Serum, Plasma, and Whole Blood Chemistries

Normal Adult Reference Range Clinical Significance

Determination Conventional Units SI Units Increased Decreased

Acetone 0.3-2.0 mg/dL 51.6-344.0/umol/L Diabetic ketoacidosis
Toxemia of Pregrnancy
Carbohydrate-free diet
High-fat

Acid, total phosphatase Males: 2-12UL Males: 2-12UL Carcinoma of prostate

Females: 0.3-9.2UL Females: 0.3- Advance Paget’s disease
9.2UL Hyperparathyroidism
Gaucher’s disease
Carcinoma of prostrate
Acid, phosphatase, 2.5-3.37 ng/mL 2.5-3.37 ug/L Carcinoma of prostate
prostatic—RIA

Alkaline phosphatase Adults:50-120 UL 50-120 UL Conditions reflecting increased

osteoblastic activity of bone
Rickets
Hyperparathyroidism
Hepatic disease
Bone disease
Adrenocorticotropic Hepatic:>25% Pituitary-dependent Cushing’s Adrenocortical tumor
hormone (ACTH) Combined:10%-25% syndrome Adrenal insufficiency
(plasma) – RIA Skeletal: <10% Ectopic ACTH syndrome secondary to
<50 pg/ml <50 ng/L Primary adrenal atrophy hypopituitarism
Aldosterone (plasma) – Supine: 3-10 ng/dL 0.08-0.30nmol/L Primary aldosteronism Addison’s disease
RIA Upright: 5-30 ng/dL 0.14-0.90nmol/L Secondary aldosteronism
Adrenal vein: 200- 5.54-22.16nmol/L
800 ng/dL
Alpha-1-fetoprotein <15ng/mL 15 ug/L Hepatocarcinoma
Metastatic carcinoma of liver
Germinal cell carcinoma of the
testicle or ovary
Fetal neural tube defects—
elevation in maternal serum
Ammonia (plasma) 15-45 ug/dL (varies 11-32/umol/L Severe liver disease
with method) Hepatic decompensation

Amylase 60-10 Somogyi U/dl 111-296U/L Acute pancreatitis Chronic pancreatitis

Mumps Pancreatic fibrosis and
Duodenal ulcer atrophy
Carcinoma of head of pancreas Cirrhosis of liver
Prolonged elevation with Pregnancy (2nd and 3rd
pseudocyst of pancreas trimesters)
Increased by medications that
constrict pancreatic duct
sphincters: morphine, codeine,
cohlinergics
ALT (alanine Males: 10-40 U/mL Males: 0.17- Same conditions as AST (SGOT),
aminotransferase), 0.68ukat/L butincrease is more marked in
formerly SGPT Females: 8-35 U/mL Females: 0.14- liver disease that AST (SGOT)
0.60ukat/L
AST (aspartate Males: 10-40 U/L Males: ).34-0.68 Myocardial infarction
aminotransferase), ukat/L Skeletal muscle disease
formerly SGOT Females: 15-30 U/L Females0.25-0.51 Liver disease
ukat/L
Biluribin Total: 0.3-1.0 mg/dL 5-17umol/L Hemolytic anemia (indirect)
Direct: 0.1-0.4 1.7-3.7 umol/L Biliary obstruction and disease
mg/dL 3.4-11.2 umol/L Hepatocellular damage (hepatitis)
Indirect: 0.1-0.4 Pernicious anemia
mg/dL Hemolytic disease of newborn
Blood gases
Oxygen, arterial 85-95 mm Hg 10.64-12.64 kPa Polycythemia Anemia
(whole blood): Partial Cardiac or pulmonary
pressure (PaO2) disease

Saturation (SaO2) 95%-99% Volume fraction: Cardiac decompensation

0.95-0.99 Chronic obstructive lung
disease

Carbon dioxide, 35-45 mm Hg 4.66-5.99 kPa Respiratory acidosis Respiratory alkalosis

arterial (whole blood) Metabolic alkalosis Metabolic acidosis
partial pressure (PaCO2)
pH (whole blood, 7.35-7.45 7.35-7.45 Vomiting Uremia
arterial) Hyperventilation Diabetic acidosis
Fever Hemorrhage
Intestinal Obstruction Nephritis
Calcium 8.6-10.2 mg/dL 2.15-2.55 mmol/L Tumor or hyperplasia of Hypoparathyroidism
parathyroid Diarrhea
Hypervitaminosis D Celiac disease
Multiple myeloma Vitamin D deficiency
Nepritis with Uremia Acute pancreatitis
Malignant tumors Nephrosis
 Sarcoidosis After parathyroidectomy
Hyperthyroidism
Skeletal immobilization
Excess calcium intake: milk
alkali syndrome
CO2 venous Adults: 24-32 mEq/L 24-32 mmol/L Tetany Acidosis
Infants: 18-24 18-24 mmol/L Respiratory disease Nephritis
mEq/L Intestinal obstruction Eclampsia
Vomiting Diarrhea
Anesthesia
Chloride 97-107 mEq/L 97/107mmol/L Nephrosis Diabetes mellitus
Nephritis Diarrhea
Urinary obstruction Vomiting
Cardiac decompensation Pneumonia
Anemia Heavy metal poisoning
Cushing’s syndrome
Intestinal obstruction
Febrile conditions
Cholesterol 150-200mg/dL 3.9-5.2 mmol/L Lipemia Pernicious anemia
Obstructive jaundice Hemolytic anemia
Diabetes Hyperthyroidism
Hypothyroidism Severe infection
Terminal states of
debilitating disease
Creatine phospokinase Males: 50-325 50-325 U/L Myocardial infarction
(CPK) mU/mL Skeletal muscle diseases
Females: 50-250 50-250 U/L Intramuscular injections
mU/mL Crush syndrome
Hypothyroidism
Alcoholic myopathy
Cerebrovascular disease
Creatine phosphokinase MM band present MB band increased in myocardial
isoenzymes (skeletal muscle)- infarction, ischemia
MB band absent
(heart muscle)
Creatinine 0.7-1.4 mg/dL 62-124 umol/L Nephritis
Chronic renal disease
Creatinine clearance Males: 85- 1.42-2.08 mL/s Kidney diseases
125mL/min
Females: 75- 1.25-1.92 mL/s
115mL/min
Glucose Fasting: 60-110 3.3-6.05 mmol/L Diabetes mellitus Hyperinsulinism
mg/dL Nephritis Hypothyroidism
Hyperthyroidism Late hyperpituitarism
Postprandial (2h): 3.58-7.7 mmol/L Early hyperpituitarism Pernicious vomiting
65-140 mg/dL Cerebral lesions Addison’s disease
Infections Extensive hepatic damage
Pregnancy
Uremia
Glucose tolerance Features of a normal Two-hour value > 200 mg/dL Decreased 2 and 3 hour
(oral) response: (11.1 mmol/L) is diagnostic for values may occur with
1. Normal diabetes mellitus hypoglycemia mellitus
fasting
between 60/- 3.3-6.05 mmol/L
110mg/dL
2. No sugar in
urine
3. Upper limits
of normal:
Fasting = 125 6.88 mmol/L
1 hour = 190 10.45 mmol/L
2 hours = 140 7.70 mmol/L
 3 hours = 125 6.88 mmol/L

Glycohemoglobin Nondiabetics and Suboptimal glucose control

(GHB, hemoglobin A1c, diabetics with good
hemoglobin A1) control: 4.4 % - 6.4%
High-density lipoprotein Males: 35-70 mg/dL 0.91-1.81 mmol/L HDL cholesterol is lower
cholesterol(HDL Females: 35- 0.91-2.20 mmol/L in patient with increased
cholesterol) 85mg/dL risk for coronary heart
disease
Immunoglobulin A Adults: 85-385 0.85-3.85g/L Gamma A myeloma Ataxia tenagiectasis
mg/dL (in children Wiskott-Aldrich syndrome Agammaglobulinemia
the normals are Autoimmune disease Hypogammaglobulinemia,
lower and vary with Hepatic cirrhosis transient
age) Dysgammaglobulinemia
Protein-losing
enteropathies
Immunoglobulin D 0-14 mg/dL 0.140mg/L IgD multiple myeloma
Some patients with chronic
infectious diseases
Immunoglobulin E 100-700 ng/mL 100-700ug/L Allergic patients and those with
parasitic infections
Immunoglobulin G Adults: 565-1765 6.35-14 g/L IgG myeloma Congenital and acquired
mg/dL Following hyperimmunization hypogammaglobulinemia
Autoimmune disease states Some malabsorption
Chronic infections syndromes
Extensive protein loss
Immunoglobulin M Adults: 55- 0.4-2.8 g/L Waldenström’s Agammaglobulinemia
375mg/dL macroglobulinemia Some IgG and IgA
Parasitic infections myeloma
Hepatitis Chronic lymphatic
 leukemia

Lactic dehydrogenase 90-176 mU/mL 90-176 U/L Untreated pernicious anemia

(LDH) Myocardial infarction
Pulmonary infarction
Liver disease
Lead (whole blood) Up to 40 ug/dL Up to umol/L Lead poisoning
Lipase <200 U/mL <200 U/L Acute and chronic pancreatitis
Biliary obstruction
Cirrhosis
Hepatitis
Peptic ulcer
Low-density lipoprotein mg/dL LDL cholesterol is highe in
cholesterol (LDL desirable levels: patients with increased risk for
cholesterol) <160 if no coronary coronary heart disease
artery disease (CAD)
and <2 risk factors
<100 if CAD present
Magnesium 1.3-2.3 mg/dL 0.62-0.95 mmol/L Excess ingestin of magnesium- Chronic alcoholism
containing antacids Severe renal disease
Diarrhea
Defective growth
Phenylalanine 1.2-3.5 mg/dL 1st 0.07-0.21mmol/L Phenylketonuria Chronic renal failure
week 0.04-0.21 mmol/L
0.7-3.5 mg/dL
thereafter
20-90IU/L
Phosphorus, inorganic 2.5-4.5 mg/dL 0.8-1.45 mmol/L Chronic nephritis
Hypoparathyroidism
Potassium 3.5-5mEq/L 3.5-5mmol/L Renal Failure Hyperparathyroidism
 Acidosis Vitamin D deficiency
Cell lysis GI losses
Tissue breakdown or hemolysis Diuretic administration
Prostrate-specific <4 ng/mL Prostatic cancer, benign prostatic
antigen hyperplasia, prostatitis
Protein, total 6-8 gm/dL 60-80 g/L Hemoconcentration Malnutrition
Protein, Albumin 4-5.5 g/dL 40-55 g/L Shock Hemorrhage
Protein, Globulin 1.7-3.3 g/dL 17-33 g/L Globulin fraction increased in Loss of plasma from burns
multiple myeloma, chronic Proteinuria
infection, liver disease
Sodium 135-145 mEq/L 135-145 mmol/L Hemoconcentration Alkali deficit
Nephritis Addison’s disease
Pyloric obstruction Myxedema
T3 (triodothyronine) 24%-34% Relative uptake Hyperhyroidism Hypothyroidism
uptake fraction: 0.24-0.34 Thyroxine-binding globulin Pregnancy
(TBG) deficiency TBG excess
Androgens and anabolic steroids Estrogens and anti-
ovulatory drugs
T4 (thyroxine) – RIA 5-11 ug/dL 65-138nmol/L Hyperthyroidism Primary and pituitary
Thyroiditis hypothyroidism
Elevated thyroxine-binding Idiopathic involvement
proteins caused by oral Cases of diminished
contraceptives thyroxine-binding proteins
Pregnancy caused by androgenic and
anabolic steroids
Hypoproteinemia
Nephritic syndrome
Triglycerides 100-200 mg/dL 1.13-3.8mmol/L Trytophan-specific
malabsorption syndrome
Urea nitrogen (BUN) 10-20 mg/dL 3.6-7.2 mmol/L Acute gomerulonephritis Severe hepatic failure

Uric acid
Immunodiagnostic Test
Determination
Anti ds-DNA antibody
Antinuclear antibody
Anti-Smith antibody
C reactive protein
Hepatitis A virus
antibodies, IgM (HAV-
Ab/Igm)
Hepatitis B surface antigen
(HBsAg)
Hepatitis B surface
antibody (HBsAb)
Rheumatoid factor
Obstructive uropathy Pregnancy
Mercury poisoning
Nephritic syndrome
2.5-8mg/dL 0.15-0mmol/L Gouty arthritis Defective tubular
Acute leukemia reabsorption
Lymphomas treated by
chemotherapy
Toxemia of pregnancy
Normal Value Clinical Significance
<70 U by enzyme-linked immunosorbent assay Valuable in supporting diagnosis or monitoring
(ELISA) disease activity and prognosis of systemic lupus
<1:20 by indirect fluorescence erythematosus (SLE)
Negative, <1:40 Increased in SLE, chronic hepatitis, scleroderma,
leukemia, and mononucleosis
Negative Highly diagnostic of SLE
<0.8 mg/dL Increase indicates active inflammation
Negative Positive in acute-stage hepatitis A: develops early
in disease
Negative Positive in acute-stage hepatitis B
Negative Positive if previous exposure and immunity to
hepatitis B
Negative or less than 40 IU/mL Elevated in rheumatoid arthritis, lupus endocarditis,
tuberculosis, syphilis, sarcoidosis, cancer