APPENDIX

C
Laboratory Reference Intervals
The tables in this appendix list some of the most common
tests, their reference intervals (formally referred to as normal
values), and possible etiologies of abnormal results. Laboratory results may vary depending on different techniques or
different laboratories. Possible etiologies are presented in
alphabetic order. Abbreviations appearing in the tables are
defined as follows:
mEq = milliequivalent
mm Hg = millimeter of mercury
mm = millimeter
mOsm = milliosmole
L
dL
mL
L
fL

=
=
=
=
=

liter
deciliter (101 liter)
milliliter (103 liter)
microliter (106 liter, 103 milliliter)
femtoliter (1015 liter, 1012 milliliter)

g
mg
mcg
ng
pg

=
=
=
=
=

gram
milligram (103 gram)
microgram (106 gram)
nanogram (109 gram)
picogram (1012 gram)

U = unit
U = microunit
IU = international unit
mmol
mol
nmol
pmol
kPa
kat

=
=
=
=
=
=

millimole (103 mole)

micromole (106 mole)
nanomole (109 mole)
picomole (1012 mole)
kilopascal
microkatal

Source: Wu HB: Tietz clinical guide to laboratory tests, ed 4,

Philadelphia, 2006, Saunders.

TABLE C-1

SERUM, PLASMA, AND WHOLE BLOOD CHEMISTRIES

TEST

REFERENCE INTERVALS
CONVENTIONAL UNITS
SI UNITS

Acetone
Quantitative
Qualitative
Albumin

<2.0 mg/dL
Negative
3.5-5.0 g/dL

<344 mol/L
Negative
35-50 g/L

Aldolase
1-Antitrypsin

1.5-8.1 U/L
78-200 mg/dL

1.5-8.1 U/L
0.78-2.0 g/L

Skeletal muscle disease

Acute and chronic inammation, arthritis

1-Fetoprotein

<10 ng/mL

<10 mcg/L

Ammonia
Amylase

15-45 mcg N/dL

30-122 U/L (method
dependent)

11-32 mol N/L

0.51-2.07 kat/L

Bicarbonate

22-26 mEq/L

22-26 mmol/L

b-Type natriuretic
peptide (BNP)
Bilirubin
Total
Indirect
Direct

<100 mcg/L

<100 pmol/L

Cancer of testes, ovaries,

and liver
Severe liver disease
Acute and chronic pancreatitis, mumps (salivary gland
disease), perforated ulcers
Compensated respiratory
acidosis, metabolic alkalosis
Heart failure

0.2-1.2 mg/dL
0.1-1.0 mg/dL
0.1-0.3 mg/dL

3-21 mol/L
1.7-17.0 mol/L
1.7-5.1 mol/L

HIGHER

POSSIBLE ETIOLOGY
LOWER

Diabetic ketoacidosis, high-fat

diet, low-carbohydrate diet,
starvation
Dehydration

Chronic liver disease,

malabsorption, malnutrition,
nephrotic syndrome
Renal disease
Chronic lung disease (early
onset), malnutrition,
nephrotic syndrome

Acute alcoholism, cirrhosis of

liver, extensive destruction
of pancreas
Compensated respiratory
alkalosis, metabolic acidosis

Biliary obstruction, impaired

liver function, hemolytic
anemia, pernicious anemia

Mosby items and derived items 2011, 2007 by Mosby, Inc., an affiliate of Elsevier, Inc.

1795

1796

APPENDIX C

TABLE C-1

Laboratory Reference Intervals

SERUM, PLASMA, AND WHOLE BLOOD CHEMISTRIEScontd

TEST

REFERENCE INTERVALS
CONVENTIONAL UNITS
SI UNITS

Blood gases*
Arterial pH
Venous pH
PaCO2

7.35-7.45
7.32-7.43
32-48 mm Hg

7.35-7.45
7.32-7.43
4.26-6.38 kPa

PvCO2
PaO2
PvO2
Calcium (total)

38-55 mm Hg
80-100 mm Hg
38-42 mm Hg
8.6-10.2 mg/dL

5.06-7.32 kPa
10.6-13.33 kPa
5.04-5.57 kPa
2.15-2.55 mmol/L

Calcium (ionized)
Carbon dioxide (CO2)
Carotene

4.64-5.28 mg/dL
23-29 mEq/L
10-85 mcg/dL

1.16-1.32 mmol/L
23-29 mmol/L
0.19-1.58 mol/L

Chloride

96-106 mEq/L

96-106 mmol/L

Cholesterol

<200 mg/dL

<5.2 mmol/L

Male: >40 mg/dL

Female: >50 mg/dL
Recommended: <100 mg/dL

>1.04 mmol/L
>1.3 mmol/L
Recommended:
<2.6 mmol/L
Near optimal:
2.6-3.34 mmol/L
Moderate risk for CAD:
3.37-4.12 mmol/L

High-density lipoproteins (HDLs)

Low-density
lipoproteins
(LDLs)

Copper
Cortisol
Creatine

Near optimal: 100-129 mg/dL

(2.6-3.34 mmol/L)
Moderate risk for CAD:
130-159 mg/dL
(3.37-4.12 mmol/L)
High risk for CAD:
>160 mg/dL (>4.14 mmol/L)
80-155 mcg/dL
8 AM: 5-23 mcg/dL
8 PM: <10 mcg/dL
0.2-1.0 mg/dL

High risk for CAD:

>4.14 mmol/L
12.6-24.3 mol/L
0.14-0.63 mol/L
<0.28 mol/L
15.3-76.3 mol/L

Creatine kinase (CK)

Male: 20-200 U/L

Female: 20-180 U/L

Male: 20-200 U/L

Female: 20-180 U/L

CK-MB
Creatinine
Ferritin

<4%-6% of total CK
0.6-1.3 mg/dL
10-250 ng/mL

<0.4-0.6
53-115 mol/L
10-250 mcg/L

Folate (folic acid)

5-16 ng/mL

11-36 nmol/L

Gamma-glutamyl
transferase (GGT)

0-30 U/L

0-0.5 kat/L

Glucose (fasting)

70-99 mg/dL

3.9-5.5 mmol/L

HIGHER

POSSIBLE ETIOLOGY
LOWER

Alkalosis

Acidosis

Compensated metabolic
alkalosis
Respiratory acidosis
Administration of high
concentration of oxygen
Acute osteoporosis, hyperparathyroidism, vitamin D intoxication, multiple myeloma

Compensated metabolic
acidosis
Respiratory alkalosis
Chronic lung disease,
decreased cardiac output
Acute pancreatitis, hypoparathyroidism, liver disease,
malabsorption syndrome,
renal failure, vitamin D
deciency

Same as bicarbonate
Cystic brosis, hypothyroidism,
pancreatic insufciency
Metabolic acidosis, respiratory
alkalosis, corticosteroid
therapy, uremia
Biliary obstruction, hypothyroidism, idiopathic hypercholesterolemia, renal disease,
uncontrolled diabetes

Cirrhosis
Cushing syndrome, pancreatitis
Active rheumatoid arthritis,
biliary obstruction, hyperthyroidism, renal disorders,
severe muscle disease
Musculoskeletal injury or
disease, myocardial infarction,
severe myocarditis, exercise,
numerous IM injections
Acute myocardial infarction
Severe renal disease
Sideroblastic anemia, anemia
of chronic disease (infection,
inammation, liver disease)
Hypothyroidism

Liver disease, infectious

mononucleosis, pancreatitis,
hyperthyroidism
Acute stress, Cushing
disease, diabetes mellitus,
hyperthyroidism, pancreatic
insufciency

Dietary deciency, malabsorption disorders

Addisons disease, diarrhea,
metabolic alkalosis, respiratory acidosis, vomiting
Extensive liver disease, hyperthyroidism, malnutrition,
corticosteroid therapy

Wilsons disease
Adrenal insufciency,
panhypopituitary states
Diabetes mellitus

Iron-deciency anemia

Alcoholism, hemolytic anemia,

inadequate diet, malabsorption syndrome, megaloblastic anemia
Hypothyroidism

Addisons disease, hepatic

disease, hypothyroidism,
insulin overdosage,
pancreatic tumor, pituitary
hypofunction

PaCO2, Partial pressure of CO2 in arterial blood; PvCO2, partial pressure of CO2 in venous blood; PaO2, partial pressure of oxygen in arterial blood; PvO2, partial pressure of oxygen in
venous blood.
*Because arterial blood gases are inuenced by altitude, the value for PaO2 decreases as altitude increases. The lower value is normal for an altitude of 1 mile.

Mosby items and derived items 2011, 2007 by Mosby, Inc., an affiliate of Elsevier, Inc.

APPENDIX C
TABLE C-1

Laboratory Reference Intervals

1797

SERUM, PLASMA, AND WHOLE BLOOD CHEMISTRIEScontd

TEST

REFERENCE INTERVALS
CONVENTIONAL UNITS
SI UNITS

Haptoglobin

26-185 mg/dL

260-1850 mg/L

Insulin (fasting)

4-24 U/mL

29-172 pmol/L

Iron, total

50-175 mcg/dL

9.0-31.3 mol/L

Iron-binding capacity

250-425 mcg/dL

44.8-76.1 mol/L

Lactic acid (L-Lactate)

Lactic dehydrogenase (LDH)

6.3-22.5 mcg/dL
140-280 U/L

0.7-2.5 mmol/L
0.83-2.5 kat/L

18%-33%

0.18-0.33

LDH2

28%-40%

0.28-0.40

LDH3

18%-30%

0.18-0.30

LDH4

6%-16%

0.06-0.16

LDH5

2%-13%

0.02-0.13

Lipase

31-186 U/L

0.5-3.2 kat/L

Magnesium

1.5-2.5 mEq/L

0.75-1.25 mmol/L

Osmolality

275-295 mOsm/kg

275-295 mmol/kg

Oxygen saturation
(arterial) (SaO2)
pH
Phenylalanine
Phosphatase, acid

>95%

>0.95

See blood gases

0.8-1.8 mg/dL
0-0.6 U/L

48-109 mol/L
0-90 kat/L

Phosphatase, alkaline

38-126 U/L

0.65-2.14 kat/L

Phosphorus
(phosphate)

2.4-4.4 mg/dL

0.78-1.42 mmol/L

Potassium

3.5-5.0 mEq/L

3.5-5.0 mmol/L

Lactic dehydrogenase isoenzymes

LDH1

HIGHER

POSSIBLE ETIOLOGY
LOWER

Infectious and inammatory

processes, malignant
neoplasms
Acromegaly, adenoma of
pancreatic islet cells,
untreated mild case of type 2
diabetes
Excessive RBC
destruction
Iron-decient state, polycythemia
Acidosis, heart failure, shock
Heart failure, hemolytic
disorders, hepatitis,
metastatic cancer of liver,
myocardial infarction, pernicious anemia, pulmonary
embolus, skeletal muscle
damage

Myocardial infarction,
pernicious anemia
Pulmonary embolus, sickle cell
crisis
Malignant lymphoma,
pulmonary embolus
Systemic lupus erythematosus,
pulmonary infarction
Heart failure, hepatitis,
pulmonary embolus and
infarction, skeletal muscle
damage
Acute pancreatitis, hepatic
disorders, perforated peptic
ulcer
Addisons disease, hypothyroidism, renal failure
Chronic renal disease, diabetes
mellitus
Polycythemia

Phenylketonuria
Advanced Pagets disease,
cancer of prostate,
hyperparathyroidism
Bone diseases, marked hyperparathyroidism, obstruction of
biliary system, rickets
Healing fractures, hypoparathyroidism, renal disease, vitamin
D intoxication
Addisons disease, diabetic
ketosis, massive tissue
destruction, renal failure

Hemolytic anemia, mononucleosis, toxoplasmosis,

chronic liver disease
Inadequately treated type 1
diabetes mellitus

Iron-deciency anemia, anemia

of chronic disease
Cancer, chronic infections,
pernicious anemia

Chronic alcoholism, severe

malabsorption
Addisons disease, diuretic
therapy
Anemia, cardiac decompensation, respiratory disorders

Excessive vitamin D ingestion,

hypothyroidism
Diabetes mellitus, hyperparathyroidism, vitamin D
deciency
Cushing syndrome, diarrhea
(severe), diuretic therapy,
gastrointestinal stula,
pyloric obstruction,
starvation, vomiting

RBC, Red blood cell; SaO2, arterial oxygen saturation.

Mosby items and derived items 2011, 2007 by Mosby, Inc., an affiliate of Elsevier, Inc.

Continued

1798

APPENDIX C

TABLE C-1

Laboratory Reference Intervals

SERUM, PLASMA, AND WHOLE BLOOD CHEMISTRIEScontd

TEST

REFERENCE INTERVALS
CONVENTIONAL UNITS
SI UNITS

Progesterone (Female)
Follicular phase
Luteal phase

15-70 ng/dL
200-2500 ng/dL

0.5-2.2 nmol/L
6.4-79.5 nmol/L

<40 ng/dL
<4 ng/mL

1.28 nmol/L
<4 mcg/L

6.4-8.3 g/dL
3.5-5.0 g/dL
2.0-3.5 g/dL
1.5:1-2.5:1

64-83 g/L
35-50 g/L
20-35 g/L
1.5:1-2.5:1

Sodium

135-145 mEq/L

135-145 mmol/L

Testosterone

Male: 280-1100 ng/dL

Postmenopause
Prostate-specic
antigen (PSA)
Proteins
Total
Albumin
Globulin
Albumin/globulin
ratio

HIGHER

POSSIBLE ETIOLOGY
LOWER

Adrenal hyperplasia, choriocarcinoma of ovary, pregnancy,

cysts of ovary

Threatened abortion. hypogonadism, amenorrhea, ovarian

tumor

Prostate cancer
Burns, cirrhosis (globulin
fraction), dehydration

Liver disease, malabsorption

Multiple myeloma (globulin

fraction), shock, vomiting

Malnutrition, nephrotic
syndrome, proteinuria, renal
disease, severe burns
Addisons disease, diabetic
ketoacidosis, diuretic
therapy, excessive loss from
GI tract, excessive perspiration, water intoxication
Hypofunction of testes,
hypogonadism

Dehydration, impaired renal

function, primary aldosteronism, corticosteroid therapy

T4 (thyroxine), total

4.6-11.0 mcg/dL

Male: 10.438.17 nmol/L

Female: 0.522.43 nmol/L
59-142 nmol/L

T4 (thyroxine), free
T3 uptake
T3 (triiodothyronine),
total
Thyroid-stimulating
hormone (TSH)
Transaminases
Aspartate aminotransferase (AST)

0.8-2.7 ng/dL
24%-34%
Ages 20-50: 70-204 ng/dL
Ages >50: 40-181 ng/dL
0.4-4.2 U/mL

10-35 pmol/L
0.24-0.34
1.08-3.14 nmol/L
0.62-2.79 nmol/L
0.4-4.2 mU/L

10-30 U/L

0.17-0.51 kat/L

Alanine aminotransferase (ALT)

Transferrin
Transferrin
saturation (%)
Triglycerides

10-40 U/L

0.17-0.68 kat/L

190-380 mg/dL
15%-50%

1.9-3.8 g/L
15%-50%

<150 mg/dL

<1.7 mmol/L

Malnutrition

Troponins (cardiac)
Troponin T (cTnT)
Troponin I (cTnI)
Urea nitrogen (BUN)

Diabetes mellitus,
hyperlipidemia, hypothyroidism, liver disease
Myocardial infarction

<0.5 ng/mL (<0.5 mcg/L)

<0.1 ng/mL (<0.1 mcg/L)
6-20 mg/dL

2.1-7.1 mmol/L

Malnutrition, severe liver

damage

Uric acid

Male: 4.4-7.6 mg/dL

Female: 2.3-6.6 mg/dL

Male: 262-452 mol/L

Female:137-393 mol/L

Vitamin A (retinol)
Vitamin B12
(cobalamin)

30-80 mcg/dL
200-835 pg/mL

1.05-2.80 mol/L
148-616 pmol/L

Increase in protein catabolism

(fever, stress), renal disease,
urinary tract infection
Gout, gross tissue destruction,
high-protein weight reduction
diet, leukemia, renal failure
Excess ingestion of vitamin A
Chronic myeloid leukemia

Vitamin C
(ascorbic acid)

0.4-2.0 mg/dL

23-114 mol/L

Zinc

70-120 mcg/dL

10.7-120 mol/L

Female: 15-70 ng/dL

Polycystic ovary, virilizing

tumors
Hyperthyroidism, thyroiditis

Cretinism, hypothyroidism,
myxedema

Hyperthyroidism
Hyperthyroidism

Hypothyroidism
Hypothyroidism

Myxedema, primary hypothyroidism, Graves disease

Secondary hypothyroidism

Liver disease, myocardial

infarction, pulmonary
infarction, acute hepatitis
Liver disease, shock

Excessive ingestion of
vitamin C

Administration of uricosuric
drugs
Vitamin A deciency
Strict vegetarianism, malabsorption syndrome, pernicious anemia, total or partial
gastrectomy
Connective tissue disorders,
hepatic disease, renal
disease, rheumatic fever,
vitamin C deciency
Alcoholic cirrhosis

Mosby items and derived items 2011, 2007 by Mosby, Inc., an affiliate of Elsevier, Inc.

APPENDIX C
TABLE C-2

Laboratory Reference Intervals

1799

HEMATOLOGY

TEST

REFERENCE INTERVALS
CONVENTIONAL
SI UNITS
UNITS

Bleeding time

2-7 min

120-420 sec

Activated partial
thromboplastin time
(aPTT)
Prothrombin time
(Protime, PT)

25-35 sec*

25-35 sec*

11-16 sec*

11-16 sec*

Fibrinogen

200-400 mg/dL

2-4 g/L

Fibrin split (degradation) products

D-Dimer

<10 mcg/mL

<10 mg/L

<250 ng/mL

<250 mcg/L

Male: 4.3-5.7 106/L

Female: 3.8-5.1 106/L
80-100 fL

POSSIBLE ETIOLOGY
HIGHER

LOWER

Male: 4.3-5.7 1012/L

Female: 3.8-5.1 1012/L
80-100 fL

Defective platelet function, thrombocytopenia, von Willebrands disease,

aspirin ingestion, vascular disease
Deciency factors I, II, V, VIII, IX and
X, XI, XII; hemophilia, liver disease;
heparin therapy
Warfarin therapy; deciency of
factors I, II, V, VII, and X; vitamin K
deciency; liver disease
Burns (after rst 36 hr), inammatory
disease
Acute DIC, massive hemorrhage,
primary brinolysis
DIC, myocardial infarction, deep vein
thrombosis, unstable angina
Dehydration, high altitudes,
polycythemia vera
Macrocytic anemia

Anemia, leukemia,
posthemorrhage
Microcytic anemia

27-34 pg

27-34 pg

Macrocytic anemia

Microcytic anemia

32%-37%

0.32-0.37

Spherocytosis

Hypochromic anemia

<30 mm/hr (some

gender variation)

<30 mm/hr (some

gender variation)

Malaria, severe liver

disease, sickle cell
anemia

Male: 39%-50%
Female: 35%-47%
Male: 13.2-17.3 g/dL
Female: 11.7-15.5 g/dL
4.0%-6.0%

Male: 0.39-0.50
Female: 0.35-0.47
Male: 132-173 g/L
Female: 117-155 g/L
4.0%-6.0%

Moderate increase: acute hepatitis,

myocardial infarction; rheumatoid
arthritis
Marked increase: acute and severe
bacterial infections, malignancies,
pelvic inammatory disease
Dehydration, high altitudes,
polycythemia
COPD, high altitudes, polycythemia
Poorly controlled diabetes mellitus

150-400 103/L

150-400 109/L

Sickle cell anemia, chronic

renal failure, pregnancy
Acute leukemia, DIC,
thrombocytopenic
purpura

Reticulocyte count

0.5%-1.5% of RBC

0.5%-1.5% of RBC

White blood cell count

4.0-11.0 103/L

4.0-11.0 109/L

Inammatory and infectious

processes, leukemia

50%-70%

0.50-0.70

0%-8%
20%-40%

0-0.08
0.20-0.40

Monocytes

4%-8%

0.04-0.08

Eosinophils

0%-4%

0-0.04

Basophils

0%-2%

0-0.02

Bacterial infections, collagen diseases,

Hodgkins lymphoma
Acute infections
Chronic infections, lymphocytic
leukemia, mononucleosis, viral
infections
Chronic inammatory disorders,
malaria, monocytic leukemia, acute
infections, Hodgkins lymphoma
Allergic reactions, eosinophilic and
chronic granulocytic leukemia,
parasitic disorders, Hodgkins
lymphoma
Hypothyroidism, ulcerative colitis,
myeloproliferative diseases

Erythrocyte count
(altitude dependent)
Mean corpuscular
volume (MCV)
Mean corpuscular
hemoglobin (MCH)
Mean corpuscular
hemoglobin concentration (MCHC)
Erythrocyte sedimentation rate (ESR)

Hematocrit
(altitude dependent)
Hemoglobin
(altitude dependent)
Hemoglobin,
glycosylated
Platelet count
(thrombocytes)

WBC differential
Segmented
neutrophils
Band neutrophils
Lymphocytes

Acute infections, chronic granulocytic

leukemia, chronic pancreatitis,
cirrhosis, collagen disorders, polycythemia, postsplenectomy
Hemolytic anemia, polycythemia vera

Burns (during rst 36 hr),

DIC, severe liver disease

Anemia, hemorrhage,
overhydration
Anemia, hemorrhage

Hypoproliferative anemia,
macrocytic anemia,
microcytic anemia
Aplastic anemia, side
effects of chemotherapy
and irradiation
Aplastic anemia, viral
infections
Corticosteroid therapy,
whole body irradiation

Corticosteroid therapy

Hyperthyroidism, stress

COPD, Chronic obstructive pulmonary disease; DIC, disseminated intravascular coagulation; RBC, red blood cell; WBC, white blood cell.
*Values depend on reagent and instrumentation used.
Components of complete blood count (CBC).

Mosby items and derived items 2011, 2007 by Mosby, Inc., an affiliate of Elsevier, Inc.

1800
TABLE C-3

APPENDIX C

Laboratory Reference Intervals

SEROLOGY-IMMUNOLOGY

TEST

REFERENCE INTERVALS
CONVENTIONAL UNITS
SI UNITS

Antinuclear antibody (ANA)

Negative at 1:40 dilution

Negative at 1:40 dilution

Anti-DNA antibody
Anti-Sm (Smith)
C-reactive protein (CRP)

<70 IU/mL
Negative
6.8-820 mcg/dL

<70 IU/mL
Negative
68-8200 mcg/L

Carcinoembryonic antigen
(CEA)

Nonsmoker: <3 ng/mL

Smoker: <5 ng/mL

Nonsmoker: <3 mcg/L

Smoker: <5 mcg/L

Complement, total
hemolytic (CH50)

75-160 U/mL

75-160 kU/L

Direct Coombs or direct

antihuman globulin test
(DAT)
Fluorescent treponemal
antibody absorption
(FTA-Abs)
Hepatitis A antibody
Hepatitis B surface antigen
(HBsAg)
Hepatitis C antibody
Monospot or monotest
Rheumatoid factor (RF)

Negative

Negative

Acquired hemolytic anemia, drug

reactions, transfusion reactions

Negative or
nonreactive

Negative or
nonreactive

Syphilis

Negative
Negative

Negative
Negative

Hepatitis A
Hepatitis B

Negative
Negative
Negative or titer <1:17

Negative
Negative
Negative or titer <1:17

RPR

Negative or nonreactive

Negative or nonreactive

VDRL

Negative or nonreactive

Negative or nonreactive

Hepatitis C
Infectious mononucleosis
Rheumatoid arthritis, Sjgrens
syndrome, systemic lupus
erythematosus
Syphilis, systemic lupus
erythematosus, rheumatoid
arthritis, leprosy, malaria, febrile
diseases, IV drug abuse
Syphilis

HIGHER

POSSIBLE ETIOLOGY
LOWER

Chronic hepatitis, rheumatoid

arthritis, scleroderma, systemic
lupus erythematosus
Systemic lupus erythematosus
Systemic lupus erythematosus
Acute infections, any inammatory condition, widespread
malignancy
Carcinoma of colon, liver,
pancreas; chronic cigarette
smoking; inammatory bowel
disease; other cancers
Acute glomerulonephritis, systemic
lupus erythematosus,
rheumatoid arthritis,
subacute bacterial
endocarditis

RPR, Rapid plasma regain test; VDRL, Veneral Disease Research Laboratory test.

TABLE C-4

URINE CHEMISTRY

TEST

SPECIMEN

REFERENCE INTERVALS
UNITS
SI UNITS

Acetone

Random

Negative

Negative

Aldosterone

24 hr

3-30 mcg/day (low

sodium diet
increases threefold
to vefold)

0.08-0.83 nmol/day

Amylase
Bence Jones protein
Bilirubin
Calcium

24 hr
Random
Random
24 hr

1-17 U/hr
Negative
Negative
100-250 mg/day

1-17 U/hr
Negative
Negative
2.5-6.3 mmol/day

Catecholamines
Epinephrine
Norepinephrine

24 hr
<20 mcg/day
15-80 mcg/day

<109 nmol/day
89-473 nmol/day

HIGHER

POSSIBLE ETIOLOGY
LOWER

Diabetes mellitus, high-fat

and low-carbohydrate diets,
starvation
Primary aldosteronism:
adrenocortical tumors
Secondary aldosteronism:
cardiac failure, cirrhosis, large
dose of ACTH, salt depletion
Acute pancreatitis
Multiple myeloma
Liver disorders
Bone tumor,
hyperparathyroidism

ACTH deciency,
Addisons disease,
corticosteroid therapy

Hypoparathyroidism,
malabsorption of
calcium and vitamin D

Pheochromocytoma,
progressive muscular
dystrophy, heart failure

Mosby items and derived items 2011, 2007 by Mosby, Inc., an affiliate of Elsevier, Inc.

APPENDIX C
TABLE C-4

Laboratory Reference Intervals

1801

URINE CHEMISTRYcontd

TEST

SPECIMEN

REFERENCE INTERVALS
UNITS
SI UNITS

Creatine

24 hr

<100 mg/day

<763 mol/day

Creatinine

24 hr

0.6-2.0 g/day

5.3-17.7 mmol/day

Creatinine clearance
Estrogens
Female
Premenopause
Postmenopause
Male
Glucose

24 hr
24 hr

59-137 mL/min/1.73 m2

0.59-1.37 mL/sec/m2

Random

15-80 mcg/day
<20 mcg/day
15-40 mcg/day
Negative

15-80 mcg/day
<20 mcg/day
15-40 mcg/day
Negative

Hemoglobin

Random

Negative

Negative

5-Hydroxyindoleacetic acid (5-HIAA)

Ketone bodies

24 hr

2-7 mg/day

10.5-36.6 mol/day

24 hr

20-50 mg/day

0.34-0.86 mmol/day

Metanephrine
Myoglobin

24 hr
Random

92-934 mcg/day
Negative

500-5100 nmol/day
Negative

Osmolality

Random

300-1300 mOsm/kg

300-1300 mmol/kg

pH

Random

4.0-8.0

4.0-8.0

Protein (dipstick)

Random

0-trace

0-trace

Protein (quantitative)

24 hr

<150 mg/day

<0.15 g/day

Sodium
Specic gravity

24 hr
Random

40-220 mEq/day
1.003-1.030

Uric acid
Urobilinogen

24 hr
24 hr

250-750 mg/day
0.5-4.0 mg/day

40-220 mmol/day
Same as conventional units
1.5-4.5 mmol/day
0.8-6.8 mol/day

Vanillylmandelic acid

24 hr

1.4-6.5 mg/day

7-33 mol/day

HIGHER

POSSIBLE ETIOLOGY
LOWER

Liver cancer, hyperthyroidism,

diabetes, Addisons disease,
infections, burns, muscular
dystrophy, skeletal muscle
atrophy
Anemia, leukemia, muscular
atrophy

Hypothyroidism

Renal disease
Renal disease

Gonadal or adrenal tumor

Endocrine disturbance,
ovarian dysfunction,
menopause

Diabetes mellitus, pituitary

disorders
Extensive burns, glomerulonephritis, hemolytic anemias,
hemolytic transfusion reaction
Malignant carcinoid syndrome
Diabetes mellitus, starvation,
dehydration
Pheochromocytoma
Crushing injuries, electric
injuries, extreme physical
exertion
Dehydration, tubular
dysfunction (kidney lost ability
to dilute urine)
Urinary tract infection, urine
allowed to stand at room
temperature
Acute and chronic renal
disease, especially involving
glomeruli; heart failure
Cardiac failure, inammatory
processes of urinary tract,
nephritis, nephrosis,
strenuous exercise
Acute tubular necrosis
Albuminuria, dehydration,
glycosuria
Gout, leukemia
Hemolytic disease, hepatic
parenchymal cell damage,
liver disease
Pheochromocytoma

ACTH, Adrenocorticotropic hormone.

Mosby items and derived items 2011, 2007 by Mosby, Inc., an affiliate of Elsevier, Inc.

Tubular dysfunction
(kidney lost ability to
concentrate urine)
Respiratory or
metabolic acidosis

Hyponatremia
Diabetes insipidus
Nephritis
Complete obstruction
of bile duct

1802

APPENDIX C

TABLE C-5

Laboratory Reference Intervals

FECAL ANALYSIS

TEST

REFERENCE INTERVALS
CONVENTIONAL UNITS
SI UNITS

Fecal fat

<6 g/24 hr

Mucus
Pus

Negative
Negative

Same as
conventional units
Negative
Negative

Blood*

Negative

Negative

Color
Brown
Clay
Tarry
Red
Black

POSSIBLE ETIOLOGY
HIGHER

LOWER

Chronic pancreatic disease, obstruction of common

bile duct, malabsorption syndrome
Mucous colitis, spastic constipation
Chronic bacillary dysentery, chronic ulcerative colitis,
localized abscesses
Anal ssures, hemorrhoids, malignant tumor, peptic
ulcer, inammatory bowel disease
Various color depending on diet
Biliary obstruction or presence of barium sulfate
More than 100 mL of blood in gastrointestinal tract
Blood in large intestine
Blood in upper gastrointestinal tract or iron medication

*Ingestion of meat may produce false-positive results. Patient may be placed on a meat-free diet for 3 days before the test.

TABLE C-6

CEREBROSPINAL FLUID ANALYSIS

TEST

REFERENCE INTERVALS
CONVENTIONAL UNITS
SI UNITS

HIGHER

Pressure

60-150 mm H2O

60-150 mm H2O

Hemorrhage, intracranial tumor, meningitis

Blood
Cell count (age
dependent)
WBC
RBC
Chloride

Negative

Negative

Intracranial hemorrhage
Inammation or infections of CNS

0-5 cells/L
Negative
118-132 mEq/L

0-5 106 cells/L

Negative
118-132 mmol/L

Uremia

Glucose

40-70 mg/dL

2.2-3.9 mmol/L

Diabetes mellitus, viral infections of CNS

Protein
Lumbar
Cisternal
Ventricular

15-45 mg/dL
15-25 mg/dL
5-15 mg/dL

0.15-0.45 g/L
0.15-0.25 g/L
0.05-0.15 g/L

Guillain-Barr syndrome, poliomyelitis, trauma

Syphilis of CNS
Acute meningitis, brain tumor, chronic CNS
infections, multiple sclerosis

POSSIBLE ETIOLOGY
LOWER
Head injury, spinal tumor,
subdural hematoma

Bacterial infections of CNS

(meningitis, encephalitis)
Bacterial infections and
tuberculosis of CNS

CNS, Central nervous system.

Mosby items and derived items 2011, 2007 by Mosby, Inc., an affiliate of Elsevier, Inc.