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TABLE 27.1: REFERENCE VALUES

TABLE 27.1
REFERENCE VALUES

Conventional SI Units
Units

ALANINE AMINOTRANSFERASE (ALT) 1,2 *

(Major sources: Liver, skeletal muscle, and


myocardium)

Infant aged <12​mo 13–45​U/L 13–45​U/L

1–3​yr 5–45​U/L 5–45​U/L

4–6​yr 10–25​U/L 10–25​U/L

7–9​yr 10–35​U/L 10–35​U/L

10–11​yr

Female 10–30​U/L 10–30​U/L

Male 10–35​U/L 10–35​U/L

12–13​yr

Female 10–30​U/L 10–30​U/L

Male 10–55​U/L 10–55​U/L

14–15​yr

Female 5–30​U/L 5–30​U/L

Male 10–45​U/L 10–45​U/L

>16​yr

Female 5–35​U/L 5–35​U/L

Male 10–40​U/L 10–40​U/L

ALBUMIN

(See Proteins)

3
ALDOLASE

(Major sources: Skeletal muscle and myocardium)

10–24​mo 3.4–11.8​U/L 3.4–11.8​U/L

2–16​yr 1.2–8.8​U/L 1.2–8.8​U/L

Adult 1.7–4.9​U/L 1.7–4.9​U/L

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4
ALKALINE PHOSPHATASE

(Major sources: Liver, bone, intestinal mucosa,


placenta, and kidney)

Infant 150–420​U/L 150–420​U/L

2–10​yr 100–320​U/L 100–320​U/L

Adolescent male 100–390​U/L 100–390​U/L

Adolescent female 100–320​U/L 100–320​U/L

Adult 30–120​U/L 30–120​U/L


2
AMMONIA

(Heparinized venous specimens on ice, analyzed


within 30​min)

Newborn 90–150​mcg/dL 64–


107​µmol/L

0–2​wk 79–129​mcg/dL 56–92​µmol/L

Infant/child 29–70​mcg/dL 21–50​µmol/L

Adult 15–45​mcg/dL 11–32​µmol/L


5
AMYLASE

(Major sources: Pancreas, salivary glands, and


ovaries)

0–14 days 3–10​U/L 3–10​U/L

15 days–13​wk 2–22​U/L 2–22​U/L

13​wk–1​yr 3–50​U/L 3–50​U/L

>1​yr 25–101​U/L 25–101​U/L


2
ANTINUCLEAR ANTIBODY (ANA)
IMMUNOFLUORESCENCE ASSAY (IFA)

Negative <1:40

Patterns with clinical


correlation:

Centromere: CREST†

Nucleolar:
Scleroderma

Homogeneous:
Systemic lupus
erythematosus

6
ANTISTREPTOLYSIN O TITER

(Fourfold rise in paired serial specimens is significant.)

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Newborn Similar to
mother's value

6–24​mo ≤50 Todd


units/mL

2–4​yr ≤160 Todd


units/mL

≥5​yr ≤330 Todd


units/mL

2
ASPARTATE AMINOTRANSFERASE (AST)

(Major sources: Liver, skeletal muscle, kidney,


myocardium, and erythrocytes)

0–10 days 47–150​U/L 47–150​U/L

10 days–24​mo 9–80​U/L 9–80​U/L

>24​mo

Female 13–35​U/L 13–35​U/L

Male 15–40​U/L 15–40​U/L

BICARBONATE 2,4

Newborn 17–24​mEq/L 17–


24​mmol/L

Infant 19–24​mEq/L 19–


24​mmol/L

2​mo–2​yr 16–24​mEq/L 16–


24​mmol/L

>2​yr 22–26​mEq/L 22–


26​mmol/L

BILIRUBIN (TOTAL) 4,7

Please see Chapter 18 for more complete information


about neonatal hyperbilirubinemia and acceptable
bilirubin values.

Cord:

Term and preterm <2​mg/dL <34​µmol/L

0–1 days:

Term and preterm <8​mg/dL <137​µmol/L

1–2 days:

Preterm <12​mg/dL <205​µmol/L

Term <11.5​mg/dL <197​µmol/L

3–5 days:

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Preterm <16​mg/dL <274​µmol/L

Term <12​mg/dL <205​µmol/L

Older infant:

Preterm <2​mg/dL <34​µmol/L

Term <1.2​mg/dL <21​µmol/L

Adult <1.5​mg/dL <20.5​µmol/L

BILIRUBIN (CONJUGATED) 2-4

Neonate <0.6​mg/dL <10​µmol/L

Infants/children <0.2​mg/dL <3.4​µmol/L

BLOOD GAS, ARTERIAL (BREATHING ROOM AIR)


2

pH Pao2 Paco2 HCO3−


(mmHg) (mmHg) (mEq/L)

Cord blood 7.28 ± 0.05 18.0 ± 6.2 49.2 ± 14–22


8.4

Newborn (birth) 7.11–7.36 8–24 27–40 13–22

5–10​min 7.09–7.30 33–75 27–40 13–22

30​min 7.21–7.38 31–85 27–40 13–22

60​min 7.26–7.49 55–80 27–40 13–22

1 day 7.29–7.45 54–95 27–40 13–22

Child/adult 7.35–7.45 83–108 32–48 20–28

NOTE: Venous blood gases can be used to assess acid-base status, not
oxygenation. Pco2 averages 6–8​mm​Hg higher than Paco2, and pH is
slightly lower. Peripheral venous samples are strongly affected by the local
circulatory and metabolic environment. Capillary blood gases correlate
best with arterial pH and moderately well with Paco2.

Conventional SI Units
Units

C-REACTIVE 0–0.5​mg/dL
4
PROTEIN

2
CALCIUM (TOTAL)

Premature neonate 6.2–11​mg/dL 1.55–


2.75​mmol/L

0–10 days 7.6–10.4​mg/dL 1.9–


2.6​mmol/L

10 days–24​mo 9–11​mg/dL 2.25–


2.75​mmol/L

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24​mo–12​yr 8.8–10.8​mg/dL 2.2–


2.7​mmol/L

12–18​yr 8.4–10.2​mg/dL 2.1–


2.55​mmol/L
3
CALCIUM (IONIZED)

0–1​mo 3.9–6.0​mg/dL 1.0–


1.5​mmol/L

1–6​mo 3.7–5.9​mg/dL 0.95–


1.5​mmol/L

1–18​yr 4.9–5.5​mg/dL 1.22–


1.37​mmol/L

Adult 4.75–5.3​mg/dL 1.18–


1.32​mmol/L
2
CARBON DIOXIDE (CO2 CONTENT)

(See Blood Gas, Arterial)

CARBON MONOXIDE (CARBOXYHEMOGLOBIN)

Nonsmoker 0.5%–1.5% of total hemoglobin

Smoker 4%–9% of total hemoglobin

Toxic 20%–50% of total hemoglobin

Lethal >50% of total hemoglobin

Conventional SI Units
Units
3
CHLORIDE (SERUM)

0–6​mo 97–108​mEq/L 97–


108​mmol/L

6–12​mo 97–106​mEq/L 97–


106​mmol/L

Child/adult 97–107​mEq/L 97–


107​mmol/L

CHOLESTEROL

(See Lipids)

CREATINE KINASE (CREATINE PHOSPHOKINASE)


2

(Major sources: Myocardium, skeletal muscle, smooth


muscle, and brain)

Newborn 145–1578​U/L 145–


1578​U/L

>6​wk–adult male 20–200​U/L 20–200​U/L

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>6​wk–adult female 20–180​U/L 20–180​U/L


2
CREATININE (SERUM) (Enzymatic)

Cord 0.6–1.2​mg/dL 53–


106​µmol/L

Newborn 0.3–1.0​mg/dL 27–88​µmol/L

Infant 0.2–0.4​mg/dL 18–35​µmol/L

Child 0.3–0.7​mg/dL 27–62​µmol/L

Adolescent 0.5–1.0​mg/dL 44–88​µmol/L

Adult male 0.9–1.3​mg/dL 80–


115​µmol/L

Adult female 0.6–1.1​mg/dL 53–97​µmol/L


2
ERYTHROCYTE SEDIMENTATION RATE (ESR)

Child 0–10​mm/hr

Adult male 0–15​mm/hr

Adult female 0–20​mm/hr


2
FERRITIN

Newborn 25–200​ng/mL 56–


450​pmol/L

1​mo 200–600​ng/mL 450–


1350​pmol/L

2–5​mo 50–200​ng/mL 112–


450​pmol/L

6​mo–15​yr 7–140​ng/mL 16–


315​pmol/L

Adult male 20–250​ng/mL 45–


562​pmol/L

Adult female 10–120​ng/mL 22–


270​pmol/L

FIBRINOGEN

See Chapter 14 .
3
FOLATE (SERUM)

Newborn 16–72​ng/mL 16–72​nmol/L

Child 4–20​ng/mL 4–20​nmol/L

Adult 10–63​ng/mL 10–63​nmol/L


2
FOLATE (RBC)

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Newborn 150–200​ng/mL 340–


453​nmol/L

Infant 74–995​ng/mL 168–


2254​nmol/L

2–16​yr >160​ng/mL >362​nmol/L

>16​yr 140–628​ng/mL 317–


1422​nmol/L
2
GALACTOSE

Newborn 0–20​mg/dL 0–
1.11​mmol/L

Older child <5​mg/dL <0.28​mmol/L

GAMMA-GLUTAMYL TRANSFERASE (GGT) 2,6

[Major sources: Liver (biliary tree) and kidney]

Cord 37–193​U/L 37–193​U/L

0–1​mo 13–147​U/L 13–147​U/L

1–2​mo 12–123​U/L 12–123​U/L

2–4​mo 8–90​U/L 8–90​U/L

4​mo–10​yr 5–32​U/L 5–32​U/L

10–15​yr 5–24​U/L 5–24​U/L

Adult male 11–49​U/L 11–49​U/L

Adult female 7–32​U/L 7–32​U/L

GLUCOSE (SERUM) 2,6

Preterm 20–60​mg/dL 1.1–


3.3​mmol/L

Newborn, <1 day 40–60​mg/dL 2.2–


3.3​mmol/L

Newborn, >1 day 50–90​mg/dL 2.8–


5.0​mmol/L

Child 60–100​mg/dL 3.3–


5.5​mmol/L

>16​yr 70–105​mg/dL 3.9–


5.8​mmol/L
2
HAPTOGLOBIN

Newborn 5–48​mg/dL 50–480​mg/L

>30 days 26–185​mg/dL 260–


1850​mg/L

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8
HEMOGLOBIN A1C

Normal 4.5%–5.6%

At risk for diabetes 5.7%–6.4%

Diabetes mellitus ≥6.5%

HEMOGLOBIN F, % TOTAL HEMOGLOBIN [MEAN


2
(SD)]

1 day 77.0 (7.3)

5 days 76.8 (5.8)

3​wk 70.0 (7.3)

6–9​wk 52.9 (11)

3–4​mo 23.2 (16)

6​mo 4.7 (2.2)

8–11​mo 1.6 (1.0)

Adult <2.0

Conventional SI Units
Units
2
IRON

Newborn 100–250​mcg/dL 17.9–


44.8​µmol/L

Infant 40–100​mcg/dL 7.2–


17.9​µmol/L

Child 50–120​mcg/dL 9.0–


21.5​µmol/L

Adult male 65–175​mcg/dL 11.6–


31.3​µmol/L

Adult female 50–170​mcg/dL 9.0–


30.4​µmol/L

LACTATE 2,3

Capillary blood:

0–90 days 9–32​mg/dL 1.1–


3.5​mmol/L

3–24​mo 9–30​mg/dL 1.0–


3.3​mmol/L

2–18​yr 9–22​mg/dL 1.0–


2.4​mmol/L

Venous 4.5–19.8​mg/dL 0.5–


2.2​mmol/L

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Arterial 4.5–14.4​mg/dL 0.5–


1.6​mmol/L

2
LACTATE DEHYDROGENASE (AT 37°C)

(Major sources: Myocardium, liver, skeletal muscle,


erythrocytes, platelets, and lymph nodes)

0–4 days 290–775​U/L 290–775​U/L

4–10 days 545–2000​U/L 545–


2000​U/L

10 days–24​mo 180–430​U/L 180–430​U/L

24​mo–12​yr 110–295​U/L 110–295​U/L

>12​yr 100–190​U/L 100–190​U/L

9
LEAD

Child <5​mcg/dL <0.24​µmol/L


3
LIPASE

0–30 days 6–55​U/L 6–55​U/L

1–6​mo 4–29​U/L 4–29​U/L

6–12​mo 4–23​U/L 4–23​U/L

>1​yr 3–32​U/L 3–32​U/L

Cholesterol (mg/dL) LDL (mg/dL) HDL


(mg/dL)

Desir​able Borderline High Optimal Near/Above Border​‐ High Desirable


Optimal line

LIPIDS 10,11

Child/adoles​cent <170 170–199 >200 <110 - 110– ≥130 >35


129

Adult <200 200–239 ≥240 <100 100–129 130– ≥160 40–60


159

Conventional SI Units
Units
2 1.6–2.4​mg/dL 0.63–
MAGNESIUM
1.05​mmol/L
2 0.78% (±0.37%)
METHEMOGLOBIN
of total
hemoglobin
2 275– 275–
OSMOLALITY
295​mOsm/kg 295​mmol/kg
(neonates as
low as 266)

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2
PHENYLALANINE

Preterm 2.0–7.5​mg/dL 121–


454​µmol/L

Newborn 1.2–3.4​mg/dL 73–


206​µmol/L

Adult 0.8–1.8​mg/dL 48–


109​µmol/L
2
PHOSPHORUS

0–9 days 4.5–9.0​mg/dL 1.45–


2.91​mmol/L

10 days–24​mo 4–6.5​mg/dL 1.29–


2.10​mmol/L

3–9​yr 3.2–5.8​mg/dL 1.03–


1.87​mmol/L

10–15​yr 3.3–5.4​mg/dL 1.07–


1.74​mmol/L

>15​yr 2.4–4.4​mg/dL 0.78–


1.42​mmol/L
12 0.930–6.0​mg/dL 1.2–
PORCELAIN
10.15​mmol/L

2
POTASSIUM

Preterm 3.0–6.0​mEq/L 3.0–


6.0​mmol/L

Newborn 3.7–5.9​mEq/L 3.7–


5.9​mmol/L

Infant 4.1–5.3​mEq/L 4.1–


5.3​mmol/L

Child 3.4–4.7​mEq/L 3.4–


4.7​mmol/L

Adult 3.5–5.1​mEq/L 3.5–


5.1​mmol/L
3
PREALBUMIN

Newborn 7–39​mg/dL

1–6​mo 8–34​mg/dL

6​mo–4​yr 12–36​mg/dL

4–6​yr 12–30​mg/dL

6–19​yr 12–42​mg/dL
2
PROTEIN ELECTROPHORESIS (g/dL)

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Age Total Protein Albumin α-1 α-2 β γ

Cord 4.8–8.0

Premature 3.6–6.0

Newborn 4.6–7.0

0–15 day 4.4–7.6 3.0–3.9 0.1–0.3 0.3–0.6 0.4–0.6 0.7–


1.4

15 day–1​yr 5.1–7.3 2.2–4.8 0.1–0.3 0.5–0.9 0.5–0.9 0.5–


1.3

1–2​yr 5.6–7.5 3.6–5.2 0.1–0.4 0.5–1.2 0.5–1.1 0.5–


1.7

3–16​yr 6.0–8.0 3.6–5.2 0.1–0.4 0.5–1.2 0.5–1.1 0.5–


1.7

≥16​yr 6.0–8.3 3.9–5.1 0.2–0.4 0.4–0.8 0.5–1.0 0.6–


1.2

Conventional SI Units
Units

3 0.7–1.32​mg/dL 0.08–
PYRUVATE
0.15​mmol/L

RHEUMATOID <30​U/mL
2
FACTOR

1
SODIUM

<1​yr 130–145​mEq/L 130–


145​mmol/L

>1​yr 135–147​mEq/L 135–


147​mmol/L

2
TOTAL IRON-BINDING CAPACITY (TIBC)

Infant 100–400​mcg/dL 17.9–


71.6​µmol/L

Adult 250–425​mcg/dL 44.8–


76.1​µmol/L

TOTAL PROTEIN

(See Proteins)

TRANSAMINASE (SGOT)

[See Aspartate aminotransferase (AST)]

TRANSAMINASE (SGPT)

[See Alanine aminotransferase (ALT)]

2
TRANSFERRIN

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Newborn 130–275​mg/dL 1.30–


2.75​g/L

3​mo–16​yr 203–360​mg/dL 2.03–3.6​g/L

Adult 215–380​mg/dL 2.15–3.8​g/L

3
TOTAL TRIGLYCERIDE

Conventional Units (mg/dL) SI Units (mmol/L)

Male Female Male Female

0–7 days 21–182 28–166 0.24– 0.32–


2.06 1.88

8–30 days 30–184 30–165 0.34– 0.34–


2.08 1.86

31–90 days 40–175 35–282 0.45– 0.4–


1.98 3.19

91–180 days 45–291 50–355 0.51– 0.57–


3.29 4.01

181–365 days 45–501 36–431 0.51– 0.41–


5.66 4.87

1–3​yr 27–125 27–125 0.31– 0.31–


1.41 1.41

4–6​yr 32–116 32–116 0.36– 0.36–


1.31 1.31

7–9​yr 28–129 28–129 0.32– 0.32–


1.46 1.46

10–19​yr 24–145 37–140 0.27– 0.42–


1.64 1.58

Conventional SI Units
Units

UREA NITROGEN 1,2

Premature (<1​wk) 3–25​mg/dL 1.1–


8.9​mmol/L

Newborn 2–19​mg/dL 0.7–


6.7​mmol/L

Infant/child 5–18​mg/dL 1.8–


6.4​mmol/L

Adult 6–20​mg/dL 2.1–


7.1​mmol/L

URIC ACID 3,6

0–30 days 1.0–4.6​mg/dL 0.059–


0.271​mmol/L

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1–12​mo 1.1–5.6​mg/dL 0.065–


0.33​mmol/L

1–5​yr 1.7–5.8​mg/dL 0.1–


0.35​mmol/L

6–11​yr 2.2–6.6​mg/dL 0.13–


0.39​mmol/L

Male 12–19​yr 3.0–7.7​mg/dL 0.18–


0.46​mmol/L

Female 12–19​yr 2.7–5.7​mg/dL 0.16–


0.34​mmol/L

VITAMIN A (RETINOL) 2,3

Preterm 13–46​mcg/dL 0.46–


1.61​µmol/L

Full term 18–50​mcg/dL 0.63–


1.75​µmol/L

1–6​yr 20–43​mcg/dL 0.7–


1.5​µmol/L

7–12​yr 20–49​mcg/dL 0.9–


1.7​µmol/L

13–19​yr 26–72​mcg/dL 0.9–


2.5​µmol/L

VITAMIN B1 4.5–10.3​mcg/dL 106–


2 242​µmol/L
(THIAMINE)

VITAMIN B2 4–24​mcg/dL 106–


(RIBOFLAVIN) 638​nmol/L

2
VITAMIN B12 (COBALAMIN)

Newborn 160–1300​pg/mL 118–


959​pmol/L

Child/adult 200–835​pg/mL 148–


616​pmol/L

VITAMIN C 0.4–2.0​mg/dL 23–


2 114​µmol/L
(ASCORBIC ACID)

VITAMIN D (1,25- 16–65​pg/mL 42–


DIHYDROXY- 169​pmol/L
2
VITAMIN D)

VITAMIN D (25-HYDROXY-VITAMIN D) 13,14

Deficiency‡ <12​ng/mL <30​mmol/L

Insufficiency‡ 12–20​ng/mL 30–

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50​mmol/L

Sufficient‡ ≥20​ng/mL ≥50​mmol/L

VITAMIN E 1-3

Preterm 0.5–3.5​mg/L 1–8​µmol/L

Full term 1.0–3.5​mg/L 2–8​µmol/L

1–12​yr 3.0–9.0​mg/L 7–21​µmol/L

13–19​yr 6.0–10.0​mg/L 14–23​µmol/L

2 70–120​mcg/dL 10.7–
ZINC
18.4​mmol/L

* There is evidence to suggest that these cutoffs may not be sensitive enough to detect pediatric chronic liver
15
disease.

† CREST: C alcinosis, R aynaud syndrome, E sophageal dysmotility, S clerodactyly, T elangiectasia.

‡ Controversy exists regarding optimal 25-hydroxyvitamin D level. Some experts recommend a level ≥30​ng/mL as
16
sufficient.

TABLE 27.1: REFERENCE VALUES is a sample topic from the Harriet Lane Handbook.

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