Rangos de referencia para análisis de sangre

Los rangos de referencia (intervalos de referencia) para análisis de sangre son conjuntos de valores utilizados por un profesional de la salud para interpretar un conjunto de resultados de pruebas médicas a partir de muestras de sangre. Los rangos de referencia para los análisis de sangre se estudian en el campo de la química clínica (también conocida como "bioquímica clínica", "patología química" o "química sanguínea pura"), la área de la patología que generalmente se ocupa del análisis de fluidos corporales.

Los resultados de las pruebas de sangre siempre deben interpretarse utilizando el rango de referencia proporcionado por el laboratorio que realizó la prueba.

Interpretación

Un rango de referencia generalmente se define como el conjunto de valores dentro del cual se encuentra el 95 % de la población normal (es decir, el intervalo de predicción del 95 %). Se determina mediante la recopilación de datos de un gran número de pruebas de laboratorio.

Plasma o sangre completa

En este artículo, todos los valores (excepto los que se enumeran a continuación) indican una concentración en plasma sanguíneo, que es aproximadamente entre un 60 y un 100 % mayor que la concentración real en sangre si la cantidad dentro de los glóbulos rojos (GR) es insignificante. El factor exacto depende del hematocrito y de la cantidad dentro de los glóbulos rojos. Las excepciones son principalmente aquellos valores que denotan concentración total en sangre, y en este artículo son:

• Todos los valores en Hematología – glóbulos rojos (excepto hemoglobina en plasma)
• Todos los valores en Hematología – glóbulos blancos
• Conteo de plaquetas (Plt)

Algunos valores son solo para el interior de los glóbulos rojos:

• Vitamina B9 (ácido fólico/folato) en glóbulos rojos
• Concentración media de hemoglobina corpuscular (MCHC)

Unidades

• La concentración masiva (g/dL o g/L) es la unidad de medición más común en los Estados Unidos. Se administra generalmente con dL (decilitres) como el denominador en los Estados Unidos, y generalmente con L (litros) en, por ejemplo, Suecia.
• La concentración de molares (mol/L) se utiliza en mayor grado en la mayoría del resto del mundo, incluido el Reino Unido y otras partes de Europa y Australia y Nueva Zelandia.
• Las unidades internacionales (UI) se basan en actividades o efectos biológicos medidos, o para algunas sustancias, una masa equivalente específica.
• La actividad enzimática (kat) se utiliza comúnmente para pruebas de función hepática como AST, ALT, LD y γ-GT en Suecia.
• Los porcentajes y unidades dependientes del tiempo (mol/s) se utilizan para parámetros derivados calculados, por ejemplo para función de células beta en la evaluación del modelo de homeostasis o la capacidad secreta de tiroides.

Arterial o venosa

Si no se especifica lo contrario, un rango de referencia para un análisis de sangre es generalmente el rango venoso, ya que el proceso estándar para obtener una muestra es por venopunción. Una excepción es para el ácido-base y los gases sanguíneos, que generalmente se administran para la sangre arterial.

Aún así, los valores en sangre son aproximadamente iguales entre los lados arterial y venoso para la mayoría de las sustancias, con la excepción de ácido-base, gases en sangre y fármacos (utilizados en ensayos de monitorización terapéutica de fármacos (TDM)). Los niveles arteriales de los fármacos son generalmente más altos que los niveles venosos debido a la extracción al atravesar los tejidos.

Usual u óptimo

Los rangos de referencia generalmente se dan como los valores habituales (o normales) encontrados en la población, más específicamente el intervalo de predicción en el que se encuentra el 95% de la población. Esto también puede llamarse rango estándar. Por el contrario, el rango (salud) óptimo o objetivo terapéutico es un rango o límite de referencia que se basa en concentraciones o niveles asociados con una salud óptima o un riesgo mínimo de complicaciones relacionadas. y enfermedades Para la mayoría de las sustancias presentadas, los niveles óptimos son también los que normalmente se encuentran en la población. Más específicamente, los niveles óptimos generalmente están cerca de una tendencia central de los valores encontrados en la población. Sin embargo, los niveles habituales y óptimos pueden diferir sustancialmente, sobre todo entre las vitaminas y los lípidos en la sangre, por lo que estas tablas dan límites en los rangos tanto estándar como óptimos (u objetivo). Además, algunos valores, incluidos la troponina I y el péptido natriurético cerebral, se dan como puntos de corte apropiados estimados para distinguir a las personas sanas de las personas con afecciones específicas, que aquí son infarto de miocardio e insuficiencia cardíaca congestiva, respectivamente, para las sustancias antes mencionadas.

Variabilidad

El rango de referencias puede variar según la edad, el sexo, la raza, el embarazo, la dieta, el uso de medicamentos recetados o a base de hierbas y el estrés. Los intervalos de referencia a menudo dependen del método analítico utilizado, por motivos como la inexactitud, la falta de estandarización, la falta de material de referencia certificado y la diferente reactividad de los anticuerpos. Además, los rangos de referencia pueden ser inexactos cuando los grupos de referencia usados para establecer los rangos son pequeños.

Ordenada por concentración

By mass and molarity

Smaller, narrower boxes indicate a more tight homeostatic regulation when measured as standard "usual" reference range.

Reference ranges for blood tests, sorted logarithmically by mass above the scale and by molarity below. (A separate printable image is available for mass and molarity)

Hormones predominate at the left part of the scale, shown with a red at ng/L or pmol/L, being in very low concentration. There appears to be the greatest cluster of substances in the yellow part (μg/L or nmol/L), becoming sparser in the green part (mg/L or μmol/L). However, there is another cluster containing many metabolic substances like cholesterol and glucose at the limit with the blue part (g/L or mmol/L).

The unit conversions of substance concentrations from the molar to the mass concentration scale above are made as follows:

• Numerically:

molar concentration × molar mass = mass concentration {displaystyle {text{molar concentration}}times {text{molar mass}}={text{mass concentration}}}

• Measured directly in distance on the scales:

log 10 ⁡ molar mass 1000 = distance to right (decades) {displaystyle log _{10}{frac {text{molar mass}}{1000}}={text{distance to right (decades)}}} ,

where distance is the direct (not logarithmic) distance in number of decades or "octaves" to the right the mass concentration is found. To translate from mass to molar concentration, the dividend (molar mass and the divisor (1000) in the division change places, or, alternatively, distance to right is changed to distance to left. Substances with a molar mass around 1000g/mol (e.g. thyroxine) are almost vertically aligned in the mass and molar images. Adrenocorticotropic hormone, on the other hand, with a molar mass of 4540, is 0.7 decades to the right in the mass image. Substances with molar mass below 1000g/mol (e.g. electrolytes and metabolites) would have "negative" distance, that is, masses deviating to the left. Many substances given in mass concentration are not given in molar amount because they haven't been added to the article.

The diagram above can also be used as an alternative way to convert any substance concentration (not only the normal or optimal ones) from molar to mass units and vice versa for those substances appearing in both scales, by measuring how much they are horizontally displaced from one another (representing the molar mass for that substance), and using the same distance from the concentration to be converted to determine the equivalent concentration in terms of the other unit. For example, on a certain monitor, the horizontal distance between the upper limits for parathyroid hormone in pmol/L and pg/mL may be 7 cm, with the mass concentration to the right. A molar concentration of, for example, 5 pmol/L would therefore correspond to a mass concentration located 7 cm to the right in the mass diagram, that is, approximately 45 pg/mL.

By units

Units do not necessarily imply anything about molarity or mass.

A few substances are below this main interval, e.g. thyroid stimulating hormone, being measured in mU/L, or above, like rheumatoid factor and CA19-9, being measured in U/mL.

By enzyme activity

White blood cells

Sorted by category

Ions and trace metals

Included here are also related binding proteins, like ferritin and transferrin for iron, and ceruloplasmin for copper.

Test	Lower limit	Upper limit	Unit*	Comments
Sodium (Na)	135, 137	145, 147	mmol/L or mEq/L	See hyponatremia or hypernatremia
	310, 320	330, 340	mg/dL
Potassium (K)	3.5, 3.6	5.0, 5.1	mmol/L or mEq/L	See hypokalemia or hyperkalemia
	14	20	mg/dL
Chloride (Cl)	95, 98, 100	105, 106, 110	mmol/L or mEq/L	See hypochloremia or hyperchloremia
	340	370	mg/dL
Ionized calcium (Ca)	1.03, 1.10	1.23, 1.30	mmol/L	See hypocalcaemia or hypercalcaemia
	4.1, 4.4	4.9, 5.2	mg/dL
Total calcium (Ca)	2.1, 2.2	2.5, 2.6, 2.8	mmol/L
	8.4, 8.5	10.2, 10.5	mg/dL
Total serum iron (TSI) – male	65, 76	176, 198	µg/dL	See hypoferremia or the following: iron overload (hemochromatosis), iron poisoning, siderosis, hemosiderosis, hyperferremia
	11.6, 13.6	30, 32, 35	μmol/L
Total serum iron (TSI) – female	26, 50	170	µg/dL
	4.6, 8.9	30.4	μmol/L
Total serum iron (TSI) – newborns	100	250	µg/dL
	18	45	µmol/L
Total serum iron (TSI) – children	50	120	µg/dL
	9	21	µmol/L
Total iron-binding capacity (TIBC)	240, 262	450, 474	μg/dL
	43, 47	81, 85	µmol/L
Transferrin	190, 194, 204	326, 330, 360	mg/dL
	25	45	μmol/L
Transferrin saturation	20	50	%
Ferritin – Males and postmenopausal females	12	300	ng/mL or µg/L
	27	670	pmol/L
Ferritin – premenopausal females	12	150 – 200	ng/mL or µg/L
	27	330 – 440	pmol/L
Ammonia	10, 20	35, 65	μmol/L	See hypoammonemia and hyperammonemia
	17, 34	60, 110	μg/dL
Copper (Cu)	70	150	µg/dL	See hypocupremia or hypercupremia
	11	24	μmol/L
Ceruloplasmin	15	60	mg/dL
	1	4	μmol/L
Phosphate (HPO42−)	0.8	1.5	mmol/L	See hypophosphatemia or hyperphosphatemia
Inorganic phosphorus (serum)	1.0	1.5	mmol/L
	3.0	4.5	mg/dL
Zinc (Zn)	60, 72	110, 130	μg/dL	See zinc deficiency or zinc poisoning
	9.2, 11	17, 20	µmol/L
Magnesium	1.5, 1.7	2.0, 2.3	mEq/L or mg/dL	See hypomagnesemia or hypermagnesemia
	0.6, 0.7	0.82, 0.95	mmol/L

• Note: Although 'mEq' for mass and 'mEq/L' are sometimes used in the United States and elsewhere, they are not part of SI and are now considered redundant.

Acid–base and blood gases

If arterial/venous is not specified for an acid–base or blood gas value, then it generally refers to arterial, and not venous which otherwise is standard for other blood tests.

Acid–base and blood gases are among the few blood constituents that exhibit substantial difference between arterial and venous values. Still, pH, bicarbonate and base excess show a high level of inter-method reliability between arterial and venous tests, so arterial and venous values are roughly equivalent for these.

Test	Arterial/Venous	Lower limit	Upper limit	Unit
pH	Arterial	7.34, 7.35	7.44, 7.45
	Venous	7.31	7.41
[H+]	Arterial	36	44	nmol/L
		3.6	4.4	ng/dL
Base excess	Arterial & venous	−3	+3	mEq/L
Oxygen partial pressure (pO2)	Arterial pO2	10, 11	13, 14	kPa
		75, 83	100, 105	mmHg or torr
	Venous	4.0	5.3	kPa
		30	40	mmHg or torr
Oxygen saturation	Arterial	94, 95, 96	100	%
	Venous	Approximately 75
Carbon dioxide partial pressure (pCO2)	Arterial PaCO2	4.4, 4.7	5.9, 6.0	kPa
		33, 35	44, 45	mmHg or torr
	Venous	5.5,	6.8	kPa
		41	51	mmHg or torr
Absolute content of carbon dioxide (CO2)	Arterial	23	30	mmol/L
		100	132	mg/dL
Bicarbonate (HCO3−)	Arterial & venous	18	23	mmol/L
		110	140	mg/dL
Standard bicarbonate (SBCe)	Arterial & venous	21, 22	27, 28	mmol/L or mEq/L
		134	170	mg/dL

Liver function

Test	Patient type	Lower limit	Upper limit	Unit	Comments
Total protein (TotPro)		60, 63	78, 82, 84	g/L	See serum total protein Interpretation
Albumin		35	48, 55	g/L	See hypoalbuminemia
		3.5	4.8, 5.5	U/L
		540	740	μmol/L
Globulins		23	35	g/L
Total bilirubin		1.7, 2, 3.4, 5	17, 22, 25	μmol/L
		0.1, 0.2, 0.29	1.0, 1.3, 1.4	mg/dL
Direct/conjugated bilirubin		0.0 or N/A	5, 7	μmol/L
		0	0.3, 0.4	mg/dL
Alanine transaminase (ALT/ALAT)		5, 7, 8	20, 21, 56	U/L	Also called serum glutamic pyruvic transaminase (SGPT)
	Female	0.15	0.75	µkat/L
	Male	0.15	1.1
Aspartate transaminase (AST/ASAT)	Female	6	34	IU/L	Also called serum glutamic oxaloacetic transaminase (SGOT)
		0.25	0.60	µkat/L
	Male	8	40	IU/L
		0.25	0.75	µkat/L
Alkaline phosphatase (ALP)		0.6	1.8	µkat/L
	Female	42	98	U/L
	Male	53	128
Gamma glutamyl transferase (GGT)		5, 8	40, 78	U/L
	Female		0.63	µkat/L
	Male		0.92	µkat/L

Cardiac tests

Test	Patient type	Lower limit	Upper limit	Unit	Comments
Creatine kinase (CK)	Male	24, 38, 60	174, 320	U/L or ng/mL
		0.42	1.5	µkat/L
	Female	24, 38, 96	140, 200	U/L or ng/mL
		0.17	1.17	µkat/L
CK-MB		0	3, 3.8, 5	ng/mL or μg/L
Myoglobin	Female	1	66	ng/mL or µg/L
	Male	17	106
Cardiac troponin T (low sensitive)			0.1	ng/mL	99th percentile cutoff
Cardiac troponin I (high sensitive)			0.03	ng/mL	99th percentile cutoff
Cardiac troponin T (high sensitive)	Male		0.022	ng/mL	99th percentile cutoff
	Female		0.014	ng/mL	99th percentile cutoff
	newborn/infants		not established		more than adults

Brain natriuretic peptide (BNP)
Interpretation	Range / Cutoff
Congestive heart failure unlikely	< 100 pg/mL
"Gray zone"	100–500 pg/mL
Congestive heart failure likely	> 500 pg/mL

NT-proBNP
Interpretation	Age	Cutoff
Congestive heart failure likely	< 75 years	> 125 pg/mL
	> 75 years	> 450pg/mL

Lipids

Test	Patient type	Lower limit	Upper limit	Unit	Therapeutic target
Triglycerides	10–39 years	54	110	mg/dL	< 100 mg/dL or 1.1 mmol/L
		0.61	1.2	mmol/L
	40–59 years	70	150	mg/dL
		0.77	1.7	mmol/L
	> 60 years	80	150	mg/dL
		0.9	1.7	mmol/L
Total cholesterol		3.0, 3.6	5.0, 6.5	mmol/L	< 3.9 mmol/L
		120, 140	200, 250	mg/dL	< 150 mg/dL
HDL cholesterol	Female	1.0, 1.2, 1.3	2.2	mmol/L	> 1.0 or 1.6 mmol/L 40 or 60 mg/dL
		40, 50	86	mg/dL
HDL cholesterol	Male	0.9	2.0	mmol/L
		35	80	mg/dL
LDL cholesterol (Not valid when triglycerides >5.0 mmol/L)		2.0, 2.4	3.0, 3.4	mmol/L	< 2.5 mmol/L
		80, 94	120, 130	mg/dL	< 100 mg/dL
LDL/HDL quotient		n/a	5	(unitless)

Tumour markers

Test	Patient type	Cutoff	Unit	Comments
Alpha fetoprotein (AFP)		44	ng/mL or µg/L	Hepatocellular carcinoma or testicular cancer
Beta human chorionic gonadotrophin (β-hCG)	In males and non-pregnant females	5	IU/L or mU/mL	choriocarcinoma
CA19-9		40	U/mL	Pancreatic cancer
CA-125		30, 35	kU/L or U/mL
Carcinoembryonic antigen (CEA)	Non-smokers, 50 years	3.4, 3.6	μg/L
	Non-smokers, 70 years	4.1
	Smokers	5
Prostate specific antigen (PSA)	40–49 years	1.2–2.9	μg/L or ng/mL	More detailed cutoffs in PSA – Serum levels
	70–79 years, non-African-American	4.0–9.0
	70–79 years, African-American	7.7–13
PAP		3	units/dL (Bodansky units)
Calcitonin		5, 15	ng/L or pg/mL	Cutoff against medullary thyroid cancer More detailed cutoffs in Calcitonin article

Endocrinology

Thyroid hormones

Test	Patient type	Lower limit	Upper limit	Unit
Thyroid stimulating hormone (TSH or thyrotropin)	Adults – standard range	0.3, 0.4, 0.5, 0.6	4.0, 4.5, 6.0	mIU/L or μIU/mL
	Adults – optimal range	0.3, 0.5	2.0, 3.0
	Infants	1.3	19
Free thyroxine (FT4)	Normal adult	0.7, 0.8	1.4, 1.5, 1.8	ng/dL
		9, 10, 12	18, 23	pmol/L
	Child/Adolescent 31 d – 18 y	0.8	2.0	ng/dL
		10	26	pmol/L
	Pregnant	0.5	1.0	ng/dL
		6.5	13	pmol/L
Total thyroxine		4, 5.5	11, 12.3	μg/dL
		60	140, 160	nmol/L
Free triiodothyronine (FT3)	Normal adult	0.2	0.5	ng/dL
		3.1	7.7	pmol/L
	Children 2-16 y	0.1	0.6	ng/dL
		1.5	9.2	pmol/L
Total triiodothyronine		60, 75	175, 181	ng/dL
		0.9, 1.1	2.5, 2.7	nmol/L
Thyroxine-binding globulin (TBG)		12	30	mg/L
Thyroglobulin (Tg)		1.5	30	pmol/L
		1	20	μg/L

Sex hormones

The diagrams below take inter-cycle and inter-woman variability into account in displaying reference ranges for estradiol, progesterone, FSH and LH.

Levels of estradiol (the main estrogen), progesterone, luteinizing hormone and follicle-stimulating hormone during the menstrual cycle.

Test	Patient type	Lower limit	Upper limit	Unit
Dihydrotestosterone	adult male	30	85	ng/dL
Testosterone	Male, overall	8, 10	27, 35	nmol/L
		230, 300	780–1000	ng/dL
	Male < 50 years	10	45	nmol/L
		290	1300	ng/dL
	Male > 50 years	6.2	26	nmol/L
		180	740	ng/dL
	Female	0.7	2.8–3.0	nmol/L
		20	80–85	ng/dL
17α-Hydroxyprogesterone	male	0.06	3.0	mg/L
		0.18	9.1	µmol/L
	Female (Follicular phase)	0.2	1.0	mg/L
		0.6	3.0	µmol/L
Follicle-stimulating hormone (FSH)	Prepubertal	<1	3	IU/L
	Adult male	1	8
	Adult female (follicular and luteal phase)	1	11
	Adult female (Ovulation)	6 95% PI (standard)	26 95% PI)
		5 90% PI (used in diagram)	15 (90% PI)
	Post-menopausal female	30	118
Luteinizing hormone (LH)	Female, peak	20 90% PI (used in diagram)	75 (90% PI)	IU/L
	Female, post-menopausal	15	60
	Male aged 18+	2	9
Estradiol (an estrogen)	Adult male	50	200	pmol/L
		14	55	pg/mL
	Adult female (day 5 of follicular phase, and luteal phase)	70	500, 600	pmol/L
		19	140, 160	pg/mL
	Adult female – free (not protein bound)	0.5	9	pg/mL
		1.7	33	pmol/L
	Post-menopausal female	N/A	< 130	pmol/L
		N/A	< 35	pg/mL
Progesterone	Female in mid-luteal phase (day 21–23)	17, 35	92	nmol/L
		6, 11	29	ng/mL
Androstenedione	Adult male and female	60	270	ng/dL
	Post-menopausal female		< 180
	Prepubertal		< 60
Dehydroepiandrosterone sulfate	Adult male and female	30	400	µg/dL
SHBG	Adult female	40	120	nmol/L
	Adult male	20	60
Anti-Müllerian hormone (AMH)	13–45 years	0.7	20	ng/mL
		5	140	pmol/L

Other hormones

Test	Patient type	Lower limit	Upper limit	Unit
Adrenocorticotropic hormone (ACTH)		2.2	13.3	pmol/L
		20	100	pg/mL
Cortisol	09:00 am	140	700	nmol/L
		5	25	μg/dL
	Midnight	80	350	nmol/L
		2.9	13	μg/dL
Growth hormone (fasting)		0	5	ng/mL
Growth hormone (arginine stimulation)		7	n/a	ng/mL
IGF-1	Female, 20 yrs	110	420	ng/mL
	Female, 75 yrs	55	220
	Male, 20 yrs	160	390
	Male, 75 yrs	48	200
Prolactin	Female	71, 105	348, 548	mIU/L
		3.4, 3.9	16.4, 20.3	µg/L
	Male	58, 89	277, 365	mIU/L
		2.7, 3.3	13.0, 13.5	µg/L
Parathyroid hormone (PTH)		10, 17	65, 70	pg/mL
		1.1, 1.8	6.9, 7.5	pmol/L
25-hydroxycholecalciferol (a vitamin D) – Standard reference range		8, 9	40, 80	ng/mL
		20, 23	95, 150	nmol/L
25-hydroxycholecalciferol – Therapeutic target range		30, 40	65, 100	ng/mL
		85, 100	120, 160	nmol/L
Plasma renin activity		0.29, 1.9	3.7	ng/(mL·h)
		3.3, 21	41	mcU/mL
Aldosterone	Adult		19, 34.0	ng/dL
			530, 940	pmol/L
Aldosterone-to-renin ratio	Adult		13.1, 35.0	ng/dL per ng/(mL·h)
			360, 970	pmol/liter per µg/(L·h)

Vitamins

Also including the vitamin B₁₂)-related amino acid homocysteine.

Test	Patient type	Standard range		Optimal range		Unit
		Lower limit	Upper limit	Lower limit	Upper limit
Vitamin A		30	65			µg/dL
Vitamin B9 (Folic acid/Folate) – Serum	Age > 1 year	3.0	16	5		ng/mL or μg/L
		6.8	36	11		nmol/L
Vitamin B9 (Folic acid/Folate) – Red blood cells		200	600			ng/mL or μg/L
		450	1400			nmol/L
	Pregnant			400		ng/mL or μg/L
				900		nmol/L
Vitamin B12 (Cobalamin)		130, 160	700, 950			ng/L
		100, 120	520, 700			pmol/L
Homocysteine		3.3, 5.9	7.2, 15.3		6.3	μmol/L
		45, 80	100, 210		85	μg/dL
Vitamin C (Ascorbic acid)		0.4	1.5	0.9		mg/dL
		23	85	50		μmol/L
25-hydroxycholecalciferol (a vitamin D)		8, 9	40, 80	30, 40	65, 100	ng/mL
		20, 23	95, 150	85, 100	120, 160	nmol/L
Vitamin E				28		μmol/L
				1.2		mg/dL

Toxins

Test	Limit type	Limit	Unit
Lead	Optimal health range	< 20 or 40	µg/dL
Blood ethanol content	Limit for drunk driving	0, 0.2, 0.8	‰ or g/L
		17.4	mmol/L

Hematology

Red blood cells

These values (except Hemoglobin in plasma) are for total blood and not only blood plasma.

Test	Patient	Lower limit	Upper limit	Unit	Comments
Hemoglobin (Hb)	Male	2.0, 2.1	2.5, 2.7	mmol/L	Higher in neonates, lower in children.
		130, 132, 135	162, 170, 175	g/L
	Female	1.8, 1.9	2.3, 2.5	mmol/L	Sex difference negligible until adulthood.
		120	150, 152, 160	g/L
Hemoglobin subunits (sometimes displayed simply as "Hemoglobin")	Male	8.0, 8.4	10.0, 10.8	mmol/L	4 per hemoglobin molecule
	Female	7.2, 7.6	9.2, 10.0
Hemoglobin in plasma		0.16	0.62	μmol/L	Normally diminutive compared with inside red blood cells
		1	4	mg/dL
Glycated hemoglobin (HbA1c)	< 50 years	3.6	5.0	% of Hb
	> 50 years	3.9	5.3
Haptoglobin	< 50 years	0.35	1.9	g/L
	> 50 years	0.47	2.1
Hematocrit (Hct)	Male	0.39, 0.4, 0.41, 0.45	0.50, 0.52, 0.53, 0.62	L/L
	Female	0.35, 0.36, 0.37	0.46, 0.48	L/L
	Child	0.31	0.43	L/L
Mean corpuscular volume (MCV)	Male	76, 82	100, 102	fL	Cells are larger in neonates, though smaller in other children.
	Female	78	101	fL
Red blood cell distribution width (RDW)		11.5	14.5	%
Mean cell hemoglobin (MCH)		0.39	0.54	fmol/cell
		25, 27	32, 33, 35	pg/cell
Mean corpuscular hemoglobin concentration (MCHC)		4.8, 5.0	5.4, 5.6	mmol/L
		31, 32	35, 36	g/dL or %
Erythrocytes/Red blood cells (RBC)	Male	4.2, 4.3	5.7, 5.9, 6.2, 6.9	x1012/L or million/mm3
	Female	3.5, 3.8, 3.9	5.1, 5.5
	Infant/Child	3.8	5.5
Reticulocytes	Adult	26	130	x109/L
		0.5	1.5	% of RBC
	Newborn	1.1	4.5	% of RBC
	Infant	0.5	3.1	% of RBC
Immature reticulocyte fraction (IRF)	Adult	1.6	12.1	% of reticulocytes
Reticulocyte hemoglobin equivalent	Adult	30.0	37.6	%
		24.1	35.8	pg
Immature platelet fraction (IPF)	Adult	0.8	5.6	%

White blood cells

These values are for total blood and not only blood plasma.

Test	Patient type	Lower limit	Upper limit	Unit
White Blood Cell Count (WBC)	Adult	3.5, 3.9, 4.1, 4.5	9.0, 10.0, 10.9, 11	x109/L x103/mm3 or x103/μL
	Newborn	9	30
	1 year old	6	18
Neutrophil granulocytes (A.K.A. grans, polys, PMNs, or segs)	Adult	1.3, 1.8, 2	5.4, 7, 8	x109/L
		45–54	62, 74	% of WBC
	Newborn	6	26	x109/L
Neutrophilic band forms	Adult		0.7	x109/L
		3	5	% of WBC
Lymphocytes	Adult	0.7, 1.0	3.5, 3.9, 4.8	x109/L
		16–25	33, 45	% of WBC
	Newborn	2	11	x109/L
Monocytes	Adult	0.1, 0.2	0.8	x109/L
		3, 4.0	7, 10	% of WBC
	Newborn	0.4	3.1	x109/L
Mononuclear leukocytes (Lymphocytes + monocytes)	Adult	1.5	5	x109/L
		20	35	% of WBC
CD4+ T cells	Adult	0.4, 0.5	1.5, 1.8	x109/L
Eosinophil granulocytes	Adult	0.0, 0.04	0.44, 0.45, 0.5	x109/L
		1	3, 7	% of WBC
	Newborn	0.02	0.85	x109/L
Basophil granulocytes	Adult	40	100, 200, 900	x106/L
		0.0	0.75, 2	% of WBC
	Newborn		0.64	x109/L

Coagulation

Test	Lower limit	Upper limit	Unit	Comments
Thrombocyte/Platelet count (Plt)	140, 150	350, 400, 450	x109/L or x1000/µL
Mean platelet volume (MPV)	7.2, 7.4, 7.5	10.4, 11.5, 11.7	fL
Prothrombin time (PT)	10, 11, 12	13, 13.5, 14, 15	s	PT reference varies between laboratory kits – INR is standardised
INR	0.9	1.2		The INR is a corrected ratio of a patient's PT to normal
Activated partial thromboplastin time (APTT)	18, 30	28, 42, 45	s
Thrombin clotting time (TCT)	11	18	s
Fibrinogen	1.7, 2.0	3.6, 4.2	g/L
Antithrombin	0.80	1.2	kIU/L
	0.15, 0.17	0.2, 0.39	mg/mL
Bleeding time	2	9	minutes
Viscosity	1.5	1.72	cP

Immunology

Acute phase proteins

Acute phase proteins are markers of inflammation.

Test	Patient	Lower limit	Upper limit	Unit	Comments
Erythrocyte sedimentation rate (ESR)	Male	0	Age÷2	mm/h	ESR increases with age and tends to be higher in females.
	Female		(Age+10)÷2
C-reactive protein (CRP)			5, 6	mg/L
			200, 240	nmol/L
Alpha 1-antitrypsin (AAT)		20, 22	38, 53	μmol/L
		89, 97	170, 230	mg/dL
Procalcitonin			0.15	ng/mL or μg/L

Isotypes of antibodies

Test	Patient	Lower limit	Upper limit	Unit
IgA	Adult	70, 110	360, 560	mg/dL
IgD		0.5	3.0
IgE		0.01	0.04
IgG		800	1800
IgM		54	220

Autoantibodies

Autoantibodies are usually absent or very low, so instead of being given in standard reference ranges, the values usually denote where they are said to be present, or whether the test is a positive test. There may also be an equivocal interval, where it is uncertain whether there is a significantly increased level.

Test	Negative	Equivocal	Positive	Unit
anti-SS-A (Ro)	< 1.0	n/a	≥ 1.0	Units (U)
anti-SS-B (La)	< 1.0	n/a	≥ 1.0
Anti ds-DNA	< 30.0	30.0–75.0	> 75.0	International Units per millilitre (IU/mL)
Anti ss-DNA	< 8	8–10	> 10	Units per millilitre (U/mL)
Anti-histone antibodies	< 25	n/a	> 25
Cytoplasmic anti-neutrophil cytoplasmic antibodies (c-ANCA)	< 20	21–30	> 30
Perinuclear anti-neutrophil cytoplasmic antibodies (p-ANCA)	< 5	n/a	> 5
Anti-mitochondrial antibodies (AMA)	< 0.1	0.1-0.9	≥ 1.0	Units (U)
Rheumatoid factor (RF)	< 20	20–30	> 30	Units per millilitre (U/mL)
Antistreptolysin O titre (ASOT) in preschoolers			> 100
ASOT at school age			> 250
ASOT in adults			> 125

Test	Negative	Low/weak positive	Moderate positive	High/strong positive	Unit
Anti-phospholipid IgG	< 20	20–30	31–50	> 51	GPLU/mL
Anti-phospholipid IgM	< 1.5	1.5–2.5	2–9.9	> 10	MPL /mL
Anti-phospholipid IgA	< 10	10–20	21–30	> 31	arb U/mL
Anti-citrullinated protein antibodies	< 20	20–39	40–59	> 60	EU

Other immunology

Test	Lower limit	Upper limit	Unit
Serum free light chains (FLC): kappa/lambda ratio	0.26	1.65	(unitless)

Other enzymes and proteins

Test	Lower limit	Upper limit	Unit	Comments
Serum total protein	60, 63	78, 82, 84	g/L
Lactate dehydrogenase (LDH)	50	150	U/L
	0.4	1.7	μmol/L
	1.8	3.4	µkat/L	< 70 years old
Amylase	25, 30, 53	110, 120, 123, 125, 190	U/L
	0.15	1.1	µkat/L
	200	240	nmol/L
D-dimer	n/a	500	ng/mL	Higher in pregnant women
		0.5	mg/L
Lipase	7, 10, 23	60, 150, 208	U/L
Angiotensin-converting enzyme (ACE)	23	57	U/L
Acid phosphatase		3.0	ng/mL
Eosinophil cationic protein (ECP)	2.3	16	µg/L

Other electrolytes and metabolites

Electrolytes and metabolites: For iron and copper, some related proteins are also included.

Test	Patient type	Lower limit	Upper limit	Unit	Comments
Osmolality		275, 280, 281	295, 296, 297	mOsm/kg	Plasma weight excludes solutes
Osmolarity		Slightly less than osmolality		mOsm/L	Plasma volume includes solutes
Urea		3.0	7.0	mmol/L	BUN – blood urea nitrogen
		7	18, 21	mg/dL
* Uric acid		0.18	0.48	mmol/L
	Female	2.0	7.0	mg/dL
	Male	2.1	8.5	mg/dL
Creatinine	Male	60, 68	90, 118	μmol/L	May be complemented with creatinine clearance
		0.7, 0.8	1.0, 1.3	mg/dL
	Female	50, 68	90, 98	μmol/L
		0.6, 0.8	1.0, 1.1	mg/dL
BUN/Creatinine Ratio		5	35	–
Plasma glucose (fasting)		3.8, 4.0	6.0, 6.1	mmol/L	See also glycated hemoglobin (in hematology)
		65, 70, 72	100, 110	mg/dL
Full blood glucose (fasting)		3.3	5.6	mmol/L
		60	100	mg/dL
Random glucose		3.9	7.8	mmol/L
		70	140	mg/dL
Lactate (Venous)		4.5	19.8	mg/dL
		0.5	2.2	mmol/L
Lactate (Arterial)		4.5	14.4	mg/dL
		0.5	1.6	mmol/L
Pyruvate		300	900	μg/dL
		34	102	μmol/L
Ketones			1	mg/dL
			0.1	mmol/L

Medication

Test	Lower limit	Upper limit	Unit	Comments
Digoxin	0.5	2.0	ng/mL	Narrow therapeutic window
	0.6	2.6	nmol/L
Lithium	0.4, 0.5, 0.8	1.3	mmol/L	Narrow therapeutic window
Paracetamol		30	mg/L	Risk of paracetamol toxicity at higher levels
		200	µmol/L