Reference Ranges—Hematology and Coagulation

Reference Ranges—Hematology and Coagulation

LABORATORY TEST NORMAL ADULT REFERENCE RANGE CLINICAL SIGNIFICANCE Conventional Units SI Units Bleeding Time 3-10 minutes 3-10 minutes ▪ Prolonged in thrombocytopenia, defective platelet function, and aspirin therapy D-dimer <250 mg/mL <250 mg/mL ▪ Increased in disseminated intravascular coagulation, malignancy, and arterial and venous thrombosis Erythrocyte Count Males 4,600,000-6,200,000/mm3 4.6-6.2 × 1012/L ▪ Increased in severe diarrhea and dehydration, polycythemia, acute poisoning, and pulmonary fibrosis ▪ Decreased in all anemias in leukemia and after hemorrhage, when blood volume has been restored Females 4,200,000- 5,400,000/mm3 4.2-5.4 × 1012/L Erythrocyte Indices Mean corpuscular volume (MCV) 84-96 µ3 84-96 Fl ▪ Increased in macrocytic anemia; decreased in microcytic anemia Mean corpuscular hemoglobin (MCH) 28-34 µµg/ cell 28-34 pg ▪ Increased in macrocytic anemia; decreased in microcytic anemia Mean corpuscular hemoglobin concentration (MCHC) 32%-36% Concentration fraction: 0.32-0.36 ▪ Decreased in severe hypochromic anemia Erythrocyte Sedimentation Rate (ESR)-Westergren Method ▪ Increased in tissue destruction, whether inflammatory or degenerative; during menstruation and pregnancy; and in acute febrile diseases Males younger than age 50 <15 mm/hour <15 mm/hour Males older than age 50 <20 mm/hour <20 mm/hour Females younger than 50 <20 mm/hour <20 mm/hour Females older than age 50 <30 mm/hour <30 mm/hour Fibrinogen 200-400 mg/ dL 2-4 g/dL ▪ Increased in pregnancy, cancer, inflammation, and nephrosis ▪ Decreased in severe liver disease and abruptio placentae Fibrin Split (Degradation) Products < mg/L < mg/L ▪ Increased in disseminated intravascular coagulation, myocardial infarction, and pulmonary embolism Fibrinolysis (Whole Blood Clot Lysis Time) No lysis in 24 hours - ▪ Increased activity associated with massive hemorrhage, extensive surgery, transfusion reactions, and liver disease Hematocrit Males 42%-52% Volume fraction: 0.42-0.52 ▪ Decreased in severe anemia, anemia of pregnancy, and acute massive blood loss ▪ Increased in erythrocytosis of any cause, and in dehydration or hemoconcentration associated with shok Females 37%-47% Volume fraction: 0.37-0.47 Hemoglobin Males 13-18 g/ dL 2.02-2.79 mmol/L ▪ Decreased in various anemias, pregnancy, severe or prolonged hemorrhage, and with excessive fluid intake ▪ Increased in polycythemia, chronic obstructive pulmonary disease, failure of oxygenation due to heart failure, and normally in people living at high altitudes Females 12-16 g/dL 1.86-2.48 mmol/L International Normalized Ratio (INR) 1.0 - ▪ INR used to standardize the prothrombin time and anticoagulation therapy 2-3 for therapy in atrial fibrillation, deep vein thrombosis, and pulmonary embolism 2.5-3.5 for therapy in prosthetic heart valves Leukocyte Count Total 5,000-10,000/mm3 5-10 × 109/L ▪ Total is elevated in acute infectious diseases, predominantly in the neutrophilic fraction with bacterial diseases, and in the lymphocytic and monocytic fractions in viral diseases ▪ Elevated in acute leukemia, following menstruation, and following surgery or trauma ▪ Eosinophils elevated in collagen disease, allergy, and intestinal parasitosis ▪ Depressed in aplastic anemia, agranulocytosis, and by toxic chemotherapeutic agents used in treating malignancy Basophils 0%-0.5% Number fraction: 0.6-0.7 Eosinophils 1%-4% Number fraction: 0.01-0.04 Lymphocytes 20%-30% Number fraction: 0.00-0.05 Monocytes 2%-6% Number fraction: 0.2-0.3 Neutrophils 60%-70% Number fraction: 0.02-0.06 Partial Thromboplastin Time (Activated) 20-35 seconds - ▪ Prolonged in deficiency of fibrinogen, factors II, V, VIII, IX, X, XI, and XII, and in heparin therapy Platelet Count 140,000-400,000/mm3 0.140-0.4 × 1012/L ▪ Increased in malignancy, myeloproliferative disease, rheumatoid arthritis, and postoperatively; about 50% of patients with unexpected increase of platelet count will be found to have a malignancy ▪ Decreased in thrombocytopenic purpura, acute leukemia, aplastic anemia, and during cancer chemotherapy Prothrombin Time 9.5-12 seconds - ▪ Prolonged by deficiency of factors I, II, V, VII, and X, for malabsorption, severe liver disease, and coumarin anticoagulant therapy Reticulocytes 0.5%-1.5% of red cells Number fraction: 0.005-0.015 ▪ Increased with any condition stimulating increase in bone marrow activity (infection, blood loss ‘pacute and chronically following iron therapy in iron deficiency anemia’, and polycythemia vera) ▪ Decreased with any condition depressing bone marrow activity, acute leukemia, and late stage of severe anemias *Laboratory values may vary according to the techniques used in different laboratories.