ABIM Laboratory Test Reference Ranges January 2017

Transcription

1 ABIM Laboratory Test Reference Ranges January 2017 Laboratory Tests Reference Ranges 1,25-Dihydroxyvitamin D See Vitamin D metabolites (1,25-dihydroxycholecalciferol), serum 17-Hydroxyprogesterone, serum Female, follicular Less than 80 ng/dl Female, luteal Less than 285 ng/dl Female, postmenopausal Less than 51 ng/dl Male (adult) Less than 220 ng/dl 25-Hydroxyvitamin D See Vitamin D metabolites (25-Hydroxycholecalciferol), serum 5-Hydroxyindoleacetic acid, urine 2 9 mg/24 hr 6-Thioguanine, whole blood pmol/8x10 8 RBCs Absolute neutrophil count (ANC) /μL Acid phosphatase, serum (Bodansky) units/ml Prostatic fraction unit/ml ACTH, plasma pg/ml Activated partial thromboplastin time seconds ADAMTS13 activity Greater than 60% Adrenocorticotropic hormone (ACTH), plasma pg/ml Albumin, serum g/dl Albumin, urine Less than 25 mg/24 hr Albumin-to-creatinine ratio, urine Less than 30 mg/g Aldolase, serum IU/mL Aldosterone, plasma Supine or seated Up to 10 ng/dl Standing Less than 21 ng/dl Low-sodium diet (supine) Up to 30 ng/dl Aldosterone, urine 5 19 μg/24 hr Alkaline phosphatase, serum U/L Alkaline phosphatase, bone specific µg/l for premenopausal women Alpha 1 -antitrypsin (AAT), serum mg/dl Alpha 2 -antiplasmin activity, plasma 75% 115% Alpha-amino nitrogen, urine mg/24 hr Alpha-fetoprotein, serum Less than 10 ng/ml Amino acids, urine mg/24 hr Aminotransferase, serum alanine (ALT, SGPT) U/L Aminotransferase, serum aspartate (AST, SGOT) U/L Ammonia, blood μg/dl Amylase, serum U/L ( [Somogyi] units/dl) Amylase, urine 1 17 U/hr Androstenedione, serum Female: ng/dl; male: ng/dl Angiotensin-converting enzyme, serum 8 53 U/L Anion gap, serum 7 13 meq/l Antibodies to double-stranded DNA 0 7 IU/mL

2 Anticardiolipin antibodies IgG IgM Anti-cyclic citrullinated peptide, antibodies to Antideoxyribonuclease B Less than 20 GPL Less than 20 MPL Less than 20 units Less than 280 units Anti-F-actin antibodies, serum 1:80 or less Antihistone antibodies Less than 1:16 Anti-liver-kidney microsomal antibodies (anti-lkm) Less than 1:20 Antimitochondrial antibodies 1:5 or less Anti myelin associated glycoprotein antibody Less than 1:1600 Antimyeloperoxidase antibodies Antinuclear antibodies Anti smooth muscle antibodies Antistreptolysin O titer Less than 3.0 U/mL 1:40 or less 1:80 or less Antithrombin activity 80% 120% Antithyroglobulin antibodies Antithyroid peroxidase antibodies Less than 200 Todd units Less than 20 U/mL Less than 2.0 U/mL Arterial blood gas studies (patient breathing room air): ph PaCO 2 PaO 2 Bicarbonate Oxygen saturation mm Hg mm Hg meq/l 95% or greater Methemoglobin 0.5% 3.0% Ascorbic acid (vitamin C), blood Ascorbic acid, leukocyte (1,3)-Beta-D-glucan, serum Beta subunit chorionic gonadotropin, urine Beta 2 -glycoprotein antibodies: IgG IgM Beta-hydroxybutyrate, serum Beta 2 -microglobulin, serum Bicarbonate, serum Bilirubin, serum Direct Indirect Bleeding time (template) Blood urea nitrogen (BUN), serum or plasma B-type natriuretic peptide, plasma C peptide, serum Calcitonin, serum Calcium, ionized, serum Calcium, serum Calcium, urine mg/dl 16.5 ± 5.1 mg/dl of leukocytes Less than 60 pg/ml Less than 2 miu/24 hr Less than 21 SGU Less than 21 SMU less than 0.4 mmol/l mg/l meq/l mg/dl mg/dl mg/dl Less than 8 minutes 8 20 mg/dl Less than 100 pg/ml ng/ml Female: 5 pg/ml or less; male: 10 pg/ml or less mmol/l mg/dl Female: Less than 250 mg/24 hr; male: less than 300 mg/24 hr 2

3 Carbohydrate antigens, serum CA 19-9 CA CA 125 Carbon dioxide content, serum 0 37 U/mL Less than 38.0 U/mL Less than 35 U/mL meq/l Carboxyhemoglobin, blood Less than 5% Carcinoembryonic antigen, plasma Carotene, serum Catecholamines, plasma Dopamine Epinephrine Supine Standing Norepinephrine Supine Standing Catecholamines, urine Dopamine Epinephrine Norepinephrine CD4 (T4) lymphocyte count Cell count, CSF: Leukocytes (WBCs) Ceruloplasmin, serum (plasma) Chloride, CSF Chloride, serum Chloride, urine Spot 24-hour measurement Cholesterol, serum Desirable Borderline-high High High-density lipoprotein Low Low-density lipoprotein Optimal Near-optimal Borderline-high High Very high Cholinesterase, serum (pseudocholinesterase) Packed cells Chorionic gonadotropin, beta-human (beta-hcg), serum Chromogranin A, serum Less than 2.5 ng/ml μg/dl Less than 30 pg/ml Less than 50 pg/ml Less than 95 pg/ml pg/ml pg/ml μg/24 hr 2 24 μg/24 hr μg/24 hr μg/24 hr /μL 0 5 cells/μl mg/dl meq/l meq/l meq/l; varies meq/24 hr; varies with intake Less than 200 mg/dl mg/dl Greater than 239 mg/dl Female: less than 50 mg/dl; male: less than 40 mg/dl Less than 100 mg/dl mg/dl mg/dl mg/dl Greater than 189 mg/dl 0.5 or more ph units/hr 0.7 or more ph units/hr Female, premenopausal nonpregnant: less than 1.0 U/L ; female, postmenopausal: less than 7.0 U/L; male: less than 1.4 U/L Less than 93 ng/ml 3

4 Citrate, urine Clotting time (Lee-White) Coagulation factors, plasma Factor I (fibrinogen) mg/24 hr 5 15 minutes mg/dl Factor II (prothrombin) 60% 130% Factor V (accelerator globulin) 60% 130% Factor VII (proconvertin) 60% 130% Factor VIII (antihemophilic globulin) 50% 150% Factor IX (plasma thromboplastin component) 60% 130% Factor X (Stuart factor) 60% 130% Factor XI (plasma thromboplastin antecedent) 60% 130% Factor XII (Hageman factor) 60% 130% Cold agglutinin titer Complements, serum C3 C4 CH50 Copper, serum Copper, urine Coproporphyrin, urine Cortisol, free, urine Cortisol, plasma Greater than 1:64 positive mg/dl mg/dl units/ml μg/dl μg/24 hr μg/24 hr 4 50 μg/24 hr 8 AM 5 25 μg/dl 4 PM Less than 10 μg/dl 1 hour after cosyntropin 18 μg/dl or greater Overnight suppression test (1-mg) Overnight suppression test (8-mg) Cortisol, saliva, 11 PM midnight Less than 1.8 μg/dl Greater than 50% reduction in cortisol Less than 0.09 µg/dl C-reactive protein, serum 0.8 mg/dl or less C-reactive protein (high sensitivity), serum Low risk = less than 1.0 mg/l; Average risk = mg/l; High risk = more than 3.0 mg/l Creatine kinase, serum MB isoenzymes Creatine, urine Creatinine clearance, urine Creatinine, serum Creatinine, urine Spot 24-hour measurement Cyclosporine, whole blood (trough) Therapeutic range Female: U/L; male: U/L Less than 5% of total Female: mg/24 hr; male: 0 40 mg/24 hr ml/min mg/dl mg/dl; varies mg/kg body weight/24 hr ng/ml 0 3 months post transplantation ng/ml More than 3 months post transplantation D-dimer, plasma Dehydroepiandrosterone sulfate (DHEA-S), serum Delta-aminolevulinic acid, serum Digoxin, serum ng/ml Less than 0.5 μg/ml Female: μg/dl; male: μg/dl Less than 20 μg/dl Therapeutic range: ng/ml (less than 1.2 ng/ml for patients with heart failure) 4

5 Dihydrotestosterone, serum Dopamine, plasma Dopamine, urine D-Xylose absorption (after ingestion of 25 g of D-xylose) Serum Urinary excretion Electrolytes, serum Sodium Potassium Chloride Bicarbonate Epinephrine, plasma Supine Standing Epinephrine, urine Erythrocyte count Erythrocyte sedimentation rate (Westergren) Erythrocyte survival rate ( 51 Cr) Erythropoietin, serum Estradiol, serum Female, follicular Male Mid-cycle peak Luteal Postmenopausal Estriol, urine Estrogen receptor protein Estrone, serum Ethanol, blood Coma level Intoxication Euglobulin clot lysis time Everolimus, whole blood (trough) Factor XIII, B subunit, plasma Fecal fat Fecal nitrogen Adult male: ng/dl Less than 30 pg/ml μg/24 hr mg/dl g during a 5-hr period meq/l meq/l meq/l meq/l Less than 110 pg/ml Less than 140 pg/ml Less than 20 μg/24 hr million/μl Female: 0 20 mm/hr; male: 0 15 mm/hr T½ = 28 days 4 26 mu/ml pg/ml pg/ml pg/ml Less than 10 pg/ml pg/ml Fecal ph Fecal potassium Fecal sodium Fecal urobilinogen Fecal weight Ferritin, serum Fibrin(ogen) degradation products Fibrinogen, plasma Fibroblast growth factor-23, serum Flecainide, serum Folate, red cell Folate, serum Greater than 12 mg/24 hr Negative: Less than 10 fmol/mg protein pg/ml Less than 0.005% (less than 5 mg/dl) More than 0.5% (more than 500 mg/dl) 0.08% 0.1% or greater ( mg/dl or greater) 2 4 hours at 37.0 C Therapeutic range: ng/ml U/dL Less than 7 g/24 hr Less than 2 g/24 hr Less than 10 meq/l Less than 10 meq/l mg/24 hr Less than 250 g/24 hr Female: ng/ml; male: ng/ml Less than 10 μg/ml mg/dl RU/mL Therapeutic range: μg/ml ng/ml of packed cells ng/ml 5

6 Follicle-stimulating hormone, serum Female, follicular/luteal Female, mid-cycle peak Female, postmenopausal Male (adult) Children, Tanner stages 1, 2 Children, Tanner stages 3, 4, 5 Free kappa light chain, serum 2 9 miu/ml (2 9 U/L) 4 22 miu/ml (4 22 U/L) Greater than 30 miu/ml (Greater than 30 U/L) 1 7 miu/ml (1 7 U/L) miu/ml ( U/L) 1 12 miu/ml (1 12 U/L) mg/l Free kappa-to-free lambda light chain ratio, serum Free lambda light chain, serum Fructosamine, serum Gamma globulin, CSF Gamma-glutamyl transpeptidase, serum Gastric secretion Basal acid analysis Basal acid output Maximal output after pentagastrin stimulation Gastrin, serum Gentamicin, serum Glucose, CSF Glucose, plasma (fasting) Glucose-6-phosphate dehydrogenase, blood Glycoprotein α-subunit, serum Growth hormone, serum At rest Response to provocative stimuli Haptoglobin, serum mg/l mmol/l mg/dl Female: 8 40 U/L; male: 9 50 U/L units of free acid Female: 2.0 ± 1.8 meq of HCl/hr; male: 3.0 ± 2.0 meq of HCl/hr 23 ± 5 meq of HCl/hr Less than 100 pg/ml Therapeutic range: peak µg/ml; trough: less than 2.0 µg/ml mg/dl mg/dl 5 15 units/g of hemoglobin Less than 1 ng/ml Less than 5 ng/ml Greater than 7 ng/ml mg/dl Hematocrit, blood Female: 37% 47%; male: 42% 50% Hemoglobin A 1C 4.0% 5.6% Hemoglobin, blood Hb A 96% 98% Hb A 2 1.5% 3.5% Hb F Less than 1% Hemoglobin, plasma Heparin anti-factor Xa assay, plasma Heparin platelet factor 4 antibody Hepatic copper Female: g/dl; male: g/dl Less than 5.0 mg/dl Hepatic iron index Less than 1.0 Histamine excretion, urine μg/24 hr Homocysteine, plasma Beta-human chorionic gonadotropin (beta-hcg), serum Hydroxyproline, urine Immature platelet fraction Immune complexes, serum IU/mL [therapeutic range for standard (unfractionated) heparin therapy] Positive: Greater than 0.4 optical density units μg/g dry weight 5 15 μmol/l Female, premenopausal nonpregnant: less than 1.0 U/L ; female, postmenopausal: less than 7.0 U/L; male: less than 1.4 U/L mg/sq meter of body surface/24 hr 1% 5% of platelet count 0 50 μg/dl 6

7 Immunoglobulins, serum IgA IgE IgG IgM Immunoglobulin free light chains, serum Kappa Lambda mg/dl Less than 380 IU/mL mg/dl mg/dl mg/l mg/l Kappa-to-lambda ratio Insulin, serum (fasting) Insulin-like growth factor 1 (IGF-1) (somatomedin-c), serum Ages Ages Ages Ages 55 and older Iodine, urine Spot Iron, serum Iron-binding capacity, serum (total) Lactate dehydrogenase, serum Lactate, arterial blood Lactate, serum or plasma Lactate, venous blood Lactic acid, serum Lactose tolerance test, GI Lead, blood Lead, urine Leukocyte count Less than 20 μu/ml ng/ml ng/ml ng/ml ng/ml µg/l; varies μg/dl μg/dl U/L Less than 1.3 mmol/l (Less than 1.3 meq/l) mmol/l meq/l; 6 16 mg/dl 6 19 mg/dl ( mmol/l) Increase in plasma glucose: greater than 15 mg/dl μg/dl Less than 80 μg/24 hr ,000/μL Segmented neutrophils 50% 70% Band forms 0 5% Lymphocytes 30% 45% Monocytes 0 6% Basophils 0 1% Eosinophils 0 3% Lipase, serum Lipoprotein(a) serum Lithium, plasma Therapeutic range Toxic level Luteinizing hormone (LH), serum Female, follicular/luteal Female, mid-cycle peak Female, postmenopausal Male (adult) Children, Tanner stages 1, 2, 3 Children, Tanner stages 4, U/L Desirable: less than 30 mg/dl meq/l Greater than 2 meq/l 1 12 miu/ml (1 12 U/L) 9 80 miu/ml (9 80 U/L) Greater than 30 miu/ml (Greater than 30 U/L) 2 9 miu/ml (2 9 U/L) Less than 9.0 miu/ml (Less than 9.0 U/L) 1 15 miu/ml (1 15 U/L) 7

8 Lymphocyte subsets CD3 CD4 CD8 CD 19 B Magnesium, serum Magnesium, urine Mean corpuscular hemoglobin Mean corpuscular hemoglobin concentration Mean corpuscular volume Mean platelet volume Metanephrines, fractionated, plasma Metanephrine Normetanephrine Metanephrines, fractionated, 24-hour urine Metanephrine Normetanephrine Myoglobin, serum Norepinephrine, plasma Supine Standing Norepinephrine, urine /μL /μL /μL /μL meq/l mg/24 hr pg g/dl fl 7 9 fl Less than 0.5 nmol/l Less than 0.9 nmol/l Less than 400 µg/24 hr Less than 900 µg/24 hr Less than 100 μg/l pg/ml pg/ml μg/24 hr Normetanephrine, fractionated, plasma Less than 0.9 nmol/l Normetanephrine, fractionated, 24-hour urine Less than 900 µg N -telopeptide, urine N -terminal-pro-b-type natriuretic peptide (NT-pro-BNP), serum or plasma Osmolality, serum Osmolality, urine Osmotic fragility of erythrocytes Osteocalcin, serum Oxalate, urine Oxygen consumption Oxygen saturation, arterial blood Female: nmol BCE/mmol creatinine; male: 7 68 nmol BCE/mmol creatinine If egfr > 60 ml/min/1.73 m years of age Heart failure unlikely: 300 pg/ml or less High probability of heart failure: 450 pg/ml or greater years of age Heart failure unlikely: 300 pg/ml or less High probability of heart failure: 900 pg/ml or greater Older than 75 years of age Heart failure unlikely: 300 pg/ml or less High probability of heart failure: 1800 pg/ml or greater If egfr < 60 ml/min/1.73 m2 18 years of age or older High probability of heart failure: 1200 pg/ml or greater mosm/kg H 2 O mosm/kg H 2 O Increased if hemolysis occurs in over 0.5% NaCl; decreased if hemolysis is incomplete in 0.3% NaCl Male: ng/ml; Female: ng/ml Less than 40 mg/24 hr ml/min 95% or greater 8

9 Parathyroid hormone, serum C -terminal Intact Intact (dialysis patients only) Parathyroid hormone-related protein, serum Partial thromboplastin time (activated) pg/ml pg/ml Target: pg/ml Less than 1.5 pmol/l seconds ph, urine Phenolsulfonphthalein, urine Phenytoin, serum Phosphatase (acid), serum Prostatic fraction Phosphatase (alkaline), serum Phospholipids, serum (total) Phosphorus, serum Phosphorus, urine Platelet count Platelet function analysis (PFA-100): Collagen epinephrine closure time Collagen ADP closure time Platelet survival rate ( 51 Cr) Potassium, serum Potassium, urine Spot 24-hour measurement Prealbumin, serum Pregnanetriol, urine At least 25% excreted by 15 minutes; 40% by 30 minutes; 60% by 120 minutes Therapeutic range: μg/ml (Bodansky) units/ml unit/ml U/L mg/dl mg/dl mg/24 hr 150, ,000/μL seconds seconds 10 days meq/l meq/l; varies meq/24 hr; varies with intake mg/dl mg/24 hr Pressure (opening) [initial], CSF mm CSF ( mm H 2 O) Procalcitonin, serum Progesterone, serum Female, follicular Female, luteal Male (adult) Proinsulin, serum Prolactin, serum less than or equal to 0.10 ng/ml ng/ml 2 30 ng/ml ng/ml 3 20 pmol/l Less than 20 ng/ml Prostate-specific antigen, serum ng/ml; no specific normal or abnormal level Protein C activity 65% 150% Protein C antigen 70% 140% Protein catabolic rate, urine goal: g/kg/24 hr Protein S activity 57% 131% Protein S antigen 60% 140% Free 60% 130% Protein, urine Spot 24-hour measurement Proteins, CSF total mg/dl; varies Less than 100 mg/24 hr mg/dl 9

10 Proteins, serum Albumin Globulin Alpha1 Alpha2 Beta Gamma Protein-to-creatinine ratio, urine Prothrombin time, plasma Pyruvic acid, blood Quinidine, serum g/dl g/dl g/dl g/dl g/dl g/dl g/dl Less than 0.2 mg/mg seconds Red cell distribution width (RDW) Red cell mass Renin activity (angiotensin-i radioimmunoassay) Peripheral plasma Normal diet Supine Upright Low sodium diet Supine Upright Diuretics + low sodium diet mmol/l Therapeutic range: 2 5 μg/ml Female: ml/kg; male: ml/kg ng/ml/hr ng/ml/hr ng/ml/hr ng/ml/hr ng/ml/hr Renal vein concentration Normal ratio (high:low): less than 1.5 Reptilase time Reticulocyte count Reticulocyte count, absolute Rheumatoid factor (nephelometry) Rheumatoid factor, latex test for seconds 0.5% 1.5% of red cells 25, ,000/µL Less than 24 IU/mL 1:80 or less Ristocetin cofactor activity of plasma 50% 150% Russell viper venom time, dilute Salicylate, plasma Sex hormone-binding globulin Sodium, serum Sodium, urine Spot 24-hour measurement seconds Therapeutic range: mg/dl Female, nonpregnant: nmol/l; male: nmol/l meq/l meq/l; varies Specific gravity, urine Sperm density Sweat test for sodium and chloride meq/24 hr; varies with intake million/ml Less than 60 meq/l T3 resin uptake 25% 35% T4 (CD4) lymphocyte count /μL Tacrolimus, whole blood Trough therapeutic range: 5 15 ng/ml {For transplant patients: ng/ml (0 3 months post transplantation); ng/ml (more than 3 months post transplantation)} Testosterone, serum Female: ng/dl; male: ng/dl Testosterone, bioavailable, serum Testosterone, free, serum Female, age yrs: ng/dl Male: pg/ml 10

11 Theophylline, serum Thrombin time Thyroid function studies Therapeutic range: 8 20 μg/ml seconds T3 resin uptake 25% 35% Thyroglobulin, serum Less than 20 ng/ml Thyroidal iodine ( 123 I) uptake Thyroid-stimulating hormone (TSH), serum 5% 30% of administered dose at 24 hours μu/ml ( mu/l) Thyroid-stimulating immunoglobulin (TSI) Less than 130% Thyroxine-binding globulin, serum Thyroxine index, free (estimate) 5 12 Thyroxine (T 4 ), serum Free Triiodothyronine (T 3 ), serum Reverse Free proteins, CSF Transaminase, serum glutamic oxaloacetic (SGOT) Transaminase, serum glutamic pyruvic (SGPT) µg/ml 5 12 μg/dl ng/dl ng/dl ng/dl pg/ml mg/dl Transferrin saturation 20% 50% Transferrin, serum Triglycerides, serum (fasting) Optimal Normal Borderline-high High Very high Troponin I, cardiac, serum Troponin T, cardiac, serum Tryptase, serum Urea clearance, urine Standard Maximal Urea nitrogen, blood Urea nitrogen, urine Uric acid, serum Uric acid, urine Uroporphyrin, urine Vancomycin, plasma Vancomycin, serum Vanillylmandelic acid, urine Venous oxygen content, mixed Venous studies, mixed, blood See aminotransferase, serum aspartate (AST) See aminotransferase, serum alanine (ALT) mg/dl Less than 100 mg/dl Less than 150 mg/dl mg/dl mg/dl Greater than 499 mg/dl 0.04 ng/ml or less 0.01 ng/ml or less Less than 11.5 ng/ml ml/min ml/min 8 20 mg/dl g/24 hr mg/dl mg/24 hr μg/24 hr Therapeutic: 15 to 20 mg/l 10 to 16 µg/ml Less than 9 mg/24 hr ml/dl ph PCO2 PO2 Bicarbonate mm Hg mm Hg meq/l Oxygen saturation (SvO2) 65% 75% 11

12 Viscosity, serum Vitamin A, serum: Adult Pediatric, age 1 2 yr (retinol) Vitamin B 12, serum Vitamin D metabolites, serum 1,25-Dihydroxyvitamin D (1,25-dihydroxycholecalciferol) 25-Hydroxyvitamin D (25-hydroxycholecalciferol) Vitamin E, serum: Adult Pediatric, age 1 2 yr (alpha-tocopherol) Volume, blood cp μg/dl μg/dl pg/ml pg/ml ng/ml mg/l mg/l Plasma Female: 43 ml/kg body weight; male: 44 ml/kg body weight Red cell Female: ml/kg body weight; male: ml/kg body weight von Willebrand factor antigen, plasma 50% 150% Zinc, serum Revised - March, μg/dl 12