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2738

APPENDIX A: Normal Blood and Bone Marrow Values in Humans


Sherrie L. Perkins
Hematology Reference Values in Normal Adults
Red Cell Values in Normal Adults
Leukocyte Values in Normal Adults
Bone Marrow in Normal Adults
Blood and Bone Marrow Values in Normal Embryo, Infants, Children, and Adolescents
Values for Various Other Measurements in Normal Subjects
Tests of Hemostasis and Blood Coagulation

TABLE A-1 -- Hematology Reference Values in Normal Adults


Men

Women

Test

Conventional Units

SI

Conventional Units

SI

Hemoglobin

14-17.4 g/dl

140-175 g/L

12.3-15.3 g/dl

123-153 g/L

Hematocrit (UPRC)

41.5-50.4

0.415-0.504

36-45

0.36-0.45

Red cell count

4.5-5.9106 /muL

4.5-5.91012 /L

4.5-5.1106 /muL

4.5-5.11012 /L

White cell count

4.4-11.3103 /muL

4.4-11.3109 /L

4.4-11.3106 /muL

4.4-11.3109 /L

Mean corpuscular
volume

80-96 fL

80-96 fL

80-96 fL

80-96 fL

Mean corpuscular
hemoglobin

27.5-33.2 pg

27.5-33.2 pg

27.5-33.2 pg

27.5-33.2 pg

Mean corpuscular
hemoglobin
concentration

33.4-35.5 g/dL

334-355 g/L

33.4-35.5 g/dL

334-355 g/L

Platelet count

150-45010 /muL

150-45010 /L

150-45010 /muL

150-450109 /L

Reticulocyte count

0.5-2.5%

0.005-0.025

0.5-2.5%

0.005-0.025

Reticulocyte count

22,500147,500/mm3

22.5-147.5109 /L

22,500147,500/mm3

22.5-147.5109 /L

Sedimentation rate
(Westergren) less
than 50 years of age

0-15 mm/hr

0-15 mm/hr

0-20 mm/hr

0-20 mm/hr

Zeta sedimentation
rate

41-54

41-54

41-54

41-54

SI =Systeme Internationale.
Values derived from Wintrobe MM. Clinical hematology. 9th ed. Philadelphia: Lea & Febiger, 1993 (1).

TABLE A-1 -- Hematology Reference Values in Normal Adults


Men
Test

Conventional Units

Women
SI

Conventional Units

SI

Henry JB. Clinical diagnosis and management by laboratory methods. 19th ed. Philadelphia: WB Saunders,
1996 (2). Beutler E, Lichtman MA, Coller BS, Kipps TJ. William's hematology. 5th ed. New York:
McGraw-Hill, 1995 (3).

2739

TABLE A-2 -- Automated Hematology Reference Values in Normal Men at 4500 ft


Coulter S+ST (80 men)

Technicon H1 (64 men)

Mean

Central 95%
Range

Mean

Central 95%
Range

White blood cells


(109 /L)

6.6

3.5-9.8

6.7

4.4-8.2

Platelets (109 /L)

280

147-412

285

147-422

Red blood cells


(1012 /L)

5.4

4.76-6.04

5.54

4.87-6.20

Hemoglobin (g/dL)

16.4

14.7-18.1

16.2

14.6-17.8

Hematocrit (%)

48.7

43.7-53.6

48.7

43.6-53.8

Mean corpuscular
volume (fL)

90.3

83.3-97.2

88.0

80.9-95.2

Mean corpuscular
hemoglobin (pg)

30.5

28.1-32.9

29.3

27.0-31.7

Mean corpuscular
hemoglobin
concentration (g/dL)

33.8

33.0-34.6

33.3

32.1-34.6

Red cell distribution


width

12.4

11.5-13.4

12.8

12.0-13.6

Mean platelet
volume

8.4

6.8-10.0

8.9

7.6-10.2

Data are based on measurements from healthy male medical students, age range 23-31 years at an altitude
of 4500 ft, January 1989.

TABLE A-3 -- Commonly Used Hematology Reference Values in Normal Adults


Men

Women

Test

Conventional Units

SI

Conventional Units

SI

Serum iron

60-150 mug/dL

10.7-26.9 mumol/L

60-150 mug/dL

10.7-26.9 mumol/L

TABLE A-3 -- Commonly Used Hematology Reference Values in Normal Adults


Men

Women

Test

Conventional Units

SI

Conventional Units

SI

Total iron binding


capacity

250-435 mug/dL

44.8-77.7 mumol/L

250-435 mug/dL

44.8-77.7 mumol/L

Ferritin

15-200 ng/mL

15-200 ng/mL

12-150 ng/mL

12-150 ng/mL

Serum B12

160-950 pg/mL

118-701 pmol/L

160-950 pg/mL

118-701 pmol/L

Serum folate

2-25 ng/mL

4-56 nmol/L

2-25 ng/mL

4-56 nmol/L

Red cell folate

140-640 ng/mL

550-1450 nmol/L

140-640 ng/mL

550-1450 nmol/L

Hemoglobin A2

1.5-3.5%

0.015-0.035

1.5-3.5%

0.015-0.035y

Hemoglobin F

<2%

<0.02

<2%

<0.02

Values derived from Wintrobe MM. Clinical hematology. 9th ed. Philadelphia: Lea & Febiger, 1993 (1).
Henry JB. Clinical diagnosis and management by laboratory methods. 19th ed. Philadelphia: WB Saunders,
1996 (2). Beutler E, Lichtman MA, Coller BS, Kipps TJ. William's hematology. 5th ed. New York:
McGraw-Hill, 1995 (3).
SI =Systeme Internationale.

TABLE A-4 -- Measures of Red Cell Concentration in Normal Adults at Sea Level
Men
Determination

Mean

95% Range

Mean

95% Range

Hematocytometer
(4)

5.4

4.5-6.3

4.8

4.2-5.5

Electronic (5)

5.2

4.4-6.0

--

--

Cyanmethemoglobin
(4)

16.0

14.0-18.0

14.0

12.0-16.0

Volume packed Macro (4)


red cells (L/L)

0.47

0.40-0.54

0.42

0.37-0.47

Micro (5)

0.46

0.51-0.51

--

--

1.6
88
1.6
57.7

0.8-3.0 18-158
0.8-3.0 30.5101.2

1.6
88
1.6
46.8

0.8-3.0
18-158 0.8-3.0
22.0-94.0

Sedimentation Wintrobe or
rate (mm/hr) (8) Westergren

0-15

10

0-20

(%)

--

40-52

--

40-52

Erythrocytes
(1012 /L)

Hemoglobin
(g/dL)

Method

Women

Reticulocytes
New methylene blue
(6,7) % 109 /L Electronic
% 109 /L

Zeta sedimentation
rate

2740

TABLE A-5 -- Erythrocyte Indices in Normal Adults


Method

Mean

95% Limits

RBC: Hemacytometer
VPRC: Macro (4)

87

80-94

90

83-97

85

77-93

88

80-96

RBC: Electronic
VPRC: Micro (9)
Mean corpuscular volume
(fL)

RBC: Hemacytometer
VPRC: Micro (5)
RBC: Electronic
VPRC: Micro (5)

Mean corpuscular
hemoglobin (pg/cell)

Coulter model STKS (10) 91

78.5-98

RBC: Hemacytometer (4) 29

26-32

Coulter model STKS (10) 31

27-34

Mean corpuscular
hemoglobin concentration
(g/dL RBC)

VPRC: Macro

34

32-36

VPRC: Micro (5)

33

31-35

Coulter model STKS (10) 34

33.5-36

RBC =red blood cell, VPRC =volume packed red cells.

TABLE A-6 -- Effect of Altitude on VPRC in Normal Men (9)


Altitude
Feet

Meters

VPRC (L/L) M

721

0.47

4,400

1340

744

0.495

7,457

2280

100

0.51

12,240

3740

40

0.54

14,900

4540

32

0.61

17,800

5430

10

0.69

Mean values in males.


VPRC =volume packed red cells.

TABLE A-7 -- Effect of Pregnancy, With and Without Iron Supplementation, on Values for Volume Packed
Red Cells (VPRC) and Hemoglobin (Hb) (11)
VPRC (Mean, L/L)

Hb (Mean, g/dL)

Intramuscular
Oral
Supplement Supplement

No
Supplement

Intramuscular
Oral
Supplement Supplement

Weeks of
Gestation

No
Supplement

0.420

--

--

13.4

--

--

12

0.383

0.406

0.357

12.5

13.1

11.4

16

0.395

0.379

0.363

12.4

12.1

11.4

20

0.364

0.370

0.371

11.7

11.8

11.8

24

0.356

0.363

0.371

11.4

11.8

11.8

28

0.346

0.369

0.368

11.0

11.8

11.8

32

0.341

0.372

0.370

10.6

12.1

11.8

36

0.343

0.375

0.375

10.7

12.1

12.0

40

0.349

0.385

0.387

10.9

12.7

12.4

0.336

0.371

0.373

10.4

12.2

11.9

0.349

0.389

0.401

10.7

12.4

12.8

21

0.381

0.420

0.411

11.6

13.6

13.0

42

0.391

0.415

0.398

11.9

13.1

12.6

180

0.392

0.401

0.408

12.1

12.4

12.9

Days
Postpartum

Approximately 20 individuals were in each group.


VPRC =volume packed red cells.
39 mg elemental iron twice daily.

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TABLE A-8 -- Estimation of Red Cell, Plasma, and Total Blood Volume in Adult Men and Women (12,13)
Men
Volume

Women
SD
(mL)

SD
(mL)

Red blood
cell volume

490

21.4

200

409

18.3

139

Plasma
volume

1050

19.6

260

455

28.9

213

Total blood
volume

1530

41.0

400

864

47.2

319

*Red cell volume measured by 51 Cr method. Plasma and blood volumes calculated from the red cell volume
and volume packed red cells without correction for trapped plasma or ``body hematocrit'' differences.
Instructions for use of table: For a subject of given weight (w, in kg), a normal mean red blood cell, plasma,
or total blood volume (V, in mL) can be calculated from the formula V=a+bw.
Example: In a 70-kg man, the mean red blood cell volume is 490+(21.470)+1988 mL2 SD;
range=1988400, or 1588 to 2388 mL. The expected normal range can be calculated from the formula
Range=mean2 SD.

TABLE A-9 -- Basic Ferrokinetic Measurements (14-17)


Measurement

Mean

95% Range

t59 Fe (minutes)

66

87.5

38-137

mg/day

35

32.2

13-50

mg/kg/day

10

0.56

0.46-0.75

mug/dL blood/day

31

0.69

0.41-0.97

55

83.9

68-100

mg/day

34

27.6

11-43

mg/kg/day

10

0.52

0.43-0.72

mug/dL blood/day

21

0.56

0.35-0.77

Plasma iron transport

Red cell

59

Fe utilization
(%)

Erythrocyte iron turnover

TABLE A-10 -- Reference Ranges* for Porphyrins and Porphyrin Precursors in Feces, Urine and
Erythrocytes (2)
Porphyrin or Precursor

Feces

Urine

Erythrocytes

Aminolevulinic acid

--

1.5-7.5 mg/24 hr

--

11.2-57.2 mumol/24 hr

TABLE A-10 -- Reference Ranges* for Porphyrins and Porphyrin Precursors in Feces, Urine and
Erythrocytes (2)
Porphyrin or Precursor

Feces

Urine

Erythrocytes

Porphobilinogen

--

<1 mg/24 hr

--

<4.4 mumol/24 hr
Uroporphyrin

0-0.06 mg/24 hr

10-30 mug/24 hr

Coproporphyrin

0-500 mug/24 hr

50-160 mug/24 hr

0-500 mug/24 hr

Protoporphyrin

0-600 mug/24 hr

--

0-60 mug/24 hr

Total porphyrin

4 mg/24 hr

<0.2 mg/24 hr

--

*95% confidence limit.

TABLE A-11 -- Measures of Hemoglobin Destruction


Measurement

95% Limits

Icterus index (units) (4)

5-7.5

Bilirubin, total (mg/dL)

0.1-1.0

Bilirubin, direct (mg/dL)

0.01-0.12

Urobilinogen, urine (Ehrlich units/day)

0.5-4.0

Urobilinogen, fecal
Ehrlich units/day

80-280

mg/day

40-200

Bilirubin production (mg/kg/day) (18)

2.6-5.0

Serum hemoglobin (mg/dL)

0.5-5.0

Serum haptoglobin (mg/dL)

60-270

Urine iron (mg/day)

<0.1

Unless otherwise indicated, values derived from Henry JB. Clinical diagnosis and management by
laboratory methods. 19th ed. Philadelphia: WB Saunders (2).

TABLE A-12 -- Normal Values for Osmotic Fragility


% Hemolysis

Sodium Chloride
(concentration in g/dL)

Before Incubation

After Incubation

0.85

0.75

0-5

0.65

0-10

0.60

0-40

TABLE A-12 -- Normal Values for Osmotic Fragility


% Hemolysis

Sodium Chloride
(concentration in g/dL)

Before Incubation

After Incubation

0.55

15-70

0.50

0-5

40-85

0.45

5-45

55-95

0.40

50-90

65-100

0.35

90-99

75-100

0.30

97-100

85-100

0.20

97-100

95-100

0.10

100

100

By permission of ASCP Press from Kjeldsberg C, Foucar K, McKenna R, et al. Practical diagnosis of
hematologic disorders. 2nd ed. Chicago: ASCP Press, 1995 (19).

2742

TABLE A-13 -- Automated Leukocyte Differential Counts, Reference Values in Normal Male Adults
Coulter S+STKR (80 Men)

Technicon H1 (64 Men)

Percentage

Mean

Central 95%
Range

Mean

Central 95%
Range

Lymphocytes

36.1

22.3-49.9

31.3

18.3-44.2

Monocytes

4.1

0.7-7.5

5.5

2.6-8.5

Granulocytes

59.7

45.5-74.0

--

--

Neutrophils

--

--

58.8

45.5-73.1

Eosinophils

--

--

1.9

0.0-4.4

Basophils

--

--

0.7

0.2-1.2

LUC

--

--

1.8

0.0-4.9

2.4

1.2-3.5

2.06

0.9-3.22

0.3

0.0-0.5

0.37

0.12-0.62

Granulocytes
(109 /L)

4.9

1.4-6.6

--

--

Neutrophils (109
/L)

--

--

4.01

1.31-6.71

Absolute Numbers
Lymphocytes
(109 /L)
Monocytes (10
/L)

TABLE A-13 -- Automated Leukocyte Differential Counts, Reference Values in Normal Male Adults
Coulter S+STKR (80 Men)

Technicon H1 (64 Men)

Percentage

Mean

Central 95%
Range

Mean

Central 95%
Range

Eosinophils (109
/L)

--

--

0.13

0.00-0.30

Basophils (109 /L)

--

--

0.05

0.01-0.09

LUC (109 /L)

--

--

0.12

0.00-0.31

Data based on measurements from healthy male students, age range 23-31 years, at an altitude of 4500 ft.
LUC =large unstained cells.

TABLE A-14 -- Scoring Criteria for Leukocyte Alkaline Phosphatase


Precipitated Azo Dye in Cytoplasm
Cell Rating

Amount *

Granule Size

Staining Intensity

Background of
Cytoplasm
No staining

None

--

1+

50%

Small

Faint to moderate

Colorless to very
pale pink

2+

40-80

Small to medium

Moderate to strong

Colorless to pale
pink

3+

80-100

Medium to large

Strong

Colorless to pink

4+

100

Medium and large

Brilliant

Non visible

By permission of Williams & Wilkins from Kaplow LS. Cytochemistry of leukocyte alkaline phosphatase.
Am J Clin Pathol 1963; 39:439 (20).
*Percentage of volume of cytoplasm occupied by azo dye precipitate.

TABLE A-15 -- Leukocyte Alkaline Phosphatase Scores in Normal Subjects


Group

Number

Mean

95% Limits

Male

51

73

22-124

Female

50

91

33-149

Total

101

82

25-139

By permission of Grune & Stratton from Cartwright GE. Diagnostic laboratory hematology. 4th ed. New
York: Grune & Stratton, 1968 (9).

2743

TABLE A-16 -- Differential Counts of Bone Marrow Aspirates from 12 Healthy Men
Mean
(%)

Observed
Range
(%)

95%
Confidence
Limits (%)

Neutrophilic series (total)

53.6

49.2-65.0

33.6-73.6

Myeloblasts

0.9

0.2-1.5

0.1-1.7

Promyelocytes

3.3

2.1-4.1

1.9-4.7

Myelocytes

12.7

8.2-15.7

8.5-16.9

Metamyelocytes

15.9

9.6-24.6

7.1-24.7

Band

12.4

9.5-15.3

9.4-15.4

Segmented

7.4

6.0-12.0

3.8-11.0

Eosinophilic series (total)

3.1

1.2-5.3

1.1-5.2

Myelocytes

0.8

0.2-1.3

0.2-1.4

Metamyelocytes

1.2

0.4-2.2

0.2-2.2

Band

0.9

0.2-2.4

0-2.7

Segmented

0.5

0-1.3

0-1.1

Basophilic and mast cells

0.1

0-0.2

--

Erythrocytic series (total)

25.6

18.4-33.8

15.0-36.2

Pronormoblasts

0.6

0.2-1.3

0.1-1.1

Basophilic

1.4

0.5-2.4

0.4-2.4

Polychromatophilic

21.6

17.9-29.2

13.1-30.1

Orthochromatic

2.0

0.4-4.6

0.3-3.7

Lymphocytes

16.2

11.1-23.2

8.6-23.8

Plasma cells

1.3

0.4-3.9

0-3.5

Monocytes

0.3

0-0.8

0-0.6

Megakaryocytes

0.1

0-0.4

--

Reticulum cells

0.3

0-0.9

0-0.8

M:E ratio

2.3

1.5-3.3

1.1-3.5

TABLE A-17 -- Red Blood Cell Values at Various Ages: Mean and Lower Limit of Normal (-2 SD)
Hemoglobin
(g/dL)
Age
Birth
(cord
blood)

Hematocrit
(%)

Red Cell
Count (1012
/L)

MCV (fl)

MCH (pg)

MCHC (g/dl)

Mean -2 SD Mean -2 SD Mean -2 SD Mean -2 SD Mean -2 SD Mean -2 SD


16.5

13.5

51

42

4.7

3.9

108

98

34

31

33

30

1 to 3
18.5
days
(capillary)

14.5

56

45

5.3

4.0

108

95

34

31

33

29

1 week

17.5

13.5

54

42

5.1

3.9

107

88

34

28

33

28

2 weeks

16.5

12.5

51

39

4.9

3.6

105

86

34

28

33

28

1 month

14.0

10.0

43

31

4.2

3.0

104

85

34

28

33

29

2 months

11.5

9.0

35

28

3.8

2.7

96

77

30

26

33

29

3 to 6
months

11.5

9.5

35

29

3.8

3.1

91

74

30

25

33

30

0.5 to 2
years

12.0

0.5

36

33

4.5

3.7

78

70

27

23

33

30

2 to 6
years

12.5

11.5

37

34

4.6

3.9

81

75

27

24

34

31

6 to 12
years

13.5

11.5

40

35

4.6

4.0

86

77

29

25

34

31

Female

14.0

12.0

41

36

4.6

4.1

90

78

30

25

34

31

Male

14.5

13.0

43

37

4.9

4.5

88

78

30

25

34

31

Female

14.0

12.0

41

36

4.6

4.0

90

80

30

26

34

31

Male

15.5

13.5

47

41

5.2

4.5

90

80

30

26

34

31

12 to 18
years

18 to 49
years

From Dallman PR. In: Rudolph A, ed. Pediatrics. 16th ed., New York: Appleton-Century-Crofts, 1977 (21).
Lubin BH. Reference values in infancy and childhood. In: Nathan DG, Oski FA, eds. Hematology of
infancy and childhood. 4th ed. Philadelphia: WB Saunders, 1993 (22).
These data were compiled from several sources. Emphasis is on recent studies using electronic counters
and on the selection of populations that are likely to exclude individuals with iron deficiency. The mean2
SD can be expected to include 95% of the observations in a normal population.
MCV =mean corpuscular volume, MCH =mean corpuscular hemoglobin, MCHC =mean corpuscular
hemoglobin concentration.

2744

TABLE A-18 -- Full-term Infants: Normal Values of Hemoglobin, Hematocrit, Erythrocyte Count, Mean
Corpuscular Hemoglobin, Mean Corpuscular Volume, and Mean Corpuscular Hemoglobin Concentration
(22,23)
Age (Month)
0.5
(N=232)

1
(N=240)

2
(N=241)

4
(N=52)

6
(N=52)

9
(N=56)

12
(N=56)

16.60.11

13.90.10

11.20.06

12.20.14

12.60.10

12.70.09

12.70.09

13.4

10.7

9.4

10.3

11.1

11.4

11.3

530.4

440.3

350.2

380.4

360.3

360.3

370.3

41

33

28

32

31

32

33

RBC count
(meanSE)
(102 /L)

4.90.03

4.30.03

3.70.02

4.30.06

4.70.05

4.70.04

4.70.04

-2 SD+2 SD

3.9-5.9

3.3-5.3

3.1-4.3

3.5-5.1

3.9-5.5

4.0-5.3

4.1-5.3

MCH
(meanSE)
(pg)

33.60.1

32.50.1

30.40.1

28.60.2

26.80.2

27.30.2

26.80.2

30

29

27

25

24

25

24

105.30.6

101.30.3

94.80.3

86.70.8

76.30.6

77.70.5

77.70.5

88

91

84

76

68

70

71

3141.1

3181.2

3181.1

3272.7

3501.7

3491.6

3431.5

281

281

283

288

327

324

321

Hb
(meanSE)
(g/dL)
-2 SD
Hct
(meanSE)
(%)
-2 SD

-2 SD
MCV
(meanSE)
(fL)
-2 SD
MCHC
(meanSE)
(g/L)
-2 SD

These values were obtained from a selected group of 256 healthy term infants followed at the Helsinki
University Central Hospital who were receiving continuous iron supplementation and who had normal
values for transferrin saturation and serum ferritin.
Values at the ages of 0.5, 1, and 2 months were obtained from the entire group, and those at the later ages
from the iron-supplemented infant group after exclusion of iron deficiency.

TABLE A-19 -- Leukocyte Counts and Differential Counts Reference Values in Children
Total
Leukocytes
Age

Neutrophils

Mean (Range) Mean (Range)

Lymphocytes
%

Mean (Range)

Monocytes
%

Mean

Eosinophils
Mean

Birth

18.1

(9.030.0)

11.0

(6.026.0)

61

5.5

(2.011.0)

31

1.1

0.4

12
hours

22.8

(13.038.0)

15.5

(6.028.0)

68

5.5

(2.011.0)

24

1.2

0.5

24
hours

18.9

(9.434.0)

11.5

(5.021.0)

61

5.8

(2.011.5)

31

1.1

0.5

1 week 12.2

(5.021.0)

5.5

(1.510.0)

45

5.0

(2.017.0)

41

1.1

0.5

2
weeks

11.4

(5.020.0)

4.5

(1.0-9.5) 40

5.5

(2.017.0)

48

1.0

0.4

1
10.8
month

(5.019.5)

3.8

(1.0-9.0) 35

6.0

(2.516.5)

56

0.7

0.3

6
11.9
months

(6.017.5)

3.8

(1.0-8.5) 32

7.3

(4.013.5)

61

0.6

0.3

1 year

11.4

(6.017.5)

3.5

(1.5-8.5) 31

7.0

(4.010.5)

61

0.6

0.3

2 years 10.6

(6.017.0)

3.5

(1.5-8.5) 33

6.3

(3.0-9.5) 59

0.5

0.3

4 years 9.1

(5.515.5)

3.8

(1.5-8.5) 42

4.5

(2.0-8.0) 50

0.5

0.3

6 years 8.5

(5.014.5)

4.3

(1.5-8.0) 51

3.5

(1.5-7.0) 42

0.4

0.2

8 years 8.3

(4.513.5)

4.4

(1.5-8.0) 53

3.3

(1.5-6.8) 39

0.4

0.2

10
years

8.1

(4.513.5)

4.4

(1.8-8.0) 54

3.1

(1.5-6.5) 38

0.4

0.2

16
years

7.8

(4.513.0)

4.4

(1.8-8.0) 57

2.8

(1.2-5.2) 35

0.4

0.2

21
years

7.4

(4.511.0)

4.4

(1.8-7.7) 59

2.5

(1.0-4.8) 34

0.3

0.2

Numbers of leukocytes are in thousands per mm3 , ranges are estimates of 95% confidence limits, and
percentages refer to differential counts. Neutrophils include band cells at all ages and a small number of
metamyelocytes and myelocytes in the first few days of life.
From Dallman PR. In: Rudolph AM, ed. Pediatrics. 16th ed. New York: Appleton-Century-Crofts, 1977
(21). Lubin BH. Reference values in infancy and childhood. In: Nathan DG, Oski FA, eds. Hematology of
infancy and childhood. 4th ed. Philadelphia: WB Saunders, 1993 (22).

2745

Cell Type

TABLE A-20 -- Bone Marrow Cell Populations of Normal Infants (22,24)


Month
0 (n=57) *

1 (n=71)

2 (n=48)

3 (n=24)

4 (n=19)

5 (n=22)

6 (n=22)

9 (n=16)

12 (n=18)

15 (n=12)

18 (n=1

all
phocytes

14.425.54 47.059.24 42.687.90 43.6311.83 47.068.77 47.199.93 47.557.88 48.768.11 47.1111.32 42.778.94 43.558

nsitional
s

1.181.13

1.950.94

2.381.35

2.171.64

1.641.01

1.830.89

2.311.16

1.921.39

2.321.90

1.700.82

1.991.0

erythroblasts 0.020.06

0.100.14

0.130.19

0.100.13

0.050.10

0.070.10

0.090.12

0.070.09

0.020.04

0.070.12

0.080.1

ophilic
hroblasts

0.240.25

0.350.33

.570.41

0.400.33

0.240.24

0.470.33

0.320.24

0.310.24

0.300.25

0.380.37

0.500.3

ly
hroblasts

0.270.26

0.440.42

0.710.51

0.500.38

0.280.30

0.550.36

0.410.30

0.390.28

0.390.27

0.460.36

0.590.3

ychromatic
hroblasts

13.066.78 6.904.45

13.063.48 10.513.39

6.842.58

7.552.35

7.303.60

7.733.39

6.833.75

6.041.56

6.973.5

hochromatic 0.690.73
hroblasts

0.541.88

0.660.82

0.700.87

0.340.30

0.460.51

0.380.56

0.390.48

0.370.51

0.500.65

0.440.4

ruded nuclei 0.470.46

0.160.17

0.260.22

0.190.12

0.160.17

0.140.11

0.160.22

0.220.25

0.230.25

0.170.12

0.210.1

e
hroblasts

14.227.14 7.604.84

13.993.82 11.403.43

7.342.54

8.162.58

7.854.11

8.343.31

7.424.11

6.721.80

7.623.6

ly/late
hroblasts

1:50

1:18

1:23

1:15

1:17

1:19

1:17

1:15

1:10

1:15

1:22

al
hroblasts

14.487.24 8.045.00

14.703.86 11.903.52

7.622.56

8.702.69

8.254.31

8.723.34

7.814.26

7.181.95

8.2137

od
culocytes

4.181.46

1.061.13

3.391.22

2.900.91

1.650.73

1.380.65

1.740.80

1.670.52

1.790.79

2.100.91

1.840.4

myelocytes

0.790.91

0.760.65

0.780.68

0.760.80

0.590.51

0.870.80

0.670.66

0.410.34

0.690.71

0.670.58

0.640.5

elocytes

3.952.93

2.501.48

2.031.14

2.241.70

2.321.59

2.731.82

2.221.25

2.071.20

2.321.14

2.480.94

2.491.3

ly
trophils

4.743.43

3.271.94

2.811.62

3.002.18

2.912.01

3.602.50

2.891.71

2.481.46

3.021.52

3.161.19

3.141.7

utrophils

amyelocytes 19.374.84 11.343.59 11.273.38 11.9313.09 6.043.63

11.893.24 11.023.12 11.803.90 11.103.82

12.487.45 12.424

ds

28.897.56 14.104.63 13.154.71 14.607.54

13.936.13 14.075.48 14.004.58 14.084.53 14.024.88

15.174.20 14.205

ure
trophils

7.374.64

4.272.69

6.943.88

3.642.97

3.072.45

3.481.62

3.772.44

4.852.69

3.972.29

5.653.92

6.313.9

e neutrophils 55.637.98 29.086.79 27.506.88 31.0011.17 31.307.80 29.737.19 29.866.74 29.867.36 30.778.69

34.607.35 32.937

ly/late
trophil ratio

1:10

1:12

1:9

1:9

1:9

1:11

1:8

1:10

1:12

1:10

1:10

TABLE A-20 -- Bone Marrow Cell Populations of Normal Infants (22,24)


Month

Cell Type

0 (n=57) *

1 (n=71)

2 (n=48)

3 (n=24)

4 (n=19)

5 (n=22)

6 (n=22)

9 (n=16)

12 (n=18)

15 (n=12)

18 (n=1

al
trophils

60.378.66 32.357.68 30.317.27 34.0111.95 34.218.61 33.128.34 32.757.03 32.337.75 33.798.76

37.767.32 36.067

al
nophils

2.701.27

2.611.40

2.501.22

2.541.46

2.374.13

1.980.86

2.081.16

1.741.08

1.921.09

3.391.93

2.702.1

al basophils

0.120.20

0.070.16

0.080.10

.090.09

0.110.14

0.940.13

0.100.13

0.110.13

0.130.15

0.270.37

0.100.1

al myeloid
s

63.199.10 35.038.09 32.907.85 36.6412.26 36.698.91 35.408.54 34.937.52 34.188.13 35.838.84

41.427.43 38.867

nocytes

0.880.85

1.010.89

0.910.83

0.680.56

0.750.75

1.291.06

1.211.01

1.170.97

1.461.52

1.681.09

2.121.5

gakaryocytes 0.060.15

0.050.09

0.100.13

0.060.09

0.060.06

0.080.09

0.040.07

0.090.12

0.050.08

0.000.00

0.070.1

sma cells

0.000.02

0.020.06

0.020.05

0.000.02

0.010.03

0.050.11

0.030.07

0.010.03

0.030.07

0.070.12

0.060.0

known blasts 0.310.31

0.620.50

0.580.50

0.630.60

0.560.53

0.500.37

0.560.48

0.420.50

0.370.33

0.460.32

0.430.4

known cells

0.220.34

0.210.25

0.160.24

0.190.21

0.230.25

0.170.22

0.100.15

0.140.17

0.110.14

0.130.18

0.200.2

maged cells

5.792.78

5.502.46

5.091.78

4.752.30

4.802.29

4.861.25

5.041.08

4.891.60

5.342.19

4.991.96

5.052.1

al

6.382.84

6.392.63

5.941.94

5.632.36

5.662.30

5.661.41

5.781.16

5.551.74

5.902.03

5.652.02

5.812.1

cellaneous

Percentages of cell types (meansstandard deviation) in tibial bone marrow of infants from birth to 18 months of age. Data obtained from normal American
fants of black, white, and Asian racial origin. The changes in the marrow during the first 18 months of postnatal life are based on differential counts of 1,0
ls classified on stained smears on each of 10 serial marrow samples aspirated from the same population of infants. Criteria for including bone marrow data
this study consisted of absence of any clinical evidence of disease, normal rate of growth, and normal serum proteins and transferrin saturations.

Expressed in round figures for facilitating comparison. MeansSD were calculated from values obtained in individual infants, and statistical comparison
were performed.
*n, number of infants studied at each stage.

2746

TABLE A-21 -- Iron and Copper in Plasma (2,25-27)


Measurement

Mean

Lower Limit of Normal * Upper Limit of Normal *

Plasma iron
mug/dL

mumol/L

122

71(43-112)

201(112-276)

109

60(28-101)

173(130-202)

21.8

12.7(7.7-20.0)

35.9(20.0-49.3)

TABLE A-21 -- Iron and Copper in Plasma (2,25-27)


Measurement

Mean

Lower Limit of Normal * Upper Limit of Normal *

19.5

107(5.0-18.0)

30.9(23.2-36.1)

Plasma total iron-binding


capacity
mug/dL

340

250(224-306)

400(429-472)

mumol/L

60.7

44.8(40.0-54.6)

71.6(66.6-84.3)

Transferrin saturation (%)

35

20

55

mug/dL

114

70

155

mumol/L

18.1

11

24

Plasma copper

*Range of values from several laboratories given in parentheses.

TABLE A-22 -- Serum Folate, Vitamin B12 , and Related Determinations (2,28)
Measurement

Mean

Lower Limit
of Normal *

Upper Limit of Normal *

Serum vitamin B12 (ng/L)

450

160(100-270)

950(750-1200)

Serum folate (mug/L)

8.1

5(2.3-7.5)

25(9-28)

Erythrocyte folate
(mug/L)

274

166(50-325)

640(300-875)

Urinary methylmalonate
(mg/day)

--

--

Urinary
formiminoglutamate
(FIGIu) (mg/day)

--

0.1

*Range of values from several laboratories given in parentheses.

TABLE A-23 -- Vitamin B12 Absorption by the Urinary Excretion Method (Schilling Test) (23)
Urinary Vitamin B12 Excretion (%)
Oral Vitamin B12 Dose (mug)

24 hr *

48 hr *

0.5

26(16-40)

37(21-48)

1.0

22(11-39)

29(14-46)

TABLE A-23 -- Vitamin B12 Absorption by the Urinary Excretion Method (Schilling Test) (23)
Urinary Vitamin B12 Excretion (%)
Oral Vitamin B12 Dose (mug)
2.0

24 hr *
11(5-17)

48 hr *
17(11-34)

*With 24-hour collections, one injection of 1000 mug ``cold'' B12 was administered; with 48-hour
collections, two injections of 1000 mug ``cold'' B12 were administered at 24-hour intervals.

TABLE A-24 -- Human Erythrocyte Enzymes in Normal Adults


Enzymes (Synonym)

Enzyme Activity
(IU/g hemoglobin)

Acetylcholinesterase

36.93.83

Adenosine deaminase

1.110.23

Adenylate kinase

25829.3

Bisphosphoglyceromutase
(2,3,-diphosphoglyceromutase)

4.780.65

Catalase
Fructose-bisphosphate aldolase
(aldolase)
Galactokinase

15.32.39104
3.190.86
0.0790.006
0.0290.006

Galactose-1-phosphate uridylyl-tranferase

28.46.94

Glucose-6-phosphate dehydrogenase

8.341.59

Glucose phosphate isomerase (phosphoglucose


isomerase)

60.811.0

gamma-Glutamyl-cysteine synthetase

0.430.04

Glutathione peroxidase [1.11.1.9]

31.42.97

Glutathione reductase (NAD(P)H)

7.181.09

Glutathione synthetase

0.190.03

Hexokinase

1.160.17

Hypoxanthine phosphoribosyltransferase
(hypoxanthine guanosine-phosphoribosyltransferase)

1.720.3

Methemoglobin reductase

2.600.71

6-Phosphofructokinase

11.02.33

Phosphogluconate dehydrogenase
(decarboxylating)

8.780.78

TABLE A-24 -- Human Erythrocyte Enzymes in Normal Adults


Enzyme Activity
(IU/g hemoglobin)

Enzymes (Synonym)
Phosphoglycerate kinase

32036.1

Pyrimidine 5`-nucleotidase

0.110.03

Pyruvate kinase

15.01.96

Triosephosphate isomerase

2111397

Uroporphyrinogen I synthase

2.52

From Beutler E, Blume KG. Human erythrocytes, enzymes, and intermediate metabolites related to clinical
disorders. In: Altman PL, Dittmer DS, eds. Human health and disease. vol. II, Bethesda: Federation of
American Societies for Experimental Biology, 1977 (26).
Lubin BH. Reference values in infancy and childhood. In: Nathan DG, Oski FA, eds. Hematology of
infancy and childhood. 4th ed. Philadelphia: WB Saunders, 1993 (22).

2747

TABLE A-25 -- Concentrations of Immunoglobulins in Serum of Normal Subjects at Different Ages


Level of gammaG *

Age

% of
No. of
Adult
Subjects mg/dL (range) Level

Level of gammaM
*

mg/dL
(range)
115(530)

Level of gammaA *

Level of Total gammaGlobulin *

% of
Adult
Level

mg/dL
(range)

% of
% of
Adult
Adult
Level mg/dL (range) Level

115

23(0-11)

12

1044201(660- 6713
1439)

Newborn

22

1031200(645- 8917
1244)

1-3 mo

29

430119(272762)

3710 3011(16- 3011


67)

2113(656)

117

481127(324699)

319

4-6 mo

33

427186(2061125)

3716 4317(10- 4317


83)

2818(893)

149

498204(2281232)

3213

7-12 mo

56

661219(2791533)

5819 5423(22- 5523


147)

3718(1698)

199

752242(3271687)

4815

13-24 mo

59

762209(2581393)

6618 5823(14- 5923


114)

5024(19112)

2512

870258(3981586)

5616

25-36 mo

33

892183(4191274)

7716 6119(28- 6219


113)

7137(19235)

3619 1024205(419- 6514


1418)

3-5 yr

28

929228(5691597)

8020 5618(22- 5718


100)

9327(55152)

4714 1078245(730- 6917


1771)

6-8 yr

18

923256(5591492)

8022 6525(27- 6625 12445(54- 6223 1112293(640- 7120


118)
221)
1725)

9-11 yr

1124235(779- 9720 7933(35- 8033 13160(12- 6630 1334254(966- 8517


1456)
132)
208)
1639)

TABLE A-25 -- Concentrations of Immunoglobulins in Serum of Normal Subjects at Different Ages


Level of gammaG *

Age

% of
No. of
Adult
Subjects mg/dL (range) Level

Level of gammaM
*

mg/dL
(range)

% of
Adult
Level

Level of gammaA *
mg/dL
(range)

Level of Total gammaGlobulin *

% of
% of
Adult
Adult
Level mg/dL (range) Level

12-16 yr

946124(7261085)

8211 5920(35- 6020 14863(70- 7432 1153169(833- 7412


72)
229)
1284)

Adults

30

1158305(569- 10026 9927(47- 10027 20061(61- 10031 1457353(730- 10024


1919)
147)
330)
2365)

By permission from Stiehm ER, Fudenberg HH. Serum levels of immune globulins in health and disease. Pediatrics
1966 37:715 (29).
*Mean is 1 SD.

2748

TABLE A-26 -- Reference Values for Tests of Hemostasis and Blood Coagulation
Normal Range
(2 SD)

Test
Bleeding time
Ivy

1-9 min *

Duke

1-5 min

Partial thromboplastin time


Standard

68-82 sec

Activated

32-46 sec

Plasma prothrombin time

11-15 sec

Coagulation time, glass tubes

8-18 min

Plasma thrombin time

10-16 sec

Fibrinogen assay

150-350 mg/dL

Euglobulin clot lysis time

>2 hours

Fibrin degradation products

>8 mug/dl

Protamine sulfate dilution

neg. 24 hr

Plasminogen activity

74-124%

TABLE A-26 -- Reference Values for Tests of Hemostasis and Blood Coagulation
Normal Range
(2 SD)

Test
Antithrombin III

85-122%

Antithrombin III antigen

27-35 mg/dL

Protein C

60-150%

Protein S

66-122%

Ritocetin factor

0.5-1.6 U/mL

von Willebrand factor antigen

43-150%

Prekallikrein (Fletcher factor)

60-146%

Specific assays for individual coagulation factors

50-150% of normal

References to methods used included in Chapter 61


*Confidence limits determined by logarithmic plot.
Minor variations depend on exact technique employed.
Significant variations depend on thromboplastin used.

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