unit
Platelet factor 4 (PF4) Prekallikrein
9 72 20 202 192 218 218 255
Enzyme immunoassay, CTAD collection tubes
Antigen concentration
Protein C concentration, enzyme immunoassay Protein C activity, chromogenic method and clotting test
Protein S, total
253
Concentration: Enzyme immunoassay. In pregnancy often low values. After the first centrifugation step, the plasma must be centrifuged a second time and separated from cells, immediately freeze the supernatant.
Adults Protein S, free 1 w2 34 56 712 Adults 1d mth mth mth mth f m
34 253
218
Clotting test
94
95
2.3 Coagulation
Analyte Group Prothrombin fragments 1+2 16 yr 712 yr 1318 yr Adults 6 mth5 yr 6 yr7 yr 816 yr Adults Reptilase time Thrombin AT III complex (TAT) Adults 16 yr 712 yr 1318 yr Adults Adults Premature infants 1d 5d 1 mth 3 mth 6 mth 1d 5d 1 mth 3 mth 6 mth Adults Reference Ranges Conventional 0.351.20 nmol/L 0.361.28 nmol/L 0.281.40 nmol/L 0.381.14 nmol/L 53100 % 65100 % 77100 % >70 % <20 s 0.83.5 0.64.1 0.73.8 0.63.6
mg/L mg/L mg/L mg/L
SI 0.351.20 nmol/L 0.361.28 nmol/L 0.281.40 nmol/L 0.381.14 nmol/L 0.531.00 0.651.00 0.771.00 >0.70 <20 s 0.83.5 0.64.1 0.73.8 0.63.6
mg/L mg/L mg/L mg/L
References 215
Notes Enzyme immunoassay
Prothrombin time (PT)
191
Therapeutic range in percent is method dependent and corresponds to INR: 2.04.5. Values >100 % are of no clinical significance.
218 290 215 Enzyme immunoassay
Thrombin coagulase Thrombin time
<23 s <30 <29 <30 <31 <32 <28 <29 <29 <30 <31 s s s s s s s s s s
<23 s <30 <29 <30 <31 <32 <28 <29 <29 <30 <31 s s s s s s s s s s
290 12
Neonates
11
<22 s Normal range: 21 s Ctrl. of heparin therapy: 13 s
<22 s Normal range: 21 s Ctrl. of heparin therapy: 13 s <40 kU/L > 0,70
20 218 9 20 Enzyme immunoassay, plasma. Urine: approx. 0.5 % of plasma value.
b-Thromboglobulin
Adults Adults
<40 U/mL >70 %
Tissue factor pathway inhibitor
96
97
2.3 Coagulation
Analyte Group Tissue plasminogen activator (t-PA) Adults Full-term infants 1d 5d 30 d 3 mth 6 mth Adults 210 yr Adults Reference Ranges Conventional <12 ng/mL 112 ng/mL 5.018.9 4.010.0 1.06.0 1.05.0 1.06.0 1.48.4 ng/mL ng/mL ng/mL ng/mL ng/mL ng/mL SI <12 mg/L 112 mg/L 5.018.9 mg/mL 4.010.0 mg/L 1.06.0 mg/L 1.05.0 mg/L 1.06.0 mg/L 1.48.4 mg/L 0.542.00 0.501.60 References 20 218 4 Notes t-PA levels increase with age, smoking, physical exercise, stress. Venous stasis induces an increase of t-PA levels. Enzyme immunoassay
von Willebrand factor (vWF)
54200 % 50160 %
192 218 Enzyme immunoassay, lower results with blood group 0.
98
99
2.4 Blood gases

Analyte Group Base excess O2-saturation pCO2 Children Children Adults Adults A. umb. V. umb. 1d 10 d3 mth 412 mth w m A. umb. V. umb. 1d 10 d3 mth 412 mth Reference Ranges Conventional 2 to + 3 mmol/L 9498 % 7080 % 3580 mm Hg 3057 mm Hg 2961 mm Hg 2743 mm Hg 2740 mm Hg 3243 mm Hg 3546 mm Hg 7.097.40 7.157.45 7.207.41 7.347.45 7.387.45 7.377.45 7.357.43 A. umb. V. umb. 10 d3 mth Adults V. umb. 1d 10 d3 mth 412 mth Adults < 22 1635 7085 71104 3644 mm mm mm mm mm Hg Hg Hg Hg Hg SI 2 to + 3 mmol/L 0.940.98 0.700.80 4.710.7 kPa 4.07.6 kPa 4.08.0 kPa 3.55.7 kPa 3.65.3 kPa 4.35.7 kPa 4.76.1 kPa 7.097.40 7.157.45 7.207.41 7.347.45 7.387.45 7.377.45 7.357.43 < 2.9 2.24.7 9.311.4 9.513.9 4.85.9 kPa kPa kPa kPa kPa 184 Blood, arterial Blood, mixed venous Blood Blood, arterial Blood, mixed venous 184 Blood 184 Blood References 184 184 184 Blood, arterial Blood, venous Blood Notes Blood, arterial, venous
Adults pH Children Children
Adults pO2 Children
Standard bicarbonate
Children Children
1221 mmol/L 1923 1925 2024 2126 mmol/L mmol/L mmol/L mmol/L
1221 mmol/L 1923 1925 2024 2126 mmol/L mmol/L mmol/L mmol/L
2229 mmol/L
2229 mmol/L
Serum, plasma
100
101
2.5 Therapeutic drug monitoring

Analyte Group Acetaminophene Acetylsalicylic acid Amikacin Therapeutic Range* Conventional 1030 mg/mL 50300 mg/mL Peak: 2025 mg/mL Trough: 510 mg/mL <200 mg/mL 520 mg/mL 812 mg/mL 612 mg/mL Chloramphenicol Cyclosporine Digitoxin 1025 mg/mL No firm therapeutic range exists. 1030 ng/mL SI 66199 mmol/L 0.831.66 mmol/L 3443 mmol/L 917 mmol/L <200 mg/L 26103 mmol/L 33.850.8 mmol/L 25.450.8 mmol/L 3177 mmol/L Range must be established for the specific assay used. 1339 nmol/L 193 218 218 Whole blood Fluorescence polarization immunoassay, turbidimetric immunoassay, electrochemiluminescence immunoasay, Roche Diagnostics Electrochemiluminescence immunoassay, homogeneous enzyme immunoassay, Roche Diagnostics Fluorescence polarization immunoassay, immunoturbidimetric immunoassay, Roche Diagnostics 193 193 218 Fluorescence polarization immunoassay, immunoturbidimetric immunoassay, Roche Diagnostics Homogeneous enzyme immunoassay, Roche Diagnostics 218 218 Fluorescence polarization immunoassay, Roche Diagnostics, blood collection: during infusion Colorimetric assay, direct ISE, Roche Diagnostics, blood collection: 12 h after final dose Reference 218 193 218 Notes Immunoturbidimetric assay, Roche Diagnostics Blood collection: 13 h after oral dose. Fluorescence polarization immunoassay, immunoturbidimetric immunoassay, Roche Diagnostics Immunoturbidimetric assay, Roche Diagnostics, laboratory-dependent cutoff in urine. Homogeneous enzyme immunoassay, immunoturbidimetric assay, Roche Diagnostics Fluorescence polarization immunoassay, Roche Diagnostics
Benzodiazepine Caffeine Carbamazepine
218 193 218
Digoxin
0.92.0 ng/mL
1.22.6 nmol/L
218
0.82.0 ng/mL
1.02.6 nmol/L
Disopyramide Ethosuximide Gentamicin
25 mg/mL 40100 mg/mL Peak: 610 mg/mL Trough: 0.52.0 mg/mL Peak: 610 mg/mL Trough: 0.52.0 mg/mL
615 mmol/L 283708 mmol/L 12.520.9 mmol/L 1.04.2 mmol/L 10.520.9 mmol/L 1.04.2 mmol/L 626 mmol/L 0.61.2 mmol/L
Lidocaine Lithium
1.56 mg/mL 0.61.2 mEq/L
* The therapeutic range given is a general recommendation which can only be clinically
interpreted in conjunction with the toxicity and the therapeutic efficacy of the drug monitored.
102
103

Analyte Group Methotrexate Therapeutic Range* Conventional A generally applicable therapeutic range is not available. Therapeutic range not yet fully established and dependent 530 mg/mL SI Therapeutic concentrations depend on the treatment protocol. on transplant type and co-administered drugs. 18.1108.3 mmol/L References 299 Notes Collect specimen at 0.5 or 2 h after i.v. or p.o. low dose, respectively. Collect specimen at 24, 48, and 72 h after high-dose infusion.
Mycophenolic acid, total (MPA) N-Acetytylprocainamide (NAPA)
218 218 Immunoturbidimetric assay, homogeneous immunoassay, fluorescence polarization immunoassay, Roche Diagnostics; commonly accepted therapeutic range for the sum of NAPA and procainamide. For effective treatment, some patients may require serum/plasma levels outside thise range. Immunoturbidimetric assay, homogeneous immunoassay, fluorescence polarization immunoassay, Roche Diagnostics; some patients may require serum/plasma levels outside thise range to obtain effective seizure control. Immunoturbidimetric assay, homogeneous immunoassay, fluorescence polarization immunoassay, Roche Diagnostics. Fluorescence polarization immunoassay, Roche Diagnostics. Immunoturbidimetric assay, homogeneous immunoassay, fluorescence polarization immunoassay, Roche Diagnostics. Thrapeutic ranges established with unspecific methods that measure quinidine as well as quinidine metabolites. Antipyretic/analgetic conditions. Anti-inflammatory/rheumatic fever conditions. Colorimetric assay, enzymatic UV test; Roche Diagnostics.
Phenobarbital
1540 mg/mL
65172 mmol/L
218
Phenytoin
Premature infants Adults
614 mg/mL approx. 1020 mg/mL 512 mg/mL 410 mg/mL
2456 mmol/L approx. 4080 mmol/L 22.950 mmol/L 16.942.3 mmol/L
218
Primidone Procainamide
218 218
Quinidine
1.55 mg/mL
4.615 mmol/L
218
Salicylic acid
30100 mg/mL 150300 mg/mL
0.220.72 mmol/L 1.092.17 mmol/L
218
Tacrolimus
520 ng/mL (trough)
416 mmol/L (trough)
299
104
105

Analyte Group Theophylline Therapeutic Range* Conventional approx. 1020 mg/mL SI approx. 56111 mmol/L References 218 Notes Homogeneous immunoassay, fluorescence immunoassay, immunoturbidimetric assay, Roche Diagnostics. Homogeneous immunoassay, fluorescence immunoassay, Roche Diagnostics Homogeneous immunoassay, fluorescence immunoassay, Roche Diagnostics Fluorescence immunoassay, Roche Diagnostics Homogeneous immunoassay, fluorescence immunoassay, Roche Diagnostics
Tobramycin Valproic acid free fraction Vancomycin
Peak: 610 mg/mL Trough: 0.52.0 mg/mL 50100 mg/mL 515 % of the plasma value Peak: 2040 mg/mL Trough: 510 mg/mL
Peak: 12.821.4 mmol/L Trough: 1.14.3 mmol/L 347693 mmol/L 0.050.15 of the plasma value Peak: 1428 mmol/L Trough: 3.57.0 mmol/L
218 218
218
106
107
2.6.1 Urinalysis, urinary sediment and status

Analyte Group Bacteria Specific gravity Children Adults Neonates Children Adults Reference Ranges Conventional <103 / mL <105 / mL 1.012 g/mL 1.0021.006 g/mL 1.0021.030 g/mL SI <10 9 /L <1011 /L 1.012 g/mL 1.0021.006 g/mL 1.0021.030 g/mL References 218 218 Chamber count Daily urine, normal diet Notes
Urinary sediment Erythrocytes Leucocytes Squamous epithelial cells Renal epithelial cells Casts hyaline epithelial erythrocyte granulated leucocyte Bacteria Yeast cells Trichomonads Salts 01 per field (<5/ mL) 14 per field (<10/ mL) 515 per field Not detectable Only occasional Not detectable Not detectable Not detectable Not detectable Not detectable Not detectable Not detectable Not detectable 01 per field (<5 Mpt/L) 14 per field (<10 Mpt/L) 515 per field Not detectable Only occasional Not detectable Not detectable Not detectable Not detectable Not detectable Not detectable Not detectable Not detectable 214 Group classification per field (magnification q 400): Not detectable 01 14 515 1550 > 50 Crowding Group classification per field (magnification q 400): Not detectable (+) + ++ +++ Crowding
108
109
2.6.1 Urinalysis, urinary sediment and status

Analyte Group Urinary status Bilirubin Erythrocytes Glucose Ketone bodies (acetacetate) Leucocytes Nitrite pH Protein Specific gravity Urobilinogen Urine volume Neonates 2 mth1 yr 23 yr > 10 yr Adults Reference Ranges Conventional <0.2 mg/dL <5/ mL <15 mg/dL <5 mg/dL <10/ mL Not detectable 4.87.4 <10 mg/dL 1.0151.025 g/mL <1 mg/dL 1560 250500 600750 7001 500 1 0001 500 mL/24 mL/24 mL/24 mL/24 mL/24 h h h h h SI <3.4 mmol/L <5 Mpt/L <0.84 mmol/L <0.5 mmol/L <10 Mpt/L Not detectable 4.87.4 <0.1 g/L 1.0151.025 <16.9 mmol/L 0.020.06 L/d 0.250.50 L/d 0.600.75 L/d 0.701.50 L/d 1.001.50 L/d 47 Normal liquid intake References 218 Combur10Test Fasting Notes
110
111
2.6.2 Clinical chemical urinalysis

Analyte Group
a1-Acid glycoprotein (Orosomucoid)
Reference Ranges Conventional <4.4 mg/g crea <1.6 mg/g crea
SI <0.5g/mol crea <560 mmol/mol crea
References 112 275
Notes Radial immunodiffusion, spontaneously voided urine. Deep-freeze immediately
1 mth15 yr Adults
Adenosine monophosphate, 3l 5l, cycl. Albumin Children
<1 mth 112 mth 15 yr 610 yr 1115 yr Adults 35 yr
<252 mg/L <12.3 mg/L <19.0 mg/L <30.4 mg/L <25.5 mg/L <20 mg/g crea or <20 mg/L or <37 mg/g or <2 mg/dL or <30 mg/24 h <6.4 mg/24 h 447 U/L 491 U/L 390 U/g crea 283 U/g crea <6 mg/kg/24 h <260 mg/24 h <320 mg/24 h 100321 mg/24 h or 6.821.3 mg/dL 1.416 mmol/24 h 50250 mmol/24 h 60600 mmol/24 h 23105 mg/24 h 420 mg/24 h 190450 mg/24 h 75199 mEq/L 46168 mEq/L 110250 mEq/24 h
<21 <3.8 <3.3 <2.7 <2.1
mg/mmol crea mg/mmol crea mg/mmol crea mg/mmol crea mg/mmol crea
112
Spontaneously voided urine, radial immunodiffusion
Children
<2.26 g (34.35 mmol)/mol crea <0.304 mmol/L or <0.304 mmol/L or <0.456 mmol/d <49 mmol/d 7.46 mkat/L 8.20 mkat/L 6.51 mkat/g crea 4.73 mkat/g crea <0.15 mmol/kg/d <6.5 mmol/d <8.0 mmol/d 2.58.0 mmol/d or 1.75.3 mmol/L 1.416 mmol/d 50250 mmol/d 60600 mmol/d 136620 nmol/d 22109 nmol/d 1.262.98 mmol/d 75199 mmol/L 46168 mmol/L 110250 mmol/d <4.2 mmol/d 0.160.94 mmol/d 100379 nmol/d
218
2nd morning urine 24 h-urine Immunoturbidimetric assay, Roche Diagnostics 24 h-urine to be acidified with HCI, pH 23 Spontaneously voided urine Amylase/creatinine quotient
d-Aminolevulic acid a-Amylase, total
Adults Adults Adults f m f m Children f m
60 218
pancreatic Calcium
134 218 242
24 h-urine, acidified (pH <2) with HCl 24 h-urine (assumed volume: 1.5 L)
Adults
Carnitin, free
Neonates Infants Adults Adults
Catecholamines Norepinephrine Epinephrine Dopamine Chloride
58
24 h-urine with 1 g boric acid, HPLC
Adults
148 299 107 171 218
24 h-urine 1st morning urine 24 h-urine
Citrate (as citric acid) Copper Cortisol, free
Adults Adults Adults
<805 mg/24 h 1060 mg/24 h 36137 mg/24 h
24 h-urine, Cortisol Elecsys
112
113

Analyte Group C-Peptide Creatinine Adults Adults f m f m f m f m Creatinine clearance Adults Reference Ranges Conventional 17.2181 mg/24 h 28217 mg/dL 39259 mg/dL 0.74- 1.57 g/24 h 1.042.35 g/24 h 29226 mg/dL 40278 mg/dL 0.721.51 g/24 h 0.982.20 g/24 h 71.2151 mL/min 82.5120 mL/min 77132.2 mL/min 52.1110 mL/min 67.5141 mL/min 64.397.7 mL/min 66.3143 mL/min 79.9167 mL/min 76.6127.3 mL/min Cystine Deoxypyridinolin total free Fructose Galactose Glomerular filtration rate (GFR) Glucose Adults Neonates Adults 30 yr 50 yr 70 yr Adults Clinical patients 5.537 mg/24 h 1964 mg/g crea 635 mg/g crea <60 mg/24 h <60 mg/dL <14 mg/24 h 79131 mL/min 75121 mL/min 54102 mL/min <20 mg/dL <15 mg/dL <17 mg/dL 5-Hydroxyindole acetic acid Hydroxyproline Adults Adults, 2675 yr <8 mg/24 h 4.825 mg/24 h q m2 body surf. SI 5.7460.3 nmol/d 2.4719.2 mmol/L 3.4622.9 mmol/L 6.613.9 mmol/d 9.220.7 mmol/d 2.5520.0 mmol/L 3.5424.6 mmol/L 6.313.4 mmol/d 8.6- 19.4 mmol/d 71.2151 mL/min 82.5120 mL/min 77132.2 mL/min 52.1110 mL/min 67.5141 mL/min 64.397.7 mL/min 66.3143 mL/min 79.9167 mL/min 76.6127.3 mL/min 46306 pmol/d 517 mmol/mol crea 1.69.3 mmol/mol crea <0.3 mmol/d <3.3 mmol/L <0.1 mmol/d 79131 mL/min 75121 mL/min 54102 mL/min <1.1 mmol/L <0.8 mmol/L <0.96 mmol/L <41 mmol/d 37190 mmol/d q m2 body surf. 157 23 105 105 81
51
References 218 172
Notes 24 h-urine, C-Peptide Elecsys Roche Diagnostics, kinetic Jaff method, rate-blanked, compensated, 1st morning urine. Roche Diagnostics, kinetic Jaff method, rate-blanked, compensated, 24 h-urine. Roche Diagnostics, enzymatic method, 1st morning urine. Roche Diagnostics, enzymatic method, 24 h-urine. Roche Diagnostics, Jaff kin., rateblanked, compensated, measured. Calculated acc. to Cockroft-Gault. Calculated using MDRD study formula. Roche Diagnostics, Jaff kin., rateblanked, non-compensated, measured. Calculated acc. to Cockroft-Gault. Calculated using MDRD study formula. Roche Diagnostics, enzym. method, measured. Calculated acc. to Cockroft-Gault. Calculated using MDRD study formula. 24 h-urine, pH 23
126 172 126 126
Cr-EDTA clearance
218 148 284 38
1st morning urine. Spontaneously voided urine. 24 h-urine 24 h-urine, HPLC 24 h-urine
114
115

Analyte Group Immunoglobulin light chains k/l ratio Immunoglobulin G (IgG) Children Adults <1mth 112 mth 15 yr 610 yr 1115yr Adults Iron Lysozyme Magnesium Mercury
a1-Microglobulin
Reference Ranges Conventional 0.704.50 18.850 mg/L Not detectable 3.75.3 mg/L 5.48.3 mg/L 7.111.1 mg/L <9 mg/24 h (<9 mg/g crea) <98 mg/24 h <3.6 mg/24 h 9.712.2 mg/24 h 7.312.2mg/dL Adults < 26 mg/L 2855 mg/L 1.14.2 mg/L 3.74.8 mg/L 4.17.4 mg/L 5.78.0 mg/L <20 mg/24 h (<1.2 mg/dL) <14 mg/g (<1.58 g/mol) crea 400800 mosmol/kg
SI 0.704.50 18.850 mg/L Not detectable 3.75.3 mg/L 5.48.3 mg/L 7.111.1 mg/L <9 mg/d (<1.0 g/mol crea) <1.8 mmol/d <3.6 mg/d 45 mmol/d 3.05.0 mmol/L < 130 nmol/L 2855 mg/L 1.14.2 mg/L 3.74.8 mg/L 4.17.4 mg/L 5.78.0 mg/L <20 mg/d (<12 mg/L) <52.6 mmol/mol crea 400800 mmol/kg <0.27 <0.65 <0.43 <0.50 <0.40 <0.47 <0.44 <0.35 <0.40 <0.37 <0.44 <0.40 mmol/d mmol/d mmol/d mmol/d mmol/d mmol/d mmol/d mmol/d mmol/d mmol/d mmol/d mmol/d
References 218 112
Notes Roche Diagnostics, immunoturbidimetric method Spontaneously voided urine, radial immunodiffusion
88 235 299 226 299 230 112
Roche Diagnostics, immunoturbidimetric method 24 h-urine 24 h-urine 24 h-urine Radial immunodiffusion, spontaneously voided urine.
Children
<1 mth 112 mth 15 yr 610 yr 1115 yr Adults
218 133 114
24 h-urine 2nd morning urine
Osmolality Oxalate Children 112 mth 13 yr 46 yr 79 yr 1012 yr 1315 yr f m f m f m f m f m f m Adults Phosphate, inorganic 1260 yr
<23 mg/24 <57 mg/24 <38 mg/24 <44 mg/24 <35 mg/24 <41 mg/24 <38 mg/24 <31 mg/24 <35 mg/24 <32 mg/24 <39 mg/24 <35 mg/24
h h h h h h h h h h h h
24 h-urine collected with 10 mL conc. HCl
<45 mg/24 h 0.41.3 g/24 h 40140 mg/dL
< 0.50 mmol/d 1342 mmol/d 1344 mmol/L
107 104 148 24 h-urine, on nonrestricted diet 1st morning urine
116
117

Analyte Group Porphyrins Total porphyrin Uroporphyrin Heptacarboxyporphyrin Hexacarboxyporphyrin Pentacarboxyporphyrin Coproporphyrin Tricarboxyporphyrin Dicarboxyporphyrin Potassium Adults Reference Ranges Conventional <100 mg/24 h <24 mg/24 h <3 mg/24 h <2 mg/24 h <4 mg/24 h 1478 mg/24 h <2 mg/24 h <1 mg/24 h Adults 3283 mEq/L 2080 mEq/L 25125 mEq/24 h Protein, Total Adults <15 mg/dL <14 mg/dL <150 mg/24 h Pyridinolin, total free Sodium Adults Adults 103260 mg/g crea 40159 mg/g crea 71171 mEq/L 54190 mEq/L 40220 mEq/24 h Transferrin Urea Adults Adults <1 mg/g crea <1 mg/24 h <35 g/24 h 0.93.0 g/dL 25.842.6 g/24 h Uric acid Adults 0.201.00 g/24 h 3792 mg/dL Vanillylmandelic acid (VMA) Adults 3.36.5 mg/24 h SI <120 nmol/d <29 nmol/d <4 nmol/d <3 nmol/d <6 nmol/d 21119 nmol/d <2 nmol/d <1 nmol/d 3283 mmol/L 2080 mmol/L 25125 mmol/24 h <150 mg/L <140 mg/L <150 mg/d 2768 mmol/mol crea 1042 mmol/mol crea 71171 mmol/L 54190 mmol/L 40220 mmol/24 h <113 mg/mol crea <1 mg/d <580 mmol/d 150500 mmol/L 430710 mmol/d 1.26.0 mmol/d 2.25.5 mmol/L 1833 mmol/d 148 299 128 299 218 23 148 299 88 234 299 234 148 297 24 h-urine 1st morning urine 24 h-urine Benzethonium chloride method, random urine Turbidimetry, nephelometry, 24 h-urine Benzethonium chloride method, 24 h-urine 24 h-urine or spontaneously voided urine. Sampling between 11 a.m. and 1 p.m. 24 h-urine 1st morning urine 24 h-urine Spontaneously voided urine 24 h-urine 24 h-urine 1st morning urine 24 h-urine 24 h-urine, concn. considerably diet-related 1st morning urine, concn. considerably diet-related References 60 Notes
Protect sample from light
118
119
2.7 Urinary calculi, gallstones

Concrement Gallstones Bilirubin Calcium carbonate Cholesterol Urinary calculi Calcium hydrogen phosphate dihydrate Calcium oxalate dihydrate Calcium oxalate monohydrate Carbonate apatite Cystine 2,8-Dihydroxyadenine Magnesium ammonium phosphate hexahydrate Magnesium ammonium phosphate monohydrate Mono-ammonium urate Mono-sodium urate monohydrate Protein Uric acid Uric acid dihydrate Xanthine 99 Major components References 99
120
121
2.8 CSF
Analyte Group Albumin Albumin, CSF/ serum ratio Children Adults Cells Glucose IgA IgG IgM Lactate Children Adults 15 yr 40 yr 60 yr Neonates Adults Children Adults Adults Adults Adults Neonates 310 d >10 d Adults Protein, total Premature infants 2732 w of pregnancy 3336 w of pregnancy 3740 w of pregnancy 1 d1 mth 23 mth 46 mth 712 mth 2 yr 34 yr 58 yr Adults Reference Range Conventional 110350 mg/L 5.0 q 10 3 6.5 q 10 3 8.0 q 10 3 <32 leucocytes/mL <3 leucocytes/mL 6080 mg/dL 4070 mg/dL 0.56.0 mg/L 1040 mg/L 0.050.8 mg/L 1060 mg/dL 1040 mg/dL 1025 mg/dL 1022 mg/dL 68240 67230 58150 2572 2072 1550 1045 1040 1038 1043 <45 mg/dL mg/dL mg/dL mg/dL mg/dL mg/dL mg/dL mg/dL mg/dL mg/dL mg/dL SI 110350 mg/L References 211 5.0 q 10 3 210, 218 6.5 q 10 3 8.0 q 10 3 <32 mpt leucocytes/L <3 mpt leucocytes/L 3.334.44 mmol/L 2.223.89 mmol/L 3.137.5 nmol/L 66.7266.8 nmol/L 0.050.8 nmol/L 1.16.7 mmol/L 1.14.4 mmol/L 1.12.8 mmol/L 1.12.4 mmol/L 0.682.40 0.672.30 0.581.50 0.250.72 0.200.72 0.150.50 0.100.45 0.100.40 0.100.38 0.100.43 <0.45 g/L g/L g/L g/L g/L g/L g/L g/L g/L g/L g/L 214 218 211 211 211 299 Notes
98 134
Electrophoresis Prealbumin Albumin a1-Globulin a2-Globulin b-Globulin g-Globulin
5.49.0 % 55.365.9 % 2.85.6 % 2.84.8 % 9.915.5 % 8.214.6 %
0.0540.090 0.5530.659 0.0280.056 0.0280.048 0.0990.155 0.0820.146
141
122
123
2.9 Stool
Analyte Conventional Albumin Blood <100 mg/fecal smear Not detectable Reference Ranges SI <100 mg/fecal smear Not detectable References 185 214 No intake of fish, meat, radish, horseradish, iron- or copper-containing preparations 3 days prior to test Notes
Chymotrypsin Composition
Adults Dry substance Volume of water Neutral fats Bile acid Stercobilinogen + Stercobilin
>13.2 U/g 1060 g/24 100180 mL/24 <7 g/24 300400 mg/24 h h h h
>220 nkat/g 1060 g/d 100180 mL/d <7 g/d 300400 mg/d 60200 mg/d <0.72 mmol/g stool <2.4 mg/g stool 5195 1684420 >200 100200 <100
mg/g mg/g mg/g mg/g mg/g
218 214
60200 mg/24 h <46 mg/g stool <2.4 mg/g stool
Copper Lactoferrin Pancreatic elastase Neonates Infants, children Adults
52 276 258 231 Normal Light to medium insufficiency Strong insufficiency
5195 1684420 >200 100200 < 100
mg/g mg/g mg/g mg/g mg/g
stool stool stool stool stool
stool stool stool stool stool
Weight Zinc
Adults Adults
100250 g/24 h <408 mg/g stool
100250 g/d <408 mg/g stool
214 52
124
125
2.10 Spermiogram
Analyte
a-Glucosidase
Reference Ranges > 20 mU/ejaculate > 200 mmol/ejaculate > 52 mmol/ejaculate > 13 mmol/ejaculate < 1 mil/mL < 10 % of spermatozoa with adhesive particles or erythrocytes > 30 % normally formed spermatozoa > 50 % spermatozoa with progressive motility (categories a and b) or > 25 % spermatozoa with rapid progressive motility (category a) 7.2 7.8 > 20 mil spermatozoa/mL > 40 mil spermatozoa/ejaculate > 75 % vital spermatozoa, i.e. cells not absorbing eosin dye > 2 mL > 2.4 mmol/ejaculate
References 291
Analyte Normozoosperms Oligozoosperms Cryptozoosperms Polyzoosperms Asthenozoosperms
Reference Ranges Normal ejaculate findings < 20 mil spermatozoa/mL < 1 mil spermatozoa/mL > 250 mil spermatozoa/mL < 50 % of spermatozoa with progressive motility (categories a and b) and < 25 % of spermatozoa with motility of category a < 30 % of spermatozoa with normal morphology Combination of oligo-, astheno- and teratozoosperms No spermatozoa in the ejaculate Ejaculate volume < 2 mL Ejaculate volume > 6 mL No ejaculate Erythrocytes in ejaculate
References 291
Acid phosphatase Citrate Fructose Leucocytes MAR test Morphology Motility
Teratozoosperms Oligoasthenoteratozoosperms Azoosperms Parvisemia Hypersemia Aspermia Hemosperms
pH Sperm concentration Total sperm count Vitality Volume Zinc
126
127
2.11 Extravascular body fluids

Amniotic fluid Analyte Albumin Bicarbonate Bilirubin Calcium CEA Chloride Creatinine Erythropoietin Glucose hCG Lysozyme Osmolality Phosphate, inorg. Potassium Prolactin Protein Sodium Urea Ascites Analyte Nonmalignant CEA Cholesterol LDH Phospholipids Protein Triglycerides < 2.5 mg/L < 45 mg/dL < 60 % of the serum LDH 0.15 0.84 mmol/L < 30 g/L 14 164 mg/dL Reference Ranges Malignant > 2.5 mg/L > 45 mg/dL > 60 % of the serum LDH 0.14 1.34 mmol/L > 30 g/L 17 849 mg/dL 9 = ; Ref. Reference Ranges < 3.0 g/L 11 45 mmol/L < 0.1 mg/dL 0.86 2.57 mmol/L < 107 mg/L 83 111 mmol/L 0.2 0.7 mg/dL 1.2 6.5 U/L 45 76 mg/dL < 4300 IU/L 6 12 mg/L 268 280 mosmol/kg 0.5 2.8 mmol/L 3.7 4.4 mmol/L < 70 nmol/L < 4.0 g/L 139 144 mmol/L 12 32 mg/dL 9 > > = > > ; Ref. Bile, clear colorless fluid Analyte Bilirubin Calcium Chloride Cholesterol Glucose Lysozyme Magnesium Osmolality pH Phosphate, inorg. Phospholipids Potassium Protein Sodium Bile, yellow bile Analyte Bicarbonate Bilirubin Calcium Chloride Cholesterol Color Glucose Iron excretion Magnesium Osmolality pH Phosphate, inorg. Phospholipids Protein Potassium Sodium Volume Reference Ranges 7 42 mmol/L 9 77 mg/dL 2.3 4.9 mmol/L 80 144 mmol/L 123 209 mg/dL yellow < 8 mg/dL 0.14 0.50 mmol/h 0.7 1.3 mmol/L 1016 1018 mosmol/kg 5.78 8.22 < 0.6 mmol/L 113 381 mg/dL 2 6 g/L 3.8 5.4 mmol/L 144 170 mmol/L 0.5 1 L/24 h 9 > > > = > > > ; Ref. Reference Ranges < 1.3 mg/dL 0.6 4.6 mmol/L 94 152 mmol/L 6 20 mg/dL < 5 mg/dL < 0.8 mg/L < 0.2 mmol/L 1006 1019 mosmol/kg 6.64 8.46 < 1.0 mmol/L < 50 mg/dL 3.0 6.6 mmol/L < 9 g/L 138 162 mmol/L 9 > > > = > > > ; 9 > > > > > > > > > = > > > > > > > > > ; Ref.
39 61 39 39 37 39 61 91 39 39 39 61 39
274 91
274
9 = ;
274
76 75 76 75
9 > > > > > > > > > = > > > > > > > > > ;
274 204
274
128
129
Coelomic fluid Analyte Albumin Bicarbonate Bilirubin Calcium Chloride Creatinine Glucose Osmolality Phosphate, inorg. Potassium Sodium Urea Duodenal fluid Analyte Calcium Potassium Sodium Amylase Bicarbonate Chymotrypsin Lipase Trypsin Volume Reference Ranges 0.7 4.2 mmol/L 4.2 11.0 mmol/L 97 153 mmol/L 9 = ; 9 > > > > > = > > > > > ; Ref. Reference Ranges 2.0 11 g/L 16 29 mmol/L < 0.5 mg/dL 1.8 3.0 mmol/L 100 115 mmol/L 0.4 3.0 mg/dL 50 88 mg/dL 264 275 mosmol/kg 1.2 12 mmol/L 3.5 4.2 mmol/L 135 141 mmol/L 16 41 mg/dL 9 > > > > > > > > > > > > > > > > > = > > > > > > > > > > > > > > > > > ; Ref.
Gastric juice Analyte Ammonium Ascorbic acid Calcium CEA Chloride 39 Citrate Free acid b-Glucosidase Lactate LDH Lysozyme Magnesium Mucin pH Potassium 77 Pyruvate Sodium Urea Uric acid Lymph Analyte Albumin Amylase Calcium Chloride Cholesterol Erythrocytes Glucose GOT GPT Leucocytes pH Potassium Protein Sodium Triglycerides Urea Reference Ranges 12 42 g/L 50 83 U/L 1.7 3.0 mmol/L 85 130 mmol/L 65 220 mg/dL 50 600/ mL 48 200 mg/dL 22 40 U/L 5 21 U/L 400 6800/ mL 7.4 7.8 3.8 5.0 mmol/L 22 60 g/L 104 108 mmol/L higher than in serum 17 36 mg/dL 9 > > > > > > > > > > > > > > > > > > > > > > > > > = > > > > > > > > > > > > > > > > > > > > > > > > > ; Ref. Reference Ranges 0.6 1.9 mmol/L 17 31 mg/L 0.6 7.0 mmol/L < 0.5 mg/L 84 119 mmol/L 57 137 mmol/L 3.3 6.5 mg/dL < 78 mmol/L < 5.0 mg/L 1.9 3.7 mg/dL < 35 U/L 43 106 mg/L 0.5 3.2 mmol/L < 0.4 g/L 2.0 4.0 1.6 2.4 10.7 14.2 mmol/L 5.0 11.8 mmol/L 0.5 0.8 mg/dL 60 69 mmol/L 32 84 mmol/L 0.7 1.6 mg/dL 0.7 1.4 mg/dL Ref. 136 207 178 32 3 178 201 178 221 201 221 91 178 17 3 207 3 178 190 3 178 201 201
6 48 mth Adults
6 48 mth Adults 6 48 mth Adults 6 48 mth Adults
after secretin stimulation
8 130 3400 U/min > > > > 8 73 mmol/h > < 16 150 U/min 950 7200 U/min > > > > 1 42 mg/min > : 120 800 mL/h
225
277
Differentiation between chyle and pseudochyle is possible with the detection of chylomicrons (only in chyle) and triglycerides 2 to 8 times higher in chyle than in pseudochyle (45).
130
131
Milk, human Analyte Calcium Chloride Cholesterol Copper Folate g-GT Iron Lactose Lysozyme Magnesium Phosphate, inorg. Phospholipids Potassium Protein Sodium Triglycerides Vitamin A Vitamin B1 Vitamin B2 Vitamin B6 Vitamin B12 Vitamin C Vitamin E Vitamin K Zinc Nasal secretion Analyte Calcium Glucose b2-Microglobulin Potassium Protein Sodium Reference Ranges 1.0 1.8 mmol/L < 10 mg/dL not detectable 6 28 mmol/L 1 35 g/L 90 148 mmol/L 9 > > = > > ; Ref. 63 142 63 Reference Ranges 7.2 8.4 mmol/L 10.9 14.6 mmol/L 7.0 9.5 mg/dL 197 751 mg/L 8 13 mg/dL 1300 8300 U/L 0.20 1.71 mg/L 62 78 g/L 55 75 mg/L 1.4 1.7 mmol/L 4.0 4.9 mmol/L 5.5 12.3 mg/dL 10.6 13.0 mmol/L 19 20 g/L 4.0 6.0 mmol/L 1.9 3.9 g/dL 30 60 mg/dL 17 24 mg/dL 40 60 mg/dL 9 31 mg/dL 16 97 mg/dL 3.8 17 mg/dL 0.2 0.3 mg/dL 0.12 0.92 mg/dL 0.75 4.0 mg/L Ref. 70 282 29 119 222 197 119 282 91 70 70 29 70 135 29 19
Pancreatic juice Analyte Amylase Bicarbonate Chymotrypsin Lipase Potassium Protein Trypsin Volume |{z} Reference Ranges 400 1780 U/min > 70 mmol/L 28 154 U/min after stimulation 780 3500 U/min 3 10 mmol/L 0.2 1.0 g/L 56 335 U/min > 1.6 mL/min |{z} 9 > > > = > > > ; 9 > > > > > = > > > > > ; |{z} Ref.
213 167 296 213 213
Peritoneal fluid Analyte Amylase Creatinine D-dimer Urea Volume Pleural fluid Reference Ranges 88 109 U/L 0.5 2.0 mg/dL < 0.77 mg/L 3 27 mg/dL 1 9 mL Ref. 92 170 287 170 287
9 > > > > > > > > > = > > > > > > > > > ;
222
Analyte Transsudate LDH LDH punctate/ serum ratio Protein Protein punctate/ serum ratio Cells Mesothelial cells Monocytes Lymphocytes Granulocytes Glucose pCO2 pH Protein Albumin Volume < 200 U/L < 0.6 < 3 g/dL < 0.5
Reference Ranges Exsudate > 200 U/L > 0.6 > 3 g/dL > 0.5 1000 5000/ mL 3 70 % 30 75 % 2 30 % < 10 % equal to plasma 105 565 mmHg 7.07 7.71 1.0 2.0 g/dL 50 70 % of protein 0.1 0.2 mL/kg body weight
Ref.
119
169
30
279 279 30
132
133
Saliva Analyte Calcium Flowrate IgA pH Potassium Protein Sodium Albumin ALP Ammonium Amylase Calcium Cells Macrophages Neutrophiles Bronchial epithelial cells Lymphocytes Eosinophiles Chloride CO2 Cortisol morning evening Creatinine Glucose GOT GPT IgA LDH Lysozyme Magnesium Osmolality pH Phospate, inorg. Potassium Protein Sodium Testosteron Urea Uric acid Reference Ranges Parotid saliva Submandibular saliva 177 14 14 73 177 14 177 87 209 117 209 209 1.5 2.5 mmol/L 0.8 17 mL/15 min 0.4 9.8 mL/15 min 0.2 8.8 IU/mL < 4.5 IU/mL 5.1 6.3 5.9 7.3 14 26 mmol/L 0.7 21 g/L 0.3 5.5 g/L 10 54 mmol/L Mixed saliva 246 344 mg/L < 11 U/L 1.1 12.0 mmol/L 11 900 304 700 U/L 0.88 2.05 mmol/L 0.67 9.73 x 106 /g 33 86 % 11 64 % <4% <3% <1% 5 40 mmol/L < 11 mmol/L 3 43 nmol/L < 10 nmol/L 0.07 0.20 mg/dL < 2 mg/dL < 43 U/L < 11 U/L 42 174 mg/L 113 609 U/L 6 12 mg/L 0.08 0.56 mmol/L 52 111 mosmol/kg 6.42 7.41 1.4 13.2 mmol/L 6.4 37 mmol/L 1.1 1.8 g/L 2 21 mmol/L 0.18 0.26 mg/L 17 41 mg/dL 0.7 6.0 mg/dL Ref.
Sweat Analyte Ammonium Chloride 6 15 yr 16 25 yr 26 35 yr 36 45 yr 46 55 yr Glucose Lactate Lysozyme a1-Microglobulin b2-Microglobulin pH Potassium f m f m f m f m f m Reference Ranges 1.4 4.7 mmol/L 41 102 mmol/L 41 100 mmol/L 71 96 mmol/L 60 101 mmol/L 75 100 mmol/L 71 102 mmol/L 71 102 mmol/L 90 103 mmol/L 75 108 mmol/L 96 107 mmol/L < 7 mg/dL 21 57 mmol/L 0.06 0.14 mg/L 6 34 mg/L 3.6 6.4 mg/L 4.0 6.8 10.7 13.6 mmol/L 11.4 23.2 mmol/L 18.8 28.2 mmol/L 13.5 40.0 mmol/L 20.0 28.8 mmol/L 22.0 43.6 mmol/L 16.3 33.0 mmol/L 28.2 44.8 mmol/L 23.0 25.2 mmol/L 32.8 40.0 mmol/L 39 102 mmol/L 44 105 mmol/L 77 94 mmol/L 62 113 mmol/L 83 98 mmol/L 75 119 mmol/L 79 97 mmol/L 75 136 mmol/L 92 109 mmol/L 65 146 mmol/L 56 234 mg/dL 0.2 0.7 mg/dL 500 mL/24 h 9 > > > > > > > > > > > > > = > > > > > > > > > > > > > ; 9 = ; 9 > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > = > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > ; Ref. 35
168 241 100 86
9 > > > > > > > = > > > > > > > ;
6 15 yr 16 25 yr
26
9 = ;
86 209 218 218 134 209 87 209 91 209 Sodium
26 35 yr 36 45 yr 46 55 yr 6 15 yr 16 25 yr 26 35 yr 36 45 yr 46 55 yr
9 > > > = > > > ;
87 86 243 209 209
f m f m f m f m f m f m f m f m f m f m
Urea Uric acid Volume
257 257 86
134
135
Synovial fluid Analyte C3C Cell count Colour Glucose Hyaluronic acid IgA IgG IgM Immunoglobulins Interleukin-1b Lactate LDH pH Protein Salts Segmented granulocytes Serotonin Uric acid Volume Tears Analyte Albumin Chloride Cholesterol Glucose HbA1c IgA IgG IgM Lactoferrin Lysozyme b2-Microglobulin pH Potassium Protein Sodium Volume Reference Ranges 14 26 mg/L 128 mmol/L 10 25 mg/dL 76 288 mg/dL 6.4 11.1 % 206 450 mg/L 3 7 mg/L 5 13 mg/L 3 7 mg/L 2.1 3.7 g/L 1.3 2.1 g/L 7.1 8.7 16 mmol/L 7.5 8.9 g/L 146 mmol/L 1 2 mL/24 h Ref. 175 86 111 120 120 Reference Ranges 0.23 0.77 mg/dL < 800/ mL light yellow and clear equal to plasma 1.5 2.5 g/L 0.6 8.2 mg/dL 1.1 19.2 mg/dL 0.4 1.9 mg/dL about 50 % serum conc. < 1.5 pg/mL equal to plasma < 240 U/L 7.3 7.6 < 25 g/L no < 10 % < 0.5 nmol/L equal to serum nearly 3.5 mL 9 = ; 9 = ; Ref. 27 229 41 27 232 5 232 232 51 232 5 232 232
2.12 Function tests 1. Oral glucose tolerance test (96) The patient eats a mixed diet consisting of more than 150 g carbohydrates per day over a period of 3 days. Any drugs known to affect glucose metabolism should be discontinued 3 days before the test. The patient must fast for a period of 12 hours. A urine sample taken from the fasting patient should be tested for glucose and ketone bodies (a positive test-strip result is a contraindication for an OGTT). The patient drinks a solution of 75 g oligosaccharides; children: 1.75 g glucose per kg body weight up to a maximum of 75 g. Exception: Pregnant women receive 50 g glucose to screen for gestational diabetes. The patient should remain seated during the test. A blood sample is collected from the fasting patient, then after 120 minutes.
175 Glucose concentration Plasma Capillary blood fasting 120 min. fasting 120 min. Normal range mg/dL mmol/L Borderline range mg/dL mmol/L Pathological range (Diabetes mellitus) mg/dL mmol/L < 110 < 6.1 110 126 6.1 7.0 > 126 > 7.0 < 140 < 7.8 140 199 7.8 11.1 > 200 > 11.1 < 95 < 5.3 95 110 5.3 6.1 > 110 > 6.1 < 140 < 7.8 140 199 7.8 11.1 > 200 > 11.1
9 = ;
9 > > > > > = > > > > > ;
86 86 174 86 86
136
137
2. Hydrogen (H2) breath test (157) The patient must fast for a period of 12 hours and not eat any heavy foods 24 hours prior to the test. The patient should not smoke or drink any mineral water 12 hours prior to the test. The patient drinks a solution of 50 g lactose and 300 mL water in 5 minutes. Children are administered 2 g lactose per kg body weight up to a maximum of 50 g lactose. The H2 concentration is measured in the breath expired prior to the start of the test, then at 30, 60 and 90 minute intervals following administration of the lactose. Reference range: A rise of < 20 ppm in the H2 concentration of the alveolar air between the lowest and the highest value finally expired (refer also to curve constructed).
3. Creatinine clearance (126) Void the bladder of prior to the test and discard the urine. Collect urine over a period exactly 24 hours. Do not add stabilizing agents; store urine in the refrigerator or at room temperature. A blood sample should be collected at the beginning and end of the collection period. The volume of the urine collected should be measured exactly, mixed thoroughly and approximately 10 mL sent to the laboratory. I. Calculation formula for a body surface area of 1.73 m2 UqV Ccr = (mL/min) S II. Calculation formula for other body surface areas UqVq1.73 (mL/min/1.73 m2 ) Ccr = SqBSA Note: For accurate evaluation of the endogenous creatinine clearance rate, it is necessary to perform two serum creatinine determinations at 24-hour intervals. The values obtained should not differ from each other by more than 10 %. Since the determination of the CCr based on a timed urine collection is inconvenient and often unreliable, various mathematical approaches for the estimation of CCr from the serum creatinine concentration were suggested. Two of these approaches have found wide recognition:
138
139
I. Calculation according to Cockroft-Gault Males: 140 ageqweight (mL/min) 75qS Females: 140 ageqweightq0.85 (mL/min) Ccr = 75qS II. Calculation according to the modified MDRD (Modification of Diet in Renal Disease) study formula Ccr = Males: Ccr = 175qS1.154 qage0.203 (mL/min) Females: Ccr = 175qS1.154 qage0.203 0:742 (mL/min) Ccr = Clearance in mL/min U = Urine creatinine concentration in mg/dL V = Volume of collected urine in mL, related to 1 min S = Serum creatinine concentration in mg/dL BSA = Body surface area in m2
Nomogram for the determination of body surface area (BSA) in square meters (63)
Connect the height in cm and the weight in kg with the edge of a transparent ruler and read the surface area in square meters at the point of intersection with the middle scale.
140
141
4. Lactose tolerance test (189) The patient must fast for a period of 12 hours. The patient drinks a solution of 50 g lactose in 400 mL water. Infants are given 4 g lactose per kg body weight. Children older than 2 years are given 2 g lactose per kg body weight up to a maximum of 50 g lactose. Capillary blood is collected for glucose determination prior to the start of the test, then at 30, 60, 90 and 120 minute intervals following administration of the lactose. Reference range: A rise in the blood glucose concentration of > 20 mg/ dL (> 1.1 mmol/L) indicates the absence of gastrointestinal disorders. Notes on test for exclusion of glucose-galactose malabsorption: Infants: + 2 g glucose + 2 g galactose/kg + body weight
5. D-xylose absorption test The patient must fast for a period of 12 hours. The bladder should be voided immediately prior to the test. The patient drinks a solution of 25 g Dxylose in 500 mL tea. The patient drinks a further 250 mL tea after a period of one to two hours. The patient must remain seated during the test. Urine is collected over a period of 5 hours. Children are administered 5 g D-xylose in 100 mL water or tea. Reference ranges: Urine (199): A D-xylose excretion in 5-hour urine of > 4.5 g (30 mmol), i. e. of > 18 % (0.18) of the amount of D-xylose administered. For children with 4 30 kg body weight (225): A serum D-xylose concentration of > 20 mg/dL (> 1.33 mmol/L) after a period of 1 hour.
Children older than 2 years: + 1 g glucose + 1 g galactose / kg + body weight Adults: + 25 g glucose + 25 g galactose
142
143
2.13 Characteristic analytes for identification of body fluids Amniotic fluid Ascites Bile Cerebrospinal fluid
a1-fetoprotein (AFP) > 10 mg/L
3 Decision supports
3.1 Enzyme patterns
No characteristic analytes Bile acids (chenodesoxycholic acid)

b2-Transferrin (not absolutely specific), chloride 113131 mmol/L, calcium 1.051.35 mmol/L, glucose approx. 6070 % of the plasma concentration, protein < 50 mg/dL (serum 140160 times higher)
x 30 x 25 x 20 x 15 x 10
1 5
Cyst fluid
Breast cysts: FSH and LH lower than in serum Renal cysts: same composition as urine Ovarian cysts (follicular cysts): estradiol elevated Pancreatic cysts: amylase, lipase High activities of amylase, lipase, trypsin, chymotrypsin pH 1.62.4, ammonia > 0.6 mmol/L Glucose < 10 mg/dL, protein 135 g/L, potassium 628 mmol/L, no b2-transferrin High activities of amylase, lipase, trypsin, chymotrypsin No characteristic analytes Ammonia > 300 mg/dL No characteristic analytes Sodium 221 mmol/L, potassium 637 mmol/L, chloride 540 mmol/L, albumin 246344 mg/L, salivary amylase Sperm Glucose < 7 mg/dL, potassium > 11 mmol/L Total protein 7.58.9 g/L (10 % of the serum concentration) with large prealbumin fraction Creatinine 90300 mg/dL, urea 0.93.0 g/dL, inorganic phosphate 40140 mg/dL
Duodenal contents Gastric secretion Nasal secretion Pancreatic secretion Pericardial fluid Peritoneal fluid Pleural fluid Saliva
x5 x1
0 Infarction
4 2 20 40 60 80 100 3
120
140 Hours
Reference range 1 CK, total 2 CK-MB
3 LDH1 4 Myoglobin 5 Troponin T
Typical enhancement of enzyme activities and protein concentrations after acute myocardial infarction (188). The y-axis represents multiples of the upper reference ranges limits.
Semen Sweat Tear fluid Urine
144
145
3.2 Lipids
1. The composition of lipoproteins Chylomicrons Total cholesterol Phospholipids Triglycerides Carbohydrates Proteins Apoproteins Protein-lipid-ratio 6% 4% 87 % <1% 1% A, B48, C, E 1:100 VLDL 813 % 615 % 6480 % 12 % 810 % A, B100, C, D, E 1:9 LDL 45 % 25 % 10 % >2% 20 % B100 1:4 HDL 20 % 30 % 25 % <1% 48 % A, C, E 1:1
3.3 Electrophoretic patterns of plasma proteins

Protein electrophoresis of healthy persons
Albumin 1-Lipoprotein (HDL) 1-Glycoprotein 1-Antitrypsin 2-Macroglobulin Haptoglobin Pre--Lipoprotein Transferrin -Lipoprotein Complement IgA IgM Prealbumin IgG 1 2
2. Classification of hyperlipoproteinemias according to FREDRICKSON Classes Typ I Typ IIa Typ IIb Typ III Typ IV Typ V Cholesterol < 260 mg/dL > 300 > 300 350 500 < 260 > 300 mg/dL mg/dL mg/dL mg/dL mg/dL Triglycerides > 1000 mg/dL < 150 150300 350500 2001000 > 1000 mg/dL mg/dL mg/dL mg/dL mg/dL Appearance of fasting serum forms an upper creamy layer, clear lower phase clear clear or turbid turbid turbid to milky turbid lower phase
Acute inflammation
3. Appearance of fasting sera at different classes of hyperlipoproteinemia according to FREDRICKSON
normal
Typ I
Typ IIa
Typ IIb
Typ III
Typ IV
Typ V
Prealbumin Albumin
1 2
Nephrotic syndrome
Prealbumin Albumin
1 2
146
147
3.4 Schematic representation of blood coagulation

Chronic inflammation
Endogene Endogeneous activation Aktivierung
Exogene Exogeneous activation Aktivierung
surface Oberflchencontact kontakt

XII
Prealbumin 1 2 Albumin
XIIa
Gewebetissue verletzung damage
XI
Paraproteinemia
XIa
Gewebetissue factor faktor III III VII
Ca2++PL+IX
IXa+VIII+PL+Ca2+ Ca2++PL+X
Prealbumin Albumin 1 2
Ca2++PL+VIIa Xa+V+PL+Ca2+
Antibody deficiency syndrome
Prothrombin Fibrinogen
Thrombin Fibrin s XIIIa+Ca2+ Fibrini XIII
Fibrinopeptides A+B Fibrinopeptide A+B

Prealbumin 1 2 Albumin
Schematic representation of plasmatic blood coagulation. Schematische Darstellung der plasmatischen Blutgerinnung. PL = = insoluble = phospholipids, Phospholipide,ss= =soluble, solublei (lslich), i = insoluble (unlslich)
148
149
3.5 Thrombophilia, risk factors
l l l l l l l l
Elevated triglyceride concentrations Elevated LDL concentrations Advanced age Sex Pregnancy or puerperium Immobilization Heavy cigarette smoking Medicines oral contraceptives antifibrinolytica steroids (estrogenes) Illnesses with elevated thrombosis risk arteriosclerosis diabetes mellitus malignant disease Family medical history Relapse thrombosis (recurring thrombosis) Unexplained prolongation of aPTT Women who have had repeated miscarriages Patients suffering from autoimmune diseases Operations Traumas Hyperviscosity syndrome Polycythemia vera Macroglobulinemia Infections and sepsis Nephrotic syndrome
Sample collection
Prior to all therapy regimes involving heparine or cumarine, withdraw a sample of blood for thrombophilia diagnostic analyses approximately 3 months after the thromboembolitic event and not during an acute phase reaction. Coagulation inhibitor deficiency or dysfunction: Antithrombin III (AT III) Protein C Protein S APC resistance Heparin cofactor II (rare) Factor XII deficiency (primary finding: prolonged aPTT) Lupus anticoagulants (primary finding: prolonged aPTT) Reduced fibrinolytic potential (rare): Plasminogen deficiency Decreased plasminogen activator (t-PA) concentrations Elevated plasminogen activator Inhibitor I (PAI-I) concentrations Congenital dysfibrinogenemia (rare)
Diagnostics
l l l l
l l l
l l
150
151
3.6 Age dependence of immunoglobulin synthesis

Immunoglobulins (mg/dL) Values of adults IgG IgM IgA 800 600 400 1700 200 0 9 10 years 7 8
3.7 Complement system, classical and alternative mechanism

Cellular lysis Membrane attack complexes C8 C5b67 C5b678 C9
10 12 2
Child age
C5Convertase
C5
C5b
C5a
Months
C3
maternal IgG
C3b,Bb
C4b2a
C3a
IgM+ IgG+
C3b + B +H
Alternative pathway
Cells
Classical pathway
Weeks
C3
Immune complexes +C1 (IgA od. IgM)
C1Complex
C3a
10
152
Functions
Immune complexes (IgA), bacteria, fungi
80
60
40
120
100
Immunoglobulins (% of normal values of adults)
20
Opsonization by coating, immune adherance
IgM
IgG
30
Fetal time
20
C3bB
C4+C2
Ba
C1qrs
Anaphylatoxic action
C3b
Chemotaxis
IgA
C6+C7
Birth
153
3.8 Tumor markers

Tumormarkers
marker of 1st choice marker of 2nd choice in brackets
3.9 Serological diagnosis of hepatitis A and B

Acute phase 28-45 Days Start of icterus Rel. concentration Reconvalescence 40-90 Days Immunity Years
Anti-HAV (IgG+IgM)
Oesophagus
(CEA, SCC)
Thyroid gland
Thyroglobulin, Calcitonin (C-cell, CEA)
HAV Anti-HAV IgM Time after exposition
Lung
parvicellular: NSE (CYFRA 21-1) non-parvicellular: (CEA, CYFRA 21-1)
Mamma
CA 15-3, CEA
Liver/Biliary ducts
AFP, CA 19-9
Stomach
CA 72-4 (CEA)
Progress of a hepatitis A infection
Bladder
(CYFRA 21-1)
Pancreas
CA 19-9 (CEA)
Uterus
SCC (CEA)
Colorectal
CEA (CA 19-9)
Prostate gland
PSA
Ovaries
CA 125 (CA 72-4)
Duration Rel. concentration
Incub. 8-24
Acute phase 2-12 Weeks Symptoms HBsAg HBeAg
Postacute phase 2-16 Weeks
Postinfection phase 5 Months up to years
Testes
AFP, hCG
Multiple Myeloma
2-Microglobulin
Anti-HBc Anti-HBs Anti-HBe Anti-HBc IgM
Infectious
Infectious
Immune
Progress of a hepatitis B infection
154
155
3.10 Urinary sediment
Diagnostically relevant findings in urinary sediment: upper left: erythrocytes upper right: leucocytes middle left: epithelial cells middle right: calcium oxalate lower left: ammoniummagnesium phosphate (tripelphosphate)
Diagnostically relevant findings in urine sediment: upper left: uric acid upper right: cystine middle left: tyrosine middle right: granulated casts lower left: erythrocyte casts
156
157
3.11 Nomogram for diagnosing acid-base disorders (185)
4 Conversion tables
4.1 Conversion table from conventional units to SI units and vice versa (/U refers to urinalysis)
Analyte/Parameter Acetaminophen
mg/mL
Conventional Units
Conversion Factors 6.62 0.151 3.61
SI Units
mmol/L
N-Acetylprocainamide (NAPA)
a1-Acid glycoprotein
mmol/L
mg/mL
0.277 0.25
mmol/L
mg/dL ACTH ng/L Albumin g/dL Albumin/U mg/g crea Aldosterone ng/dL Amikacin
mg/mL
4.0 0.2202 4.541 10 0.1 0.113 8.85 27.74 0.036 1.71 0.585 7.626
mmol/d mmol/L
pmol/L
g/L
g/mol crea
pmol/L
Nomogram for diagnosing acid-base disorders considering the degree of compensation. pCO2 is represented logarithmically on the abscissa. Bicarbonate concentration is reported on the ordinate. The patients values result in an ordered pair, the status point, which allows the classification of a singular acid-base disorder as acute or chronic or which suggests a combined disorder. If the disorder appears with a normal degree of compensation, the status point is found within one of the corresponding, shaded fields. If the status point doesnt fall within one of these fields, it must be decided which of the following situations is present: the disorder just appeared, compensation has not yet taken place. the organ which is responsible for compensation, such as the lung for respiratory and the kidney for metabolic disorders, is not functioning properly. a second acid-base disorder is present, e.g. respiratory acidosis in ventilatory failure and lactic acidosis might be present simultaneously.
d-Aminolevulic acid/U
mg/24 h
0.131 0.587
mmol/L
Ammonium (NH3)
mg/dL
1.703 3.04 nmol/L
AMP, 3l-5l-cyclic ng/mL

a1-Antitrypsin
0.329 0.184
mmol/L
ng/mL
5.435
158
159
Analyte/Parameter Apolipoprotein A-1
Conventional Units
Conversion Factors 0.357
SI Units
mmol/L
Analyte/Parameter Ceruloplasmin
Conventional Units
SI Units
mmol/L
mg/dL Apolipoprotein B g/L Ascorbic acid mg/dL Bilirubin mg/dL Caffeine

mg/mL
2.80 1.95 0.5128 56.78 0.0176 17.1 0.0585 5.15 0.194 0.28 pmol/L Citrate/U
mmol/L mmol/L mmol/L mmol/L
mg/dL Chloramphenicol
mg/mL
13.40 3.09 0.323 3.18 mol/mol crea

mmol/L
Chloride/U g/g crea Cholesterol mg/dL Citrate mg/dL 0.019 38.61 0.314
0.0259
mmol/L
52.1
mmol/L
Calcitonin ng/L Calcium mg/dL Calcium/U mg/24 h Calcium/U mg/g crea Carbamazepine mg/L Carcinoembryonic antigen (CEA) Carnitin mg/dL Carotene
mg/dL
0.0052 mg/24 h 192 0.157

mg/dL
mmol/d
3.57 0.250 4.01 0.025 40.1 0.00282 355 4.23 0.236 16.9 mIU/mL Cortisol/U
mmol/L
mmol/L
Copper 6.354
mmol/L
mmol/d
Copper/U
mg/24 h
0.0157 63.54 1.527

mg/L
mmol/d
mol/mol crea
Coproporphyrins 0.655
nmol/L
Cortisol
mg/dL
27.586 0.03625 2.7586

mg/24 h
nmol/L
nmol/d
ng/mL
0.0592 21.28 0.047 0.0186 53.69

mmol/L mmol/L
0.3625 0.333 nmol/L
C-Peptid ng/mL Creatinine mg/dL 0.0113 3.0
88.4
mmol/L
160
161
Analyte/Parameter Creatinine/U
Conventional Units
SI Units mmol/d
Analyte/Parameter Ethosuximide
Conventional Units
SI Units
mmol/L
g/24 h C-reactive protein (CRP) Cystine/U mg/24 h Dehydroepiandrosterone sulfate (DHEA-S) Digitoxin ng/mL Digoxin ng/mL Disopyramide mg/L Dopamine Dopamine/U Epinephrine ng/L Epinephrine/U
mg/24 h
0.113 95.2 nmol/L

mg/L
0.141 0.83 IU/mL
mg/dL
0.0105 8.34 0.12 0.02714

mmol/L mmol/d
ng/mL Fluoride
mg/L
1.21 0.053 19.0 2.266 nmol/L

mmol/L
Folic acid ng/mL 0.441
mg/dL
36.846 1.31 0.76 1.28 0.781 2.95 0.339 6.54 pmol/L FT4
mmol/L
nmol/L
Fructose mg/dL 18.02
0.0555
mmol/L
nmol/L
Fructose/U mg/24 h FT3 pg/mL 0.651 180.2
0.0055
mmol/d
1.536
pmol/L
12.87 ng/dL 0.0777 0.0555 mg/dL 18.02 0.0055 mg/24 h 180.2 2.09
mg/mL
pmol/L
ng/L
0.153 5.46 0.183 5.46 0.183 3.67 pmol/L Gentamicin nmol/d Galactose/U pmol/L Galactose
mmol/L
mmol/d
Estradiol (E2) pg/mL Estriol (E3) ng/mL Ethanol mg/dL 4.608 0.288 0.273
mmol/L
0.478 0.0555 mmol/L
3.47
nmol/L
Glucose mg/dL 18.02
0.217
mmol/L
Glycerol mg/dL 9.209
0.109
mmol/L
162
163
Analyte/Parameter Haptoglobin
Conventional Units
SI Units
mmol/L
Analyte/Parameter IgM
Conventional Units
SI Units
mmol/L
mg/dL Hemoglobin g/dL Homocysteic acid mg/L

b-Hydroxybutyrate
100 0.621 1.61 7.41 0.135 96.2

mmol/L mmol/L
g/L mmol/L Insulin

mU/mL
0.971 6.945 0.144 0.179

mmol/L
pmol/L
Iron
mg/dL
5.59 0.0179
mmol/d
Iron/U
mg/24 h
mg/dL 17-Hydroxycorticosteroids 5-Hydroxyindole acetic acid/U 17-Hydroxyprogesterone 25-Hydroxy-vitamin D3 ng/mL Hydroxyproline mg/L IBC
mg/dL
0.0103 27.59
mmol/d
55.9 0.111 mmol/L
Lactate mg/dL 9.008
mg/dL
0.036 5.23
mmol/d
Lead
mg/L
0.00483 207.2 12.5 mg/dL 0.080 76.3 mg/dL 0.0131 4.27 mg/L 0.234 1.441 mg/dL 0.6941 0.411 mg/dL 2.431 0.0411 mg/24 h 24.31 0.00465 mg/g crea 215
mmol/L
mg/24 h
0.191 3.03 nmol/L Lecithin
mmol/L
ng/mL
0.330 2.50 0.40 7.626 0.131 0.179 5.59 6.25

mmol/L mmol/L mmol/L
mmol/L
Leucine
mmol/L
Lidocaine
mmol/L
Lithium
mmol/L
IgA g/L IgE mg/mL IgG g/L 0.150 2.4 0.16
Magnesium
mmol/L
0.42
IU/mL
Magnesium/U
mmol/d
6.67
mmol/L
Magnesium/U
mol/mol crea
164
165
Analyte/Parameter Mercury
Conventional Units
SI Units
mmol/L
Analyte/Parameter Phenobarbital
Conventional Units
SI Units
mmol/L
mg/L
200.60 621.1
mmol/L
mg/L Phenylalanine mg/dL 33.3 nmol/L Phenytoin mg/L 0.1129 g/mol crea Phosphate, inorganic mg/dL 84.7 nmol/L Phosphate/U g/24 h 0.0571 nmol/L Phosphate/U mg/g crea 5.91 pmol/L Phospholipids mg/dL 5.91 nmol/d pO2 mm Hg 0.118 pmol/L Porphobilinogen mg/L 11.4
mmol/d
0.232 0.061 16.5 3.96 0.252 0.323 3.097 32.3 0.031 0.00361 277 0.0129 77.52 0.133 7.502 4.42 0.226 1.2 nmol/d
mmol/L mmol/L
Methemoglobin (Hb/4; Mr = 161145.5)

a1-Mikroglobulin (Orosomucoid) a1-Microglobulin/U
mmol/L
g/dL
0.0016
mg/L
0.03
mmol/L
mg/g crea
b2-Microglobulin
8.861
mmol/d
mg/L Myoglobin ng/mL Norepinephrine ng/L Norepinephrine/U

mg/24 h
0.1181
mol/mol crea
17.513
mmol/L
0.169
kPa
0.169
N-terminal-pro brain natriuretic peptide (NT-proBNP) Oxalate/U
pg/mL
8.457 Porphyrine/U
mg/24 h Oxyhemoglobin % Parathyrin (parathyroid hormone, PTH) pCO2 mm Hg
0.088 0.01 100 0.106 pmol/L Prealbumin l Potassium
mg/24 h
0.833 0.256 mmol/L
mg/dL
3.91 0.182
mmol/L
ng/L
9.43 0.133 7.502 kPa Primidone
mg/dL
5.495 4.58
mmol/L
mg/L
0.218
166
167
Analyte/Parameter Procainamide
Conventional Units
SI Units
mmol/L
Analyte/Parameter Sorbitol
Conventional Units
SI Units
mmol/L
mg/L Progesterone ng/mL Prolactin ng/mL Protein g/dL Protein/U mg/g crea Pyruvate mg/dL Quinidine mg/L Salicylate mg/L Selenium
mg/L
0.236 3.18 0.314 21.2 0.0472 10.0 0.1 0.113 8.85 113.6 0.0088 3.08 0.325 0.00724 138 0.0127 78.96 10.53 nmol/L Urea
mmol/L mmol/L mmol/L
mg/dL nmol/L T3 ng/mL mU/L T4

mg/dL
0.018 1.536 0.651 12.87 0.078 3.47 nmol/L nmol/L nmol/L
g/L
Testosterone ng/mL 0.288
g/mol crea
Thallium
mg/L
5.92 0.169 5.55 mg/L 0.180 2.14 mg/L 0.467 0.126 mg/dL 7.957 0.0114 mg/dL 87.5 0.167 mg/dL 6.006 16.7 g/24 h 0.06 1.883 g/g crea 0.531 59.5 mg/dL 0.0168
nmol/L
Theophylline
mmol/L
Tobramycin
mmol/L
mmol/L
Transferrin
mmol/L
Triglycerides
mmol/L
Sexual hormone binding globulin (SHBG) Sodium
mmol/L
mg/mL
0.095 0.435 mmol/L Urea/U
mmol/d
mg/dL Sodium/U g/g crea Soluble transferrin receptor (sTfR)
2.30 4.90 0.204 11.8 nmol/L Uric acid mol/mol crea Urea/U
mol/mol crea
mmol/L
mg/L
0.085
168
169
Analyte/Parameter Uric acid/U
Conventional Units
SI Units mmol/d
4.2 Conversion factors for enzyme activities: U / L mkat/ L and nkat/ L

Unit Factor 60 0.06 0.0167 16.67 1 mkat/L W mmol/s L 1 nkat/L W 1 nmol/s L 1 mmol/min W 16.67 nkat 1 mmol/min W 1 U Unit U/L U/L
mkat/L nkat/L
g/24 h Uric acid/U mg/g crea Urobilinogen mg/dL Valproic acid mg/L Vancomycin
mg/mL
0.168 0.00067 1487 16.9 0.059 6.93 0.144 0.690 1.449 5.03
mmol/d mmol/L mmol/L mmol/L
mol/mol crea
mkat/L nkat/L
U/L U/L
Vanillylmandelic acid/U Vitamin A (retinol)
mg/24 h
0.199 0.0349
mmol/L
mg/dL
28.65 37.7 nmol/L
Vitamin B1 (thiamin)
mg/dL
0.0265 4.05 nmol/L
Vitamin B6 (pyridoxal phosphate) Vitamin B12
ng/mL
0.247 0.738 pmol/L
pg/mL Vitamin C mg/dL Vitamin E (a-tocopherol) Zinc

mg/dL
1.355 56.78 0.0176 23.2

mmol/L mmol/L
mg/dL
0.043 0.153 6.537

mmol/L
170
171
5 Sample Stability (84)

Maximum storage time of samples before clinical chemical analyses and possible additives for sample-stabilization
Analyte Stability in serum/plasma/blood / CSF/urine 20 C 48 C 2025 C Stability in primary sample (e.g. blood) at room temperature and tendency of change thereafter Stabilizer Comments
172
Clinical chemistry, serum/plasma, immunological tests
Acid phosphatase (ACP) 4 mth Albumin Alkaline phosphatase Ammonium Amylase Antistreptolysin O
a1-Antitrypsin
1 h unstabilized 8d 5 mth 7d 2h 7d 2d 5 mth 3d 7d 15 min 7d 2d 3 mth Ref. 220 5 mmol/L serine and 2 mmol/L borate Avoid contamination by sweat-ammonia Avoid contamination by saliva 2.5 mth 8d 1d 8h 2h 5 mg NaHSO4 /mL serum (pH 45) Unstabilized Serum > Plasma Stabilize after separation of serum 6d 4 d 15 min in EDTA heparinate 4 d 6 mth 3 mth 1 mth 1 yr 3w 2 mth 5 mth Anti-TSHR Apolipoprotein A-I Apolipoprotein B Bilirubin C3C-Complement C4-Complement CA 153 CA 199 CA 724 CA 125 Calcium totalionized 7 d 7d 3 d unstable 1h 1d 3 mth 3 mth 3 mth 3 mth 8 mth 2 d 15 min 1 d* Carcinoembryonic Antigen (CEA) 3d 1 h (unstabilized) Catecholamines Norepinephrine Epinephrine Dopamine Ceruloplasmin 2 mth 2 mth 6 mth 8d 3d 3d 7d 8d 2d 5d 1 mth 1 mth 5d 3w 2h 7d 7d 3d 7d Ca-titrated heparin 3 d* 6 mth 7d 7d 1d 1d 1d 4d 2d Only freeze once Only freeze once Keep in the dark Recommend plasma, pretreat serum 9 1 mth > > = 6 mth > > ; stabilized 3 mth 2d 2w 1d 8d Glutathione 1.2 mg/ mL + EGTA
*24 h stable in gel tubes as primary tubes; 72 h stable after centrifugation in closed tubes
173
174
Analyte Stability in serum/plasma/blood / CSF/urine 20 C > 1 yr 3 mth 3 mth 3 mth 1 yr > 1 yr 3 mth 3 yr 3 mth 4w 7d 7d 7d 2d SH-donators Store in the dark CK-BB unstable Ref. 220 3 mth 3 mth 3 mth 6 mth 8h 1d 8d 8h 1d 1d 1 mth Ref. 220 2 mth 15 d 7d 7d 2w 2w 1 yr 1 yr 7d 7d 7d 7d 2d 1d 7d 7d 48 C 2025 C Stability in primary sample (e.g. blood) at room temperature and tendency of change thereafter 1 d 7 d 2 d 1 d 7 d 7d 7d 7d after centrif. 23 d 7 d Stabilizer Comments Chloride Cholesterol totalHDLLDLCholinesterase Copper Cortisol C-reactive protein (CRP) Creatinine Creatine kinase (CK)
b-CrossLaps Serum Heparin plasma EDTA plasma
CYFRA 211 Cystatin C Erythropoietin Estradiol (E2) Estriol (E3) Ferritin
1 mth 624 h 1d 5 mth 1 yr 1 yr 1 yr 7d 30 min 7 d 3 mth 8w 1 yr
1w
2d 2w 3d 2d 7d 7d 6h 2w 1d 1d 7d 3d 30 min 2w Ascorbic acid 2 mg/mL
Folic acid Follicle stimulating hormone (FSH) Free thyroxine (FT4) Free triiodothyronine (FT3) Fructosamine
g-GT
3 mth 3 mth 12 h 1 d GLDH 10 min Glucose hemolysate plasma GOT (ASAT) 1 d 7 d 3 mth 2 mth > 1 yr 4w
8d 2w 2w 7d 7d 7d 7d 7d
2d 1d 3d 7d 7d 2 d 2d 4d Fluoride monoiodo acetate Nonenzymatic glycolysis, stability depends on the number of cells
175
GPT (ALAT)
4 d
7d
7d
3d
176
Analyte Stability in serum/plasma/blood / CSF/urine 20 C 3 mth 3 mth 6 mth 1 yr 17 d 11 d 17 d 15 min 2 h < 5 min, unstable 3d 3d 6d > 1 yr 3w 6 mth 1d 4h 7d 3d 6d Interference by EDTA, citrate, oxalate Mannose/fluoride, Deproteinization oxalate/monoiodo recommended acetate with deproteinization 8 6 6 8 6 mth mth mth mth mth 8 mth 7d 7d 8 mth 4 mth 8 mth 7d 7d 4 mth 2 mth 3d 1d 7d 3d 8 mth 3 mth 8d 1d EDTA Method-dependent 48 C 2025 C Stability in primary sample (e.g. blood) at room temperature and tendency of change thereafter 1d 8d 3 d (EDTA-blood) Stabilizer Comments Growth hormone (STH, somatotropin) Haptoglobin HbA1c Human chorionic gonadotropin (hCG) Immunoglobulin Immunoglobulin Immunoglobulin Immunoglobulin Immunoglobulin Insulin Iron Lactate A D E G M
LDH Lipase Lipoprotein [a], (Lp [a]) Luteinizing hormone (LH)
a2-Macroglobulin
1 h
6w 1 yr
7d 7d 2w 7d 1 yr 3d 7d 1 d 1 yr 7d
7d 7d 2d 1d 7d 7d
Serum > plasma (hemolysis)
Do not freeze
Magnesium Myoglobin Neuron specific enolase (NSE) Osmolality P1NP pro BNP Parathyrin Phosphate (inorg.) Potassium
1 h 2 h
3 mth 3 mth
1w 7d
2d 7d Heparin Freeze only once serum > plasma (platelets, hemolysis) 3 mth 6 mth 12 mth 6 h (24 h in EDTA) 1 h 1 h 6 mth 1 yr 1 yr 1d 5d 6d 2d 4d 1w 3h 24 h 3d 8h 1d 1w EDTA Ref. 220 Ref. 220 Method-dependent Platelet-dependent (serum) Serum > plasma (hemolysis, thrombocytolysis)
177
178
Analyte Stability in serum/plasma/blood / CSF/urine 20 C 1 yr 1 yr 3 mth 1 mth 1 yr 3w 1 mth 4 d 7d 1 d in women 2d 1 mth 7d 11 d 6 mth 1 mth 7d 3d 8 mth 5d 4 mth 1 mth 3d 1 yr 3d 1 yr 2 wk 2 wk 1d 1d Ref. 220 3d 1d 4w 7d 6d 1d 1 mth 7d 7d 7d 3d 1d 3d 1d 48 C 2025 C Stability in primary sample (e.g. blood) at room temperature and tendency of change thereafter 7d 2d 7d 7d 1d Stabilizer Comments Progesterone Prolactin Prostate specific antigen (PSA) total free Protein total electrophoresis Rheumatoid factor (RF) Sodium Testosterone Thyroglobulin Thyroid stimulating hormone (TSH) Thyroxine (T4) Transferrin
Triglycerides Triiodothyronine (T3) Troponin T Urea Uric acid Vitamin A Vitamin B1 Vitamin B2 Vitamin B6 Vitamin B12 Unstable without EDTA 8h 1 d 7 d 7 d > 1 yr 3 mth 3 mth 1 yr 6 mth 2 yr 1 yr 1 mth Days 2 mth Hours 2 d; serum in separation gel tubes: 1d Vitamin C Vitamin D Vitamin E Vitamin K Zinc 3 h (4 C) 3d 8 h unstable 30 min 1 yr 3 mth 1 yr 1 mth unstable 2w 1w 3w 3h 3d Metaphosphate (60 mg/mL) 30 min 2d EDTA-Plasma EDTA-Plasma 7d 8d 1d 7d 7d 1 mth 2d 2d 1d 7d 3d Protect from light Protect from light Protect from light Protect from light Ref. 220 Protect from light Protect from light Protect from light Protect from light Protect from light
179
180
Analyte Stability in serum/plasma/blood / CSF/urine 20 C 48 C 2025 C Stability in primary sample (e.g. blood) at room temperature and tendency of change thereafter Stabilizer Comments
Hematology
Dried blood smears are more stable 212 h 312 h 212 h 3 h4 d 12 h6 d 2 h2 d 4d 2h 7d 4d Differential leucocyte count Band neutrophils Segmented neutrophils Monocytes Lymphocytes Eosinophils Basophils Erythrocytes Erythrocyte sedimentation rate (ESR) Hematocrit (centrif.) 1 d 4h Lower filling of sample tube decreases stability (EDTA ). Do not keep in the refrigerator. Instrument-dependent. EDTA blood Temperaturedependent; 1 part of citrate, 4 parts of blood In K2-EDTA more stable than in K3-EDTA 7d 4d EDTA blood EDTA blood Hemoglobin in blood Leucocytes 7d 4d Reticulocytes Thrombocytes 1d 7d 4d EDTA blood EDTA blood
Coagulation, plasma/blood
Antithrombin III D-Dimer Factor II Factor V Factor VII Factor VIII Factor IX Factor X Factor XI Factor XII Factor XIII Fibrin monomers Fibrinogen Fibrin(ogen) degradation products (FDP) 1d 8h unstable 1 mth 3 mth 1 mth 1 mth 1d 7d 1d 2w 4w 4w unstable unstable 8h 8h 1 mth 6 mth 4w 4w 2d unstable 4h 2w 4d 7d 8h 6h 1d 6h 3h 6h 6h 6h 6h 4h 2h 7d 3h Add 10 U thrombin and 150 IU kallikrein per mL blood Heparin inhibits thrombin effect Centrifugation at 4 C
181
182
Analyte Stability in serum/plasma/blood / CSF/urine 20 C 2h 4w 812 h 1 mth 28 h 28 h 2d 6h Reagent dependent; reduced stability in heparin plasma Avoid repeated thawing Separate cell-free plasma after centrifugation Reagent dependent 4h 4h 2d Reagent dependent 48 C 2025 C Stability in primary sample (e.g. blood) at room temperature and tendency of change thereafter Stabilizer Comments Fibrinopeptide A Hepato Quick Partial thromboplastin time (PTT) Protein C Protein S 4h 4h 4h 1 mth 7d 7d Prothrombin time (PT) Reptilase time Thrombin time von Willebrand-factor 6 mth 7d 4 h 1 mth 2d 1 mth 4h 8h 1 mth 1d 1d
Blood gases
Base excess Bicarbonate < 15 min Unstable Recommended: 4 C, 30 min 15 min 15 min 2w 2h 7d 1 d (closed) 1 h (open) 2h 2h Close the tube pCO2 pH Close the tube pO2 15 min 2h Close the tube
Stability depends on pH
Close the tube, decrease due to formation of lactate, increase due to loss of CO2
Therapeutic drug monitoring

Benzodiazepine Carbamazepine Cyclosporine A+G Digitoxin Digoxin Disopyramide Ethosuximide Gentamicin 4h <1 d 2d 13 d 6 mth 6 mth 5 mth 5 mth 4w 1 mth 5 mth 7d 13 d 3 mth 3 mth 2w 4w 4w 4h 5 mth 2d 21 d 2w 2w EDTA Store the hemolysate
183
184
Analyte Stability in serum/plasma/blood / CSF/urine 20 C 6h 1 h 6 mth 2d 2d 5 mth 6 mth 1d 3 mth 1 mth 2d 3 mth 7d 3d 3 mth 3 mth <2 h 2d Lower values in heparin plasma 2w 4w 5 mth 4w 2d 6 mth 6 mth 6 mth Unstable in SST tubes 3d 6 mth 7h 1d Do not use Li-heparinate Protect from light 48 C 2025 C Stability in primary sample (e.g. blood) at room temperature and tendency of change thereafter Stabilizer Comments Lidocaine Lithium Methotrexate Phenobarbital Phenytoin Primidone Procainamide Quinidine Theophylline Tobramycin Valproic acid
Urinanalysis
Albumin
d-Aminolevulic acid
6 mth 1 mth 3w 3w
1 mth 4d 10 d 4d
7d 1d 2d 2d pH < 2 pH 67 with 0.3 % NaHCO3
Do not freeze (nephelometry) Protect from light Avoid contamination by saliva Crystallization upon cooling unless acidified 9 > > > = > > > ;
Amylase Calcium
Catecholamines Norepinephrine Epinephrine Dopamine
20 d
4d
4d
pH < 2 and sodium metabisulfite (250 mg/L) enhance stability: 20 and + 4 C: 1 yr + 25 C: 3 w Citrate Cocaine Copper Creatinine Cystine 4w 4 mth 1 yr 6 mth 1 yr 3w 7d 6d 3 mth 3d 2d 7d Acidify with HCl 1d 1 vol % thymol, 5 mL/L; pH < 1.7 pH 5, ascorbic acid Unstable in native urine
185
186
Analyte Stability in serum/plasma/blood / CSF/urine 20 C 2d 2h 2 h 48 C 2025 C Decrease depends on the number of cells and bacteria Acidify Acidify Do not freeze (nephelometry) Stability in primary sample (e.g. blood) at room temperature and tendency of change thereafter Stabilizer Comments Glucose 5-Hydroxyindole acetic acid Hydroxyproline Immunoglobulin G (IgG) 1 mth > 1 yr 1 yr 6 mth 3 mth 4 mth (pH 1.5) unstable unstable unstable 7d 1 mth 7d 3h unstable unstable pH 2 (HCl), 1 vol % Vitamin C thymol, 5 mL/L urine 3d 3d 7d 3d pH < 2 7d Iron Magnesium
a1-Microglobulin
2d 5d 5d 5d 2d 2h Osmolality Oxalate pH Phosphate, inorg. Porphobilinogen Porphyrine Potassium Protein Sediment Casts Epithelial cells Erythrocytes Leucocytes Test strips Bacteria (nitrite) Erythrocytes Protein Sodium Urea Uric acid Vanillinmandelic acid unstable at pH < 7 1 yr 4w unstable > 1 yr 45 d 7d unstable 7d 1d 1d 1h 1h 1 mth (pH 6) 1 mth 1 yr 1 mth 7d 7d 2 mth 7d unstable 1 vol % thymol, 2 d (pH < 5) 5 mL/L 4d (pH 6) 4d 45 d 1d Do not freeze or store the urine refrigerated. Osmolarity > 300 mosmol/kg pH 67 pH 67 Precipitates at alkaline pH pH < 5 protect from light Protect from light 1h 1h 1h 45 d 2d 4d 7d Alkalize at pH > 8 pH 35 Precipitates at pH < 7
Increases by formation of NH3
187
References
Comments
1
Monoiodoacetate
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Stability in serum/plasma/blood / CSF/urine
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48 C
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CSF
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Analyte Albumin Tumor cells Leucocytes
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Protein
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Lactate
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List of key words
Abbreviations, list of 4 Acetoacetate 14 Acetaminophen 102 Acetylsalicylicacid 102 Acid phosphatase (ACP) 14 al-Acid glycoprotein 14 Adenosine monophosphate, 3l-5l-cyclic (cAMP) 14, 112 Adrenocorticotrophic hormone (ACTH) 14 Alanine aminotransferase (ALT, ALAT) 14 Albumin 16 CSF/serum ratio 122 Aldosterone 16 Alkaline Phosphatase 18 Aluminium 18 Amikacin 102 d-Aminolevulic acid 112 Ammonium 20 a-Amylase 20, 112 Amyloid A 20 Anion gap 20 Anti-DNase B 20 Anti-phospholipid antibodies (APA) 86 a2-Antiplasmin 86 Antistreptolysin O 20 Antithrombin III 86 Anti-thyroglobulin (Anti-TG) 20 Anti-thyroid-peroxidase (Anti-TPO) 22 a l-Antitrypsin 22 Apolipoprotein A-1 22 Apolipoprotein B 22 Ascites 128 Aspartase aminotransferase (AST, ASAT) 24
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Bacteria 108 Base excess 100 Benzodiazepine 102 Bicarbonate 100, 128, 129, 130, 133 Bile 129 Bilirubin 24, 110, 120 Bleeding time 86 Blood coagulation, scheme 149 Blood collection 8 Blood gases 100 Blood in stool 124 C3C-Complement 24 C4-Complement 24 C4bBP 86 CA 15-3 24 CA 19-9 24 CA 72-4 24 CA 125 24 Cadmium 24 Caffeine 102 Calcitonine 24 Calcium 26, 112, 128, 129, 130, 131, 132, 134 Carbamazepine 102 Carcino embryonic antigen (CEA) 26 Carnitine 26, 112 Casts 108 Catecholamines 26, 112 Cells, CSF 122 Ceruloplasmin 26 Chloramphenicol 102 Chloride 26, 112, 128, 129, 130, 131, 132, 135, 136 Cholesterol 28 Cholinesterase (CHE) 30 Dibucaine inhibition test 30 Chromium 30 Chymotrypsin 124, 126 Citrate 112, 126, 131 CO-Hb 76
Coelomic fluid 130 Complement system 153 Composition, stool 124 Conversion table (conventional units to SI units) 159 Copper 30, 112, 124 Coproporphyrins 161 Cortisol 30, 112 C-peptide 30, 114 C-reactive Protein (CRP) 30 Creatine kinase (CK) 32 Creatine kinase MB (CK-MB) 32 Creatinine 32, 114, 139 Creatinine clearance test 114, 139 b-CrossLaps 34 Cyclosporine 102 CYFRA 21-1 34 Cystatin C 34 Cystine 114 D D-Dimer 86, 133 Dehydroandrosterone sulfate (DHEAS) Deoxypyridinolin 114 Differential leucocyte count 76 Digitoxin 102 Digoxin 102 Disopyramide 102 Dopamine 112 Duodenal fluid 130 Elastase 36 Eosinophiles 76 Epinephrine 112 Erythrocyte sedimentation rate (ESR) Erythrocytes 76 Erythropoietin 36 Estradiol (E2) 36 Estriol (E3) 36 Ethosuximide 102 Extravascular body fluids 128 34
76
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227
Factor II 88 Factor V 88 Factor VII 88 Factor VIII 88 Factor IX 88 Factor X 88 Factor XI 88 Factor XII 88 Factor XIII 36 Fatty acids, free 36 Ferritin 36 al-Fetoprotein (AFP) 38 Fibrin monomers 88 Fibrinogen 90 Fibrin(ogen) degradation products (FDP) 90 Fibrinopeptide A 90 Fibronectin 90 Fluoride 38 Folic acid 38 Follicle stimulating hormone (FSH) Free PSA/total PSA ratio 40 Free thyroxine (FT4) 40 Free triiodothyronine (FT3) 40 Fructosamine 40 Fructose 40, 114, 126 FTI 40 FT4I 42 Function tests 137
Glutamate dehydrogenase (GLDH) 44 Glutamate oxaloacetic transaminase (GOT) 22 Glutamate pyruvate transaminase (GPT) 14 g-Glutamyl transferase (g-GT) 46 Glycerol 46 Growth hormone (STH, somatotropin) 46 H Haptoglobin 46 HbA1c 46 Hematocrit (Hct, PCV) 78 Hemoglobin (Hb) in blood 78 in plasma 46 Hemoglobin composition 78 Hemopexin 46 Hemosperms 126 Heparin cofactor II 90 Hepatitis 155 Hepato Quick 90 High molecular weight kininogen (HMWKG) 90 Homocysteic acid 48 Human chorionic gonadotropin (hCG) 128 Hydrogen (H2) breath test 138 b-Hydroxybutyrate 48 a-Hydroxybutyrate dehydrogenase (a-HBDH) 48 17-Hydroxycorticosteroids 164 5-Hydroxyindole acetic acid 114 17-Hydroxyprogesterone 48 25-Hydroxyvitamin D 72 Hydroxyproline 114 Immunoglobulin 147, 152 Immunoglobulin Immunoglobulin Immunoglobulin 152
38
48,
Galactose 42, 114 Gallstones 120 Gastric juice 131 Gastrin 42 Gentamicin 102 Glomerular filtration rate 114 Glucose 42, 110, 114, 122, 128, 129, 130, 131, 132, 133, 134, 135, 136, 137 Glucose-6-phosphate dehydrogenase (G6P-DH) 78 a-Glucosidase 126
A (IgA) 48, 122, 134, 136, D (IgD) 48, 122 E (IgE) 48, 122 G (IgG) 50, 116, 122, 136,
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Immunoglobulin G subclasses 50 Immunoglobulin light chains 52, 116 Immunoglobulin M (IgM) 50, 122, 136, 147, 152 Insulin 52 International normalized ratio (INR) 90 Iron 52, 116 Iron-binding capacity (IBC) 52 K L Kappa/lambda ratio, urine 116
Mycophenolic acid Myoglobin 56 N
104
Lactate 52, 122 Lactate dehydrogenase (LDH) 54 Lactoferrin 124 Lactose tolerance test 142 Lead 54 Lecithin 165 Leucine 165 Leucocytes 80, 108 Lidocaine 102 Lipase 54 Lipoproteins, composition 146 Lipoprotein a (Lp [a]) 54 Lithium 102 Luteinizing hormone (LH) 56 Lymph 131 Lysozyme 56, 116
a2-Macroglobulin 56, 92 Magnesium 56, 116, 129, 134 Mannose binding protein (MBP) 56 MAR test 126 MCH 80 MCHC 80 MCV 82 Mercury 56, 116 Methemoglobin 82 Methotrexate 104 al-Microglobulin 116, 135 b2-Microglobulin 56, 132, 135, 136 Milk, human 132
N-Acetylprocainamid (NAPA) 104 Nasal secretion 132 Neuron-specific enolase (NSE) 56 Nomograms Acid-base disorders 158 Body surface area (BSA) 141 Norepinephrine 112 N-terminal pro brain natriuretic protein (NT-proBNP) 58 Oral glucose tolerance test 137 Osmolality 58, 116 Osmotic resistance of erythrocytes 82 Osteocalcin 58 Oxalate 116 P1NP 58 Pancreatic elastase 124 Pancreatic juice 133 Parathyrin (PTH) 60 Partial thromboplastin time (PTT) 92 pCO2 100 Peritoneal fluid 133 pH 100, 110, 126, 129, 131, 133, 134, 135, 136 Phenobarbital 104 Phenylalanine 167 Phenytoin 104 Phosphate, inorganic 60, 116, 128, 129, 130, 132, 134 Phosphohexose isomerase (PHI) 60 Phospholipids 128, 129, 132 Plasmin-a2-antiplasmin complex 92 Plasminogen 92 Plasminogen activator inhibitor (PAI) 94 Platelet factor 4 (PF4) 94 Pleural fluid 133 pO2 100 Porphyrins 118 231
230
Potassium 60, 118, 128, 129, 130, 131, 132, 133, 134, 135, 136 Pre-analytical considerations 7 Prealbumin 62 Pregnancy-associated plasma protein A (PAPP-A) 62 Prekallikrein 94 Primidone 104 Procainamide 104 Procalcitonin 62 Progesterone 62 Prolactin 62 Prostate-specific antigen (PSA) 62 Protein 64, 110, 118, 122, 128, 129, 131, 132, 133, 134, 136 Protein C 94 Protein S 94 Protein-lipid-ratio 146 Prothrombin fragments 1+2 96 Prothrombin time (PT) 96 Pyridinolin 118 Pyruvate 64, 131 Pyruvate kinase (erythrocytes) 82 Q R Quinidine 104
Sodium 64, 118, 128, 129, 130, 131, 132, 134, 135, 136 Sorbitol 64 Spermiogram 126 Squamous cell carcinoma antigen (SCC) 64 Stool 124 Sweat 135 Synovial fluid 136 T Tacrolimus 104 Tears 136 Testosterone 66 Thallium 66 Theophylline 106 Therapeutic drug monitoring 102 Thrombin-AT III-Komplex (TAT) 96 Thrombin coagulase 96 Thrombin time 96 Thrombocytes 84 b-Thromboglobulin 96 Thrombophilia, risk factors 150 Thyroglobulin 66 Thyroid stimulating hormone (TSH) 66 Thyroxine (T4) 66 Thyroxine binding capacity (as T4-uptake) 68 Tissue factor pathway inhibitor 96 Tissue plasminogen activator (t-PA) 98 Tobramycin 106 Total sperm count 126 Transferrin 68 Transferrin carbohydrate deficient (CDT) 68 Transferrin-receptor, soluble (sTfR) 68 Transferrin saturation (TS) 68 Triglycerides 68, 128, 131 Triiodothyronine (T3) 68 Troponin I 68 Troponin T 68 Tumor markers 154 T-uptake (free thyroxine binding capacity) 70 233
Reptilase time 86 Reticulocytes 82 Reticulocytes hemoglobin equivalent (RET-He) 82 Rheumatoid factor (RF) 64 S100 64 Salicylic acid 104 Saliva 134 Sample collection 9 Sample stability 172 Sediment 108, 156 Selenium 64 Sexual hormone binding globulin (SHBG) 64
232
Urea 70, 118, 128, 130, 131, 133, 134, 135 Uric acid 70, 118, 131, 134, 135, 136 Urinalysis 108 Urinary calculi 120 Urinary sediment 108 Urine status 108 Urine volume 110 Urine specific gravity 110 Urobilinogen 110 Valproic acid 106 Vancomycin 106 Vanilyylmandelic acid (VMA) Vitamin A 72, 132 Vitamin B1 72, 132 Vitamin B2 72, 132 Vitamin B6 72, 132 Vitamin B12 72, 132 Vitamin C 72, 132 Vitamin D 72, 132 Vitamin E 74, 132 Vitamin K 74, 132 von Willebrand factor (vWF) D-Xylose absorption test 143 Zinc 74, 126, 132
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Reference Ranges for Adults and Children Heil/Ehrhardt Reference Ranges for Adults and Children 2008

Pre-Analytical Considerations 2008

www.roche.de Roche Diagnostics Ltd. Forrenstrasse CH-6343 Rotkreuz Switzerland

Preface, 9th Edition

BSA C4bBP CA CO2 CSF CTAD d DGKC EDTA EGTA ELISA Eq f g

h H2 Hb Hct (PCV) HPLC IFCC INR kat

MCH MCHC MCV mil min mol

mosmol mth NACB NCEP NGSP O2 Pa pCO2

Clinical questions Plausibility check Interferences

1.1 Influence factors

1.2 Sample collection

References 16 237 218

Roche Diagnostics, ACTH Elecsys, samples drawn 710 a.m.

mkat/L mkat/L mkat/L mkat/L mkat/L mkat/L mkat/L mkat/L mkat/L

IFCC, without pyridoxal phosphate

IFCC, with and without pyridoxal phosphate

2.1 Clinical chemistry and immunological tests, serum/plasma

227 218 218 218

2.1 Clinical chemistry and immunological tests, serum/plasma

DGKC (calculated for 37 C) IFCC

<2.00 mkat/L <2.50 mkat/L <0.11 mmol/L

2.1 Clinical chemistry and immunological tests, serum/plasma

References 218 218 218 2

Adults <1 yr 19 yr 1018 yr Adults

218 155 194 218

Reflotron, COBAS INTEGRA, cobas, Roche/Hitachi instruments

Anti-CCP Elecsys Optimum cut-off (sensitivity: 67.7 %; specificity: 97.0 %)

Reference ranges vary with season and geographical area.

Adults Children Anti-thyreoglobulin, thyreoglobulin autoantibodies (Anti-TG)

2.1 Clinical chemistry and immunological tests, serum/plasma

<1 mth 26 mth 7 mth2 yr 3 yr19 yr Adults Healthy subjects

f m f m 1d 25 d 6 d6 mth 712 mth 13 yr 46 yr 712 yr f m yr yr yr yr yr

Children, adolescents 68 IFCC, without pyridoxal phosphate

Children, adolescents <1 13 46 712 1317

IFCC, with and without pyridoxal phosphate

2.1 Clinical chemistry and immunological tests, serum/plasma

Reflotron, blood, serum, plasma

2.1 Clinical chemistry and immunological tests, serum/plasma

218 244 266 218

Roche/Hitachi, COBAS INTEGRA, cobas systems.

112 mth 17 yr 815 yr Adults f m

Plasma with addition of glutathione and EGTA

97108 97108 97108 97106 97107

mEq/L mEq/L mEq/L mEq/L mEq/L

98107 mEq/L 101110 mEq/L

2.1 Clinical chemistry and immunological tests, serum/plasma

Classification acc. to NCEP ATP III

Classification acc. to NCEP ATP III European guidelines

65 46, 218 Classification acc. to NCEP ATP III

2.1 Clinical chemistry and immunological tests, serum/plasma

200 241 159 Special tubes required

2.1 Clinical chemistry and immunological tests, serum/plasma

712 yr 1317 yr Adults Adults

<0.90 mg/dL <1.20 mg/dL

2.1 Clinical chemistry and immunological tests, serum/plasma

CYFRA 211 Cystatin C Children

CYFRA 211 Elecsys

2.1 Clinical chemistry and immunological tests, serum/plasma

Healthy lab. workers 13 yr 46 yr 79 yr 1012 yr 1315 yr 1618 yr

ELISA, reference range depends on test used. Serum

Fatty acids, free Ferritin

Adults Children, adolescents <1 yr 13 yr 46 yr 712 yr f m 1317 yr f m 1760 yr 2060 yr f m

<0.7 mmol/L 12327 667 467 784 14124 1368 14152