CH-2.21 Analyte Reference Interval Instrumentation Methodology Chart
Document Type: Quick ReferenceLocation: Clinical Biochemistry and Hematology\Clinical Biochemistry\02 Reference Manual\Analyte Reference Documents
Revision Number: 49.01 Last Approved: 2/1/2018 11:37:43 AM
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CH-2.21 Analyte Reference Interval Instrumentation Methodology Chart
To search for a specific item use Ctrl-F to open up a Find boxAnalytes with Critical Values are indicated with red font – refer to CH-2.11 Clinical Biochemistry Critical Values
Site Designations:
FMC Foothills Medical Centre BMSH Banff Mineral Spring HospitalACH Alberta Children’s Hospital CLH Claresholm General HospitalPLC Peter Lougheed Centre CMGH Canmore General HospitalRGH Rockyview Hospital DDHS Didsbury Health Centre
RRL Rapid Response Lab
SHC South Health Campus HRH High River HospitalACHC Airdrie Community Health Centre OGH Oilfields General HospitalCCHC Cochrane Community Health Centre SDHS Strathmore District Health ServicesSCHC South Calgary Health Centre VCH Vulcan Health Centre
HCTL Health Centre Testing Labs SMCHC Sheldon M. Chumir Health Centre
CRL
OHWC Okotoks Health and Wellness CentreDSC DSC General Chemistry
InstrumentationDSC Urinalysis
DSC UrinalysisCobas 6000 PLC RGH SHC c501 and e601
ANA TOX Analytical Toxicology ACH c501 onlyCobas 8000 DSC c701, e602 and ISE
Diagnostic and Scientific Centre
IMMUNO CHEM
ImmunospecialchemistryFMC c702, e602 and ISE
Cobas c513 DSC c513 (A1C testing)Cobas c701-c502 DSC c701, c502 and ISECobas e601 Immuno Chem e601 only
CH-2.21 Analyte Reference Interval Instrumentation Methodology Chart Rev 49.01
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DOCUMENTATION GUIDELINESWhen providing information on reports, documents and the GTS, age and reference intervals should be provided in the following format, when PathNet reporting does not require alternate formats:
Age At the lowest end of the age scale use “Less than or equal to XX days/months/years”; NOT “0-XX days” e.g. Less than or equal to 30 days; NOT 0-30 days
At the highest end of the age scale use “XX to 150y”Reference Interval
Greater than or > ; NOT greater than or equal to (≥) Less than or < ; NOT less than or equal to (≤)
A
Analyte Site Instrumentation Method Reference Interval Units Notes
RRL Cobas 6000Enzymatic UV assay using G6PDH.
FMC Cobas 8000Colorimetric enzymatic assay utilizing arylacylamidase
AcetaminophenSMCHC CCHC
BMSH CLH CMGH
DDHS HRH OGH SDHS
VCH
Vitros Colorimetric slide method.
Therapeutic Range: 70 - 130 µmol/L
Acetone FMCAgilent 7890B Gas
Chromatograph analyzerGas Chromotography < 6 mmol/L
Adrenocorticotropic Hormone (ACTH)
IMMUNO CHEM
Siemens Immulite 2000 Chemiluminescent assay2.0 - 11.5
Females on oral contraceptives may have values below normal reference value
pmol/L
DSC FMC Cobas 8000
RRL Cobas 6000UV assay without pyridoxal phosphate activation
HCTL CRL Vitros Multiple-point rate slide assay
Alanine Aminotransaminase (ALT) - Blood **ACH
**SHCPiccolo Express Colorimetric assay
Age
< 18 y
18-150 y
Male
1-35
1-60
Female
1-35
1-40
U/L
Alternate Name: Alanine Transferase
**VHF patients only
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Analyte Site Instrumentation Method Reference Interval Units Notes
DSC FMC Cobas 8000
RRL Cobas 6000
The Roche/Hitachi Albumin/BCP is a colorimetric assay utilizing bromcresol purple
Albumin - Blood HCTL BMSH CMGH
DDHS HRH SDHS VCH
Vitros Colorimetric assay
Age
< 365 d
1-150 y
Interval
30-50
33-48
g/L
Albumin – CSF DSC Cobas c701-c502 Immunoturbidmetric 0.10 – 0.30 g/L
DSC FMC Cobas 8000Albumin - Fluid
RRL Cobas 6000
The Roche/Hitachi Albumin/BCP is a colorimetric assay utilizing bromcresol purple
No Reference Interval g/L
Albumin mg/L
CreatinineNo Reference
Interval mmol/L
< 1 m < 17.50
1 m - 2 y < 4.00Albumin/ Creatinine
Ratio> 2 y < 3.00
mg/mmolAlbumin - Urine DSC Cobas c701-c502 Immunoturbidimetric assay
Albumin Excretion Rate
< 20 µg/min
Alcohol Refer to Ethanol
Aldosterone - BloodIMMUNO
CHEMLiaison XL Chemiluminescence
Upright at least 30 minutes, with normal salt intake: 70-1090 pmol/LSupine at least 30 minutes, with normal salt intake: 50-645 pmol/L
pmol/L
Aldosterone/ Renin Ratio
IMMUNO CHEM
Calculation Calculation
An aldosterone (pmol/L)/renin concentration (mIU/L) ratio >60 may be indicative of primary aldosteronism if drawn in the absence of confounding drugs. Clinical correlation or further investigation may be required for confirmation of this interpretation.
no units
Aldosterone - UrineIMMUNO
CHEMLiaison XL Chemiluminescence
Normal diet3 - 78
nmol/ 24hrs
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Analyte Site Instrumentation Method Reference Interval Units Notes
DSC FMC Cobas 8000
RRL Cobas 6000
Colorimetric assay.
HCTL CRL Vitros Multiple-point rate slide assay
Alkaline Phosphatase (ALP)
**ACH **SHC
Piccolo Express Colorimetric assay
Age< 6 y
6-10 y11-12 y13-14 y15-16 y17-18 y19-20 y21-49 y
50-150 y
Male40-39045-45055-48055-54050-42040-20030-15030-13030-145
Female40-39045-45060-48045-30030-16030-12030-11530-11530-145
U/L**VHF patients only
Allergy Testing, IgEIMMUNO
CHEMUnicap Immunoassay test Negative < 0.35 kU/L
Alpha-1 Antitrypsin -Blood
DSC Cobas c701-c502 Immunoturbidimetric assay 0.90 - 2.00 g/L
Alpha-1 Fetoprotein -Fluid
IMMUNO CHEM
ArchitectChemiluminescent Microparticle Immunoassay technology (CMIA)
No Reference Interval µg/L
Alpha-1 Fetoprotein, Non-pregnant - Blood
IMMUNO CHEM
ArchitectChemiluminescent Microparticle Immunoassay technology (CMIA)
0.0 - 10.0 µg/L
Alpha-1 Microglobulin - Urine
IMMUNO CHEM
Optilite Turbidimetric < 12.0 mg/L
Pre-dose Post-doseAmikacin ACH Cobas 6000
Kinetic Interaction of Microparticles in Solution (KIMS) Immunoassay 1.0 - 4.0 20.0 - 25.0
mg/L
Amiodarone ANA TOX Agilent LC 1100 Liquid Chromatography with DAD 1.5-3.9 µmol/LSee also Desethylamiodarone
FMC Cobas 8000Ammonia - Blood
RRL Cobas 6000Enzymatic kinetic assay utilizing glutamate dehydrogenase (GLDH).
12 - 47 µmol/L
Amphetamine Screen -Urine
Refer to CH-2.22 Drugs of Abuse Tests
DSC Cobas 8000 Enzymatic colorimetric assay
ACH Cobas 6000 Enzymatic colorimetric assayAmylase - Blood **ACH **SHC
Piccolo Express Colorimetric assay
30 - 110 U/L**VHF patients only
DSC Cobas 8000Amylase - Fluid
ACH Cobas 6000Enzymatic colorimetric assay No Reference Interval U/L
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Analyte Site Instrumentation Method Reference Interval Units Notes
Amylase - Urine DSC Cobas c701-c502
The formation of p-nitrophenol directly proportional to a-amylase activity measured by absorbance at 409 nm.
0 - 460 U/L
Age Male FemaleAndrostenedione
IMMUNO CHEM
Siemens Immulite 2000 Chemiluminescent assay16-150 y 2.1-10.8 1.0-11.5
nmol/L
Anion GapDSC FMC
RRL HCTL CRL
Calculation Anion Gap = Na – (CL + CO2) 4-16 mmol/LRefer to CH-2.42 Anion Gap
Anti-Endomysial Antibodies (AENDAB)
IMMUNO CHEM
Manual Indirect Immunoflorescence Slide Negative
Refer to Celiac Screen Reflexive assay for TTG-IgA > 20kU/L
Male Female
Age Value Age Value
<16 y See Note <16 y See Note
16-20 yNo Ref Interval
16-19 yNo Ref Interval
20-24 y 11.8-67.8
25-29 y 8.4-65.4
30-34 y 4.8-53.9
35-39 y 5.5-37.4
40-44 y 0.7-21.1
21-70 y10.2 –82.8
45-50 y 0.3-14.7
Anti-Mullerian Hormone
IMMUNO CHEM
Cobas e601 Chemiluminescence assay
71-150 yNo Ref Interval
51-150 yNo Ref Interval
pmol/L
Male and Female < 16 y – Pediatric Reference Intervals are not available and results should be interpreted in context with the clinical presentation. Please contact Pediatric Endocrinology for consultation
Anti-Nuclear Antibody (ANA)
Refer to Nuclear Antibodies - Blood
Anti-Streptolysin O Titre (ASOT)
DSC Cobas c701-c502 Immunoturbidimetric assay 0 - 200 IU/mL
Anti-Thyroglobulin Antibody (Anti-TG)
Refer to Thyroglobulin Antibodies
Anti-Thyroid Peroxidase, Anti-Thyroid Antibodies, Thyroid Antibodies, Anti-Microsomal Abs or Anti-TPO
Refer to Thyroid Peroxidase Antibody
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Analyte Site Instrumentation Method Reference Interval Units Notes
Apolipoprotein (A-1) (APOA)
IMMUNO CHEM
Optilite TurbidimetricMale
1.10 - 1.70Female
1.20 - 1.90g/L
< 18 y < 0.90
Acceptable limit relative to dyslipidemia and atherosclerosis risk is < 0.9 g/L
Apolipoprotein (B) (APOB)
IMMUNO CHEM
Optilite Turbidimetric
18 - 150 y < 1.20
If result is ≥ 1.2 g/L :Treatment advised if FRS is Intermediate or High (Refer to Non – HDL Cholesterol for FRS ranges)Treatment target for ApoB < 0.8 g/L(2016 CCS Guideline, Can J Cardiol 2016)
If result is < 1.2 g/L:Treatment target for ApoB < 0.8 g/L(2016 CCS Guideline, Can J Cardiol 2016)
g/L
DSC FMC Cobas 8000
RRL Cobas 6000UV assay
DDHS HRH SDHS
Vitros Multiple - point rate slide assay
Alternate Name: Aspartate TransaminaseAspartate
Aminotransferase (AST), Blood
**ACH **SHC
Piccolo Express Colorimetric assay
Age<1 y1-3 y4-10 y11-150 y
Male10-65 10-5510-458-40
Female10-6510-5510-458-32
U/L
**VHF patients only
B
Analyte Site Instrumentation Method Reference Interval Units NotesBarbiturate Screen -Urine
Refer to CH-2.22 Drugs of Abuse Tests
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Analyte Site Instrumentation Method Reference Interval Units NotesFMC RRL
BMSH CMGHDDHS HRHSDHS
GEM 4000
CLH GEM 3500
**ACH **SHC
Base Excess (BE)
OGHVCH
i-STAT System
HCO3 – 24.8 + 16.2 (pH – 7.40) * - 5 to + 1 mmol/L
This analyte is part of a panel test
*Established by AHS Calgary Zone Respiratory Services
**VHF patients only
i-STAT CG4+ Cartridge
Bence Jones Protein -Urine
Go to: Electrophoresis, Protein - Urine
Benzodiazepine Screen - Urine
Refer to CH-2.22 Drugs of Abuse Tests
Beta-2 Glycoprotein Antibody
IMMUNO CHEM
BioPlex Multiplex Flow Assay Negative No units
Beta-2 MicroglobulinIMMUNO
CHEMSiemens Immulite 2000
Chemiluminescent immunometric assay
1.00 - 2.60 mg/L
Beta-Carotene ANA TOX Agilent LC 1100Liquid Chromatography with DAD
0.19 - 1.58 µmol/L
Beta HCG, Qualitative - Urine
FMC RRL HCTL CRL
DSC Urinalysis
Manual
The Quidel QuickVue One-Step hCG Combo kit or Quidel Quick Vue One-Step hCG Urine kit is a qualitative colorimetric method.
No Reference Interval
CH-2.21 Analyte Reference Interval Instrumentation Methodology Chart Rev 49.01
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Analyte Site Instrumentation Method Reference Interval Units Notes
DSC FMC Cobas 8000RGH PLC
SHCCobas 6000
Electrochemiluminescence immunoassay (ECLIA)
BMSH mini VIDASEnzyme Immunoassay Sandwich method
CMGH HRH
AccessTwo-site immunoenzymatic (sandwich) assay
STATS from ACH go to FMC
Beta HCG, Quantitative - Blood
**ACH **SHC
i-STAT SystemTwo-site enzyme –linked immunosorbant (ELISA) method
Males and non-pregnant females: 0 - 5
IU/L
**VHF patients onlyi-STAT BhCG Cartridge
FMC RRLBMSH CMGH DDHS HRHSDHS
GEM 4000Log HCO3 = pH + log pCO2 –
7.608
**ACH **SHC
i-STAT SystemLog HCO3 = pH + log pCO2 –
7.608
*20-24
CLH GEM 3500 Derived analyte
Bicarbonate (HCO3)
OGHVCH
i-STAT SystemLog HCO3 = pH + log pCO2 –7.608
ArterialVenous
Capillary
18 - 2322 - 2820 - 24
mmol/L
*Established by AHS Calgary Zone Respiratory Services
This analyte is part of a panel test
**VHF patients only
i-STAT CG4+ Cartridge
Bile Acids DSC Cobas c701-c502 Enzymatic Colorimetric
<1 m: 70 µmol/L1 – 3 m: < 41 µmol/L3 – 12 m: < 30 µmol/L>12 m: < 8.2 µmol/L
µmol/L
DSC FMC Cobas 8000
RRL Cobas 6000Colorimetric assay utilizing a diazonium ion with blank
Bilirubin, Direct (Conjugated)
HCTL BMSH CMGH DDHS
HRH OGH SDHS
Vitros Colorimetric slide assay
Age
< 15 d (Neonatal)
15 d - 150 y
Value
0 – 20
0 - 7
µmol/L
Alternate Name: Conjugated Bilirubin
CH-2.21 Analyte Reference Interval Instrumentation Methodology Chart Rev 49.01
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Analyte Site Instrumentation Method Reference Interval Units NotesDSC FMC Cobas 8000 Age Value
RRL Cobas 6000 Colorimetric assay utilizing a diazonium ion with blank.
Neonatal< 1 d1-2 d3-14 d
0-1000-1500-220
Bilirubin, Total
HCTL CRL
Vitros Colorimetric slide assay
15-365 d1-4 y5-9 y10-14 y15-150 y
0-230-100-140-190-24
µmol/L
Neonatal Bilirubins done
only at DSC FMC RRL
CMGH DDHS HRH OGH
SDHS
Bilirubin, Total
Piccolo Xpress Analyzer
VHF patients only
**ACH **SHC
Piccolo Express Colorimetric assay
Age< 1 d1-2 d3-14 d15-365 d1-4 y5-9 y10-14 y15-150 y
Value5-1085-1595-2315-295-155-195-255-30
µmol/L**VHF patients only
DSC FMC Cobas 8000Bilirubin, Total -Fluid RRL Cobas 6000
Colorimetric assay utilizing a diazonium ion with blank.
No Reference Interval µmol/L
Blood - Urine Go to: Urinalysis
Blood GasesThis is a panel test which may include the following, dependent on site and instrumentation: pH, pCO2, pO2, Bicarbonate (HCO3), Base Excess (BE), Total Hemoglobin, O2 Saturation (Oxyhemoglobin), Carboxyhemoglobin, Methemoglobin, Hematocrit, Sodium, Potassium, Chloride, Ionized Calcium, Glucose and Lactate. Refer to individual analytes.
C
Analyte Site Instrumentation Method Reference Interval Units Notes
CA 125 - BloodIMMUNO
CHEMCobas e601 Chemiluminescence assay Female: < 36 KU/L
CA 125 - FluidIMMUNO
CHEMCobas e601 Chemiluminescence assay No Reference Interval KU/L
CA 15-3IMMUNO
CHEMArchitect
Chemiluminescent Microparticle Immunoassay
< 31.2 kU/L
CA 19-9 - BloodIMMUNO
CHEMCobas e601 Chemiluminescence assay < 36 KU/L
CA 19-9 - FluidIMMUNO
CHEMCobas e601 Chemiluminescence assay No Reference Interval KU/L
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Analyte Site Instrumentation Method Reference Interval Units Notes
DSC FMC Cobas 8000
RRL Cobas 6000
Colorimetric assay with endpoint determination and sample blank utilizing NM-BAPTA
SMCHC BMSH CLH
CMGH DDHS HRH OGH SDHS
VCH
Vitros Colorimetric slide assayCalcium - Blood
**ACH **SHC
Piccolo Express Colorimetric assay
Age
1-10 d
11-365 d
1-150 y
Value
1.90-2.60
2.25-2.75
2.10-2.55
mmol/L
**VHF patients only
DSC FMC Cobas 8000Calcium - Fluid
RRL Cobas 6000
Colorimetric assay with endpoint determination and sample blank utilizing NM-BAPTA
No Reference Interval mmol/L
FMCRRL
GEM 4000Potentiometric sensor which is located in a cartridge
Age< 29 d29 d-150 y
*Value0.90-1.301.15-1.35
*Established by CLS Chemistry Division.Also done by Respiratory at ACH, FMC, PLC, RGH and SHC
Calcium, Free or Ionized
**ACH **SHC
i-STAT SystemMeasured by ion-selective electrode (ISE) potentiometry
Age< 29 d29 d-150 y
Value0.90-1.301.15-1.35
mmol/L
**VHF patients onlyi-STAT Chem 8+
Calcium - Stool FMC Cobas 8000Colorimetric assay with endpoint determination and sample blank utilizing NM-BAPTA.
No Reference Interval mmol/LLiquid Random Stool
Calcium - Urine DSC Cobas c701-c502o-cresolphthalein complex one reaction measured photometrically at 552 nm.
2.5 - 7.5 mmol/
day
Calcium/Creatinine Ratio, Urine
DSC Cobas c701-c502 Calculation No Reference Interval
Refer to CH-55.07 Cobas c701-c502 Calculations
Calculus Analysis DSC Nicolet FTIRRenal calculi composition is determined by infrared spectroscopy.
No Reference Interval
Cannabinoid Screen –Urine (THC)
Refer to CH-2.22 Drugs of Abuse Tests
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Analyte Site Instrumentation Method Reference Interval Units Notes
Carbamazepine FMC Cobas 8000Kinetic Interaction of Microparticles in Solution (KIMS) Immunoassay
Therapeutic Range: 20 - 50 µmol/LAlternate
Name : Tegretol
Carboxyhemoglobin (COHB)
FMC RRL BMSH
CMGH DDHS HRH
SDHS
GEM 4000 CO-Oximetry
Age
< 8 y
8 y – 150 y
*Value
No Reference Interval
0.0 - 3.0
%
*Established by CLS and AHS Calgary Zone Respiratory Services
This analyte is part of a panel test
Carcinoembryonic Antigen (CEA) - Blood
IMMUNO CHEM
ArchitectChemiluminescent Microparticle Immunoassay technology (CMIA)
0.0 - 5.0 µg/L
Carcinoembryonic Antigen (CEA) - Fluid
IMMUNO CHEM
ArchitectChemiluminescent Microparticle Immunoassay technology (CMIA)
No Reference Interval µg/L
Cardiolipin Antibody IMMUNO
CHEMBioPlex Multiplex Flow Assay Negative No units
Norepinephrine (nmol/L)
Epinephrine(pmol/L)Age
(Resting)
2 - 10 d 1.00 - 6.97 197 - 2183
10 d - 4 m 2.18 - 12.29 300 - 1092
4 - 12 m 1.59 - 6.62 300 - 2402
12 - 24 m 0.40 - 10.69 197 - 3493
2 - 3 y 1.00 - 8.68 98 - 2402
3 - 18 y 0.50 - 7.38 98 - 2511
18 - 150 y 0.41 - 4.43 55 - 601Dopamine: 2 d - 150 y is
0 - 200 pmol/L
Catecholamine, Blood ANA TOX Agilent LC 1100 Liquid Chromatography with ECD
Clonidine Suppression Test: Normal response - amaximum fall of plasma norepinephrine to less than 2.96 nmol/L and a decrease of greater than 50% from basal values.
Refer to CH10-2.10
Catecholamines - HPLC
Coulochem
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Analyte Site Instrumentation Method Reference Interval Units Notes
Ceruloplasmin DSC Cobas c701-c502 Immunoturbidimetric assayMale0.15- 0.30
Female0.16 – 0.45
g/L
DSC FMC Cobas 8000
RRL Cobas 6000Indirect potentiometric assay using an ion-selective electrode.
HCTL CRL Vitros Direct potentiometric assay Chloride - Blood
***ACH ***SHC
i-STAT System Potentiometric
98-111 mmol/L
***VHF patients only
i-STAT Chem 8+ Cartridge
Chloride – Blood (Blood Gases)
FMC RRL GEM 4000 Potentiometric 98 - 111 mmol/L
Established by CLS Chemistry DivisionThis analyte is part of a panel test
DSC FMC Cobas 8000Chloride - Fluid
RRL Cobas 6000Indirect potentiometric assay using an ion-selective electrode
No Reference Interval mmol/L
Chloride – Stool FMC Cobas 8000Indirect potentiometric assay using an ion-selective electrode
No Reference Interval mmol/L
DSC Cobas c701-c502FMC Cobas 8000
24 hour 170-255 mmol/dayChloride – Urine
RRL Cobas 6000
Indirect potentiometric assay using an ion-selective electrode
Random No Reference Interval mmol/L
Age Male/Female
DSC Cobas 8000Enzymatic colorimetric assay (CHOD-PAP)
< 366 d 2.36 - 5.32Acceptable limit relative to dyslipidemia and atherosclerosis risk is < 4.40 mmol/L
366 d to 17 y
2.70 – 5.89Acceptable limit relative to dyslipidemia and atherosclerosis risk is < 4.40 mmol/L
Cholesterol, Total –Blood
BMSH VitrosCholesterol oxidase, esterase, peroxidise
18 to 150 y Desirable < 5.17High ≥ 6.21
mmol/L
Cholesterol – Fluid DSC Cobas 8000Enzymatic colorimetric assay (CHOD-PAP)
No Reference Interval mmol/L
Cholinesterase Go to: Pseudocholinesterase (Acetycholinesterase is a sendout to DynaLife Dx)
Chromogranin AIMMUNO
CHEMTriturus Enzyme Immunoassay < 111 ng/mL
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Analyte Site Instrumentation Method Reference Interval Units NotesChylomicrons, Visual – BloodChylomicrons, Visual -Fluid
DSC Manual Reported as present or absent No Reference Interval None
CH-6.30 Chylomicron in Serum Plasma
and Fluids
DSC FMC Cobas 8000
RRL Cobas 6000Liquid IFCC is an UV assay
CK – Blood (Creatine Kinase)
BMSH CLH CMGH
DDHS HRH OGH SDHS
VCH
Vitros Multiple- point rate
Male
0 – 195
Female
0 – 170U/L
CK-MB FMC Cobas 8000The CK-MB STAT is an Electrochemiluminescence immunoassay (ECLIA)
0.0 – 5.0 µg/L
PSC: Order Troponin T-hs instead of CKMB
Clozapine ANA TOX Agilent LC 1100 Liquid Chromatography with DAD
Recommended clozapine interval is 1070 to 1835 nmol/L to achieve a therapeutic response. Significant CNS toxicity may be associated with levels >3500 nmol/L for clozapine and >2000 nmol/L for desmethylclozapine.
nmol/L
DSC FMC Cobas 8000
RRL Cobas 6000CO2-L is an enzyme assay utilizing PEPC
HCTL CRL Vitros Enzymatic endpoint slide assayCO2 Content – Blood (Carbon Dioxide)
***ACH ***SHC
Piccolo Express Colorimetric assay
Age< 6 y6-150 y
Value18-2721-31
mmol/L
***VHF patients only
DSC FMC Cobas 6000CO2 Content – Fluid
RRL Cobas 8000CO2-L is an enzyme assay utilizing PEPC
No Reference Interval mmol/LDone on dialysates only
Cocaine Metabolite Screen, Urine
Refer to CH-2.22 Drugs of Abuse Tests
Complement C3 -Blood
DSC Cobas c701-c502 Immunoturbidimetric assay 0.6-1.6 g/L
Complement C3 -Synovial Fluid
DSC Cobas c701-c502 Immunoturbidimetric assay No reference interval g/L
Complement C4 DSC Cobas c701-c502 Immunoturbidimetric assay 0.1-0.4 g/L
DSC Cobas 8000Cortisol - Blood
FMC Cobas 8000Electrochemiluminescent immunoassay
Cortisol AM:Cortisol PM:Cortisol:
170-500 75-285 No reference interval
nmol/L
Cortisol - Oncology Refer to Oncology Cortisol
CH-2.21 Analyte Reference Interval Instrumentation Methodology Chart Rev 49.01
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Analyte Site Instrumentation Method Reference Interval Units Notes
Cortisol - SalivaryIMMUNO
CHEMCobas e601 ECLIA
AMPM
4.7-32.0 0.0-3.6
nmol/L
Cortisol - UrineIMMUNO
CHEMCobas e601 ECLIA 24 hour 100.0 – 380.0 nmol/d
C-Peptide IMMUNO
CHEMSiemens Immulite 2000 Chemiluminescent assay Fasting 0.40-1.40 nmol/L
DSC FMC Cobas 8000
RRL Cobas 6000Immunoturbidimetric assayC-Reactive Protein
(CRP) (Quantitative)HRH Vitros Fixed-point Immuno rate
0.0-8.0 mg/L
C-Reactive Protein, High Sensitivity (hsCRP)
DSC Cobas 8000Particle enhanced Immunoturbidimetric assay
A reference interval for High Sensitivity CRP is not available
mg/L
Creatine Kinase Refer to CK-Creatine Kinase
DSC FMC Cobas 8000
RRL Cobas 6000
Enzymatic colorimetric assay utilizing creatininase
HCTL CRL Vitros 2 point rate assayCreatinine - Blood
***ACH ***SHC
Piccolo Express Colorimetric assay
Age
< 2 y2-5 y6-12 y13-14 y15-150 y
Male & Unknown10-4020-4520-7530-9550-120
Female
10-4020-4520-7530-9540-100
µmol/L
***VHF patients only
DSC FMC Cobas 8000Creatinine - Fluid
PLC Cobas 6000Enzymatic colorimetric assay utilizing creatininase
No Reference Interval µmol/L
DSC Cobas c701-c502Enzymatic colorimetric assay utilizing creatininase
FMC Cobas 8000Creatinine - Urine (Random)
RRL Cobas 6000Enzymatic colorimetric assay utilizing creatininase
No Reference Interval mmol/L
CH-2.21 Analyte Reference Interval Instrumentation Methodology Chart Rev 49.01
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Analyte Site Instrumentation Method Reference Interval Units Notes
Creatinine - Urine (24 hour)
DSC Cobas c701-c502Enzymatic colorimetric assay utilizing creatininase
Age< 3 y3-8 y9-12 y13-17 y18-50 y51-80 y81-150 y
Maleno range1.20-6.202.70-11.504.40-20.308.80-22.107.00-18.605.30-17.70
Femaleno range1.20-6.202.70-11.503.50-14.106.20-14.104.40-12.403.50-11.50
mmol/d
Creatinine Clearance DSC Calculation 1.20-2.30 mL/s/1.73 m2
Refer to CH-55.07 Cobas c701-c502 Calculations
Crystals, Synovial Fluid
FMC PLCRGH SHC
DSC Urinalysis
Manual-Polarizing Microscopy
The identification of crystals within exudative synovial fluid is performed using a compensating polarizing microscope.
No Reference Interval
Refer to GL-14.02 Fluid Crystal Identification –Specimen or GL-14.06 Fluid Crystal Identification -FMC PLC RGH SHC
CTx (C-Telopeptide –Beta Cross Laps)
IMMUNO CHEM
Cobas e601 Chemiluminescent assay 0-400 ng/L
Cyclic Citrullinated Peptide Antibody (Anti-CCP)
IMMUNO CHEM
ArchitectChemiluminescent microparticle Immunoassay (CMIA)
< 5.0 U/mL
Cyclosporin Ana ToxAgilent LC with ABsciex
MSTandem Mass Spectrometry
Results interpreted by clinician. Interpretation is dependent upon various factors such as transplant type, time post transplant, and concomitant immunosuppressive therapy
µg/L
D
Analyte Site Instrumentation Method Reference Interval Units Notes
Depakene Go to: Valproate
Desethyl-amiodarone Ana Tox Agilent LC 1100Liquid Chromatography with DAD
1.3-3.5 µmol/LRefer to CH10-2.01 Amiodarone -HPLC DAD
DHEA-S IMMUNO Siemens Immulite 2000 Chemiluminescent assay Age Male Female µmol/L
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Page 16 of 48
Analyte Site Instrumentation Method Reference Interval Units Notes
1d-10y 0.3-6.0 0.3-6.0
11-54y 2.2-13.0 1.5-13.0
(Dehydroepiandrosterone Sulphate)
CHEM
55-150y 0.6-10.0 0.3-6.0
Normal individuals: > 0.74Heterozygous individuals:
0.57-0.72Dibucaine Number(See also Pseudocholinesterase)
DSC Calculation
To determine the dibucaine number (DN), cholinesterase activity is measured with and without dibucaine. Homozygous
individuals:< 0.51
No Units
Refer to CH-55.07 Cobas c701-c502 Calculations
FMC Cobas 8000PLC RGH
SHCCobas 6000
Kinetic Interaction of Microparticles in Solution (KIMS) Immunoassay Digoxin
BMSHHRH SDHS
Vitros Multiple-point immuno-rate assay
Therapeutic range: 1.0-2.6
Evidence-based therapeutic range for CHF: 0.6-1.2
nmol/L
Dilantin / Dilantin, Free
Go to: Phenytoin / Phenytoin, Free
DNA Antibodies IMMUNO
CHEMBioPlex Multiplex Flow Assay
0 – 9
Negative: < 5 Indeterminate: 5 – 9 Positive: > 9
kIU/L
Drugs Of Abuse Screen, Urine (UDS –Acute Care)Drugs Of Abuse Screen, Urine (UDSR – Routine)Drug Screen, Comprehensive(FDSU)
Refer to CH-2.22 Drugs of Abuse Tests
E
Analyte Site Instrumentation Method Reference Interval Units NotesAlbumin 33 - 48Alpha 1 Globulin 2.2 - 4.0Alpha 2 Globulin 5 -10Beta 1 Globulin 3 - 6Beta 2 Globulin 2 - 5
Electrophoresis, Protein - Serum
DSC Capillyrs/Hydrasys Electrophoresis
Gamma Globulin 5 - 16
g/L
Electrophoresis, Protein - Urine
DSC Capillyrs/Hydrasys Electrophoresis No Reference Interval
Erythropoietin IMMUNO
CHEMSiemens Immulite 2000 Chemiluminescent assay 4-20 U/L
CH-2.21 Analyte Reference Interval Instrumentation Methodology Chart Rev 49.01
Page 17 of 48
Analyte Site Instrumentation Method Reference Interval Units NotesFemale< 11 y (pre-puberty)Follicular phaseLuteal phaseMid-cycle phase61-150 y (post-menopause)
0-130 90-700 150-950 250-1500 0-150
Male< 11 y 0-130
Estradiol DSC Cobas 8000Competition principle using chemiluminescent technology
11-150 y 0-160
pmol/L
FMC Cobas 8000RRL Cobas 6000
Enzymatic method with alcohol dehydrogenase
Ethanol - Blood
SMCHCCCHC BMSH CMGH CLH
DDHS HRH SDHS VCH
Vitros Colorimetric slide assayNo Reference Interval mmol/L
Ethanol - Urine Refer to CH-2.22 Drugs of Abuse Tests
Ethylene Glycol FMCAgilent 7890B Gas
Chromatograph analyzer
Gas chromatography No Reference Interval mmol/L
Extractable Nuclear Antigen Antibodies -Blood
IMMUNO CHEM
BioPlex Multiplex Flow Assay Negative
Includes the following:Centromere B, Chromatin, Jo-1, Ribosomal P, RNP 68, RNP A, Ro-52/TRIM21, Scl-70,SS-A/Ro-60, SS-B/La, Sm, SmRNP, dsDNA
CH-2.21 Analyte Reference Interval Instrumentation Methodology Chart Rev 49.01
Page 18 of 48
F
Analyte Site Instrumentation Method Reference Interval Units Notes
Fat Globules, Random – Stool
DSC Urinalysis
Manual < 6 fat globules/hpf
Refer to GL-15.02 Fat Globules and Meat Fibers -Stool
Fecal Fat Output< 7 y 0.0-6.97-150 y 0.0-20.9
mmol/ day
Fecal Fat – 72 Hour ACH Manual
A weighed sample is manually extracted, evaporated, dissolved and titrated to obtain a measurement of the total fatty acids present.
Fat Excretion RangeAll ages 0.0-9.9 %
%
Fecal Fat Excretion Range only calculated for patients assessed for fat intake at ACH
Fecal Elastase IMMUNO
CHEMManual Enzyme immunoassay > 199 µg/g
Fecal Immunochemical Test (FIT)
DSC Urinalysis
OC-Sensor Diana Immunoassay Negative
As of November 18, 2013 this test replaced Occult Blood – Stool for community patients
For screening asymptomatic 50-74 year olds.
Ferritin DSC Cobas 8000Particle Enhanced Immunoturbidmetric Assay
Age1d-2 y3-12 y13-150 y
Male6-11010-11030-400
Female6-11010-11013-375
µg/L
First Trimester Screen
IMMUNO CHEM
Perkin Elmer Auto Delfia
Solid phase 2 site fluoroimmunometric assays.
No Reference IntervalIncludes PAPP-A And Free BHCG
Folate - SerumIMMUNO
CHEMCobas e601 Chemiluminescence assay >12.0 nmol/L
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Analyte Site Instrumentation Method Reference Interval Units Notes
Female
1d – 1y 0-7
2-5y 0-4
6-10y 0-3
Follicular 2-10
Luteal 1-9
Mid-Cycle Peak 3-33
Post-Menopause 23-116
Male
1d – 10y 0-2
11-12y 0-8
Follicle Stimulating Hormone (FSH)
DSC Cobas 8000Two-site sandwich immunoassay using chemiluminescent technology.
13-150y 1-18
IU/L
Free Androgen Index (FAI)
IMMUNO CHEM
CalculationThis is a calculation done by using the testosterone and the SHBG results.
Male > 29.9
Female < 5.1
No UnitsRefer to CH-37.07
Immulite Calculations
Free Prostatic Specific Antigen (FPSA)
Go to: PSA, Fractionated/Free
Fructosamine DSC Cobas c701-c502 Colorimetric method. 200-285 µmol/L
G
Analyte Site Instrumentation Method Reference Interval Units Notes
DSC FMC Cobas 8000
RRL Cobas 6000Enzymatic colorimetric assay
HCTL BMSH CMGH DDHS
HRH SDHS
Vitros Multiple point rate assayGamma Glutamyl-transferase (GGT)
***ACH ***SHC
Piccolo Express Colorimetric assay
Male
11-63
Female
8-35U/L
***VHF patients only
Gastrin IMMUNO
CHEMSiemens Immulite 2000 Chemiluminescent assay Fasting >10 hours: < 100 ng/L
CH-2.21 Analyte Reference Interval Instrumentation Methodology Chart Rev 49.01
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Analyte Site Instrumentation Method Reference Interval Units NotesTherapeutic Target for Multiple-Daily DosingPre-dose 0.0 - 1.9FMC Cobas 8000
Fluorescence Polarization immunoassay.
Post-dose 5.0 - 10.0Therapeutic Target for Extended Interval DosingPre-dose 0.0-1.0
Gentamicin
RRL Cobas 6000 Enzymatic Immunoassay
Post-doseContraindicated for adults with normal renal function
mg/L
Glomerular Basement Membrane Antibody (GBM)
IMMUNO CHEM
BioPlex Multiplex Flow Assay < 1 AI (Antibody Index)
Glomerular Filtration Rate (GFR)
DSC FMC RRL HCTL
CRLCalculation
Calculation using Creatinine and age of patient. Done on all patients > 17 y
>59 mL/min/1.73 sq.m
Refer to CH-2.45 Estimated Glomerular Filtration Rate
DSC FMC Cobas 8000
RRL Cobas 6000Hexokinase-UV assay
HCTL CRL Vitros Glucose Oxidase - ColorimetricGlucose - Blood
***ACH ***SHC
Piccolo ExpressModified Hexokinase-Colorimetric
Fasting< 30 d 2.5 – 5.530 d – 150 y 3.3 – 6.0
Random< 30 d 2.5 – 11.030 d – 150y 3.3 – 11.0
mmol/L
***VHF patients only
Glucose - Blood (Blood Gases)
FMC RRL GEM 4000 Amperometric sensors
Age
< 29 d
29 d - 150 y
Value
2.4 - 5.6 (fasting)
3.9 – 6.1 (fasting)
mmol/L
Established by CLS Chemistry DivisionThis analyte is part of a panel test
DSC FMC Cobas 8000
RRL Cobas 6000Hexokinase-UV assay
Glucose - CSF
BMSH Vitros Glucose Oxidase - Colorimetric
Age Values< 31 d 1.4 - 4.331 d – 150 y 2.2 - 3.9
mmol/L
DSC FMC Cobas 8000Glucose - Fluid
RRL Cobas 6000Hexokinase-UV assay No Reference Interval mmol/L
Glucose - Urine Quantitative
ACH Cobas 6000 Hexokinase-UV assay No Reference Interval mmol/L
Glucose - Urine Qualitative
Go to: Urinalysis
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Analyte Site Instrumentation Method Reference Interval Units Notes
DSC FMC Cobas 8000
RRL Cobas 6000
Hexokinase-UV assay
Glucose - Gestational Screen for Diabetes
CRL Vitros Glucose Oxidase - Colourimetric
< 7.8 mmol/L at 1 hour after 50g glucose load
Test should be performed between 24-28 weeks gestation.
A glucose tolerance test is warranted if the 1 hour glucose value is 7.8-11.0 mmol/L
Gestational diabetes mellitus is diagnosed if the 1 hour glucose value is greater than or equal to 11.1 mmol/L
mmol/L
CH-2.21 Analyte Reference Interval Instrumentation Methodology Chart Rev 49.01
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Analyte Site Instrumentation Method Reference Interval Units Notes
DSC FMC Cobas 8000 Hexokinase-UV assay
RRL Cobas 6000 Hexokinase-UV assay
CRL Vitros Glucose Oxidase - Colourimetric
NOTES: GTTNP
If fasting glucose value is over 7.8 mmol/L when tested by glucose meter the GTTNP will be cancelled.
GTTPIf fasting glucose is over 5.9 mmol/L when tested by glucose meter or over 5.2 mmol/L when tested by chemistry analyzer the GTTP will be cancelled.
mmol/L
Glucose Tolerance (GTTNP or GTTP)
REFERENCE INTERVALS:
Fasting Specimen (GTTNP):Less than 30 d: 2.5-5.530 d to 150 y: 3.3-6.0
Non-Pregnant Adults/Children <17 (GTTNP): Diagnosis of Diabetes Mellitus: Fasting plasma glucose > 6.9 mmol/L or 2 h post administration of the 75g glucose drink > 11.0 mmol/L in the
presence of symptomatic hyperglycemia, or observed on two occasions without symptomsDiagnosis of impaired fasting glucose (Prediabetes): Fasting glucose 6.1 to 6.9 mmol/L AND plasma glucose 2 hours post administration of the
75g glucose drink < 7.8 mmol/L Diagnosis of impaired glucose tolerance (Prediabetes): Fasting plasma glucose < 6.1 mmol/L AND plasma glucose 2 hours post administration of
the 75 g glucose drink between 7.8 and 11.0 mmol/LDiagnosis of impaired fasting glucose and impaired glucose tolerance (Prediabetes): Fasting plasma glucose between 6.1 and 6.9 mmol/L AND
plasma glucose 2 hours post administration of the 75g glucose drink between 7.8 and 11.0 mmol/L
Pregnant (GTTP): Note: the 75g Oral Glucose Tolerance Test for Gestational Diabetes Mellitus (GDM) should be performed if the Gestational Diabetes Screen result is between 7.8 and 11.0 mmol/L
Diagnosis of Gestational Diabetes Mellitus:GDM is diagnosed if one or more of the following values are elevated during the 75g Oral Glucose Tolerance Test:Fasting glucose > 5.2 mmol/LPlasma glucose 1 hour post administration of glucose drink > 10.5 mmol/LPlasma glucose 2 hours post administration of glucose drink > 8.9 mmol/L
Male FemaleGrowth Hormone
IMMUNO CHEM
Siemens Immulite 2000 Chemiluminescent assay 0-3 0-8
µg/L
CH-2.21 Analyte Reference Interval Instrumentation Methodology Chart Rev 49.01
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H
Analyte Site* Instrumentation and Additional Info
Method Reference Interval Units Notes
Haptoglobin DSC Cobas c701-c502 Immunoturbidimetric assay 0.3-2.0 g/L
DSC Cobas 8000The Roche/Hitachi HDL-C Plus is an enzymatic colorimetric assayHDL Cholesterol
BMSH Vitros Colorimetric assay
No Reference Interval mmol/L
Hematocrit (Blood Gases)
FMC RRLCMGH
DDHS HRH SDHS
GEM 4000 Derived analyteRefer to:
HE-1.21 CBC Reference IntervalsThis analyte is part of a panel test
Hemoglobin, Total (Blood Gases)
FMC RRLCMGH
DDHS HRH SDHS
GEM 4000 CO-Oximetry
Refer to:HE-1.11 Hematology Critical Values
or HE-1.21 CBC Reference Intervals
g/LThis analyte is part of a panel test
Hemoglobin A1c DSC Cobas c513 Colorimetric method. < 6.5 % %Hepatitis A Antibody, IgG(Anti-HAV IgG)
Negative
Hepatitis A Antibody, IgM (Anti- HAV IgM)
Negative
Hepatitis B Core Antibody (Anti-HBc)
Negative
Hepatitis B Core Antibody, IgM (Anti-HBc IgM)
Negative
Hepatitis Be Antigen (HBeAg)
Negative
Hepatitis Be Antibody (Anti-HBe)
Negative
Hepatitis B Surface Antibody (Anti-HBs)
Antibody to Hepatitis B Surface Antigen levels greater than or equal to
10 IU/L are generally considered protective
IU/L
Hepatitis B Surface Antigen (HBsAg)
IMMUNO CHEM
ArchitectMicroparticle Enzyme Immunoassay (MEIA)
Negative
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Page 24 of 48
Analyte Site* Instrumentation and Additional Info
Method Reference Interval Units Notes
24 Hour
All Ages 10-40µmol/d
Random
< 6 y < 13
5 HIAA (5-Hydroxyindoleacetic Acid)
ANA TOXAgilent LC 1100 with
MS 6410Tandem Mass Spectrometry
6 y to 150 y < 10
µmol/mmol
Refer to CH10-1.20 5-Hydroxyindoleacetic Acid - 6410 6460
HIV Serology, CLSIMMUNO
CHEMArchitect
ChemiluminescentMicroparticle Immunoassay technology (CMIA)
Negative no units
HIV Serology by Rapid Assay
FMC PLC RGH SHC
Manual24 INSTI™ - HIV-1 Antibody Test Kit
Non-ReactiveRefer to GL-16.02 HIV Serology by Rapid Assay
Age Male Female
16-49 y 4.9-13.7 4.1-9.9Homocysteine - BloodIMMUNO
CHEMArchitect
Chemiluminescent Microparticle Immunoassay technology (CMIA) 50-150 y 4.9-13.7 3.8-12.8
µmol/L
Hydrogen Breath Test ANA TOX Quintron
A measured aliquot of breath carried through the HMS column by room air acting as the carrier gas separates hydrogen (H2) and methane (CH4), which appear sequentially at the end of the column.
No Reference Interval
I
Analyte Site Instrumentation Method Reference Interval Units NotesImmunofixation Electrophoresis (IFE) - Blood/Urine
DSC Capillarsys/Hydrsys Electrophoresis No Reference Interval
CH-2.21 Analyte Reference Interval Instrumentation Methodology Chart Rev 49.01
Page 25 of 48
Analyte Site Instrumentation Method Reference Interval Units Notes
Age Male/Female
1 d-2 m 0.00-1.20
3 m-5 m 0.05-1.20
6-12 m 0.10-1.20
1 y 0.20-1.60
2 y 0.30-2.00
3-5 y 0.35-2.40
6-7 y 0.40-2.80
8-10 y 0.45-3.20
11-15 y 0.50-3.80
Immunoglobulin A -Blood
DSC Cobas c701-c502 Immunoturbidimetric assay
16-150 y 0.60-4.20
g/L
Age Mean +2SD
< 1 y 8.0 117.0
1 - 4 y 9.0 313.0
5 - 10 y 18.0 555.0
11 - 15 y 26.0 481.0Immunoglobulin E
IMMUNO CHEM
Cobas e601 Chemiluminescence assay
Adult: approximately 95% of adult values fall between 0.0 and 160.0 kU/L with a geometric mean value of 17.0 kU/L
kU/L
Immunoglobulin Free Light Chains
IMMUNO CHEM
Optilite Turbidimetric
Free Kappa Light Chain: 3.30-19.40 Free Lambda Light Chain: 5.71-26.30Free Kappa/Free Lambda Ratio:
0.26-1.65
mg/L
Age Male/Female
1 d-2 m 2.60 - 14.00
3-12 m 2.80 - 16.00
1-2 y 4.00 - 16.00
3-5 y 5.40 - 16.00
6-7 y 5.80 - 16.00
8-10 y 6.20 - 17.00
11-15 y 6.40 - 17.00
Immunoglobulin G -Blood
DSC Cobas c701-c502 Immunoturbidimetric assay
16-150 y 6.80 - 18.00
g/L
Immunoglobulin G -CSF
DSC Cobas c701-c502 Immunoturbidimetric assay No Reference Interval g/L
CH-2.21 Analyte Reference Interval Instrumentation Methodology Chart Rev 49.01
Page 26 of 48
Analyte Site Instrumentation Method Reference Interval Units Notes
Subclass Male/Female
IgG1 3.82 – 9.29
IgG2 2.42 – 7.00
IgG3 0.22 – 1.76
IgG Subclasses, Subgroups or Subtypes
IMMUNO CHEM
Optilite Turbidimetric
IgG4 0.04 – 0.86
g/L
Age Male/Female
< 5 m 0.14 – 1.40
5 m – 3 y 0.20 – 1.60
4 y – 6 y 0.20 – 2.10
7 y – 11 y 0.30 – 2.10
12 y – 19 y 0.30 – 2.40
Immunoglobulin M DSC Cobas c701-c502 Immunoturbidimetric assay
20 y – 150y 0.40 – 3.00
g/L
InsulinIMMUNO
CHEMArchitect
Chemiluminescent Microparticle Immunoassay technology (CMIA)
Fasting < 120pmol/
L
Insulin Like Growth Factor 1
IMMUNO CHEM
Liaison® XL Chemiluminescence assayRefer to Guide to Services for Reference
Intervalsµg/L
Age Sex Iron TIBC
< 18 y Male 5-25 40-77
< 18 y Female 5-25 40-77
18 y – 150 y Male 8-30 40-80
Iron -Blood (& TIBC)
DSC Cobas 8000 Colorimetric assay
18 y – 150 y Female 6-28 40-80
µmol/L
TIBC is a calculation (DSC only)
Iron - Overdose Refer to Overdose Iron
Isopropanol FMCAgilent 7890B Gas
Chromatograph analyzer
Gas Chromotography No Reference Intervalmmol/
L
K/L
Analyte Site Instrumentation Method Reference Interval Units NotesKetone Screen -Blood
FMC RRL Precision Xtra Meter Amperometry Negative mmol/L
Ketone - Urine Go to: Urinalysis
FMC Cobas 8000
RRL Cobas 6000Colorimetric Assay
Lactate - BloodHCTL CRL
Vitros Colorimetric assay
0.5-2.2 mmol/L
CH-2.21 Analyte Reference Interval Instrumentation Methodology Chart Rev 49.01
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Analyte Site Instrumentation Method Reference Interval Units Notes
FMC RRL GEM 4000 Amperometric
Lactate – Blood (Blood Gases)
***ACH ***SHC
i-STAT System Lactate oxidase + amperometry
< 2.0 mmol/L
Established by CLS Hematology DivisionThis analyte is part of a panel test***VHF patients
onlyi-STAT CG4+ Cartridge
FMC Cobas 8000
Lactate, CSFRRL Cobas 6000
Colorimetric Assay
Age< 3 d3-10 d10 d – 150 y
Value1.1-6.71.1-4.41.1-2.4
mmol/L
DSC FMC Cobas 8000
RRL Cobas 6000UV assay
Lactate Dehydrogenase (LD) - Blood HCTL
CRLVitros Multiple-point rate assay slide
Age1 d – 5 y6 – 10 y11 – 15 y16 – 150 y
Value125-320 125-300 115-260 100-235
U/L
DSC FMC Cobas 8000Lactate Dehydrogenase - CSF RRL Cobas 6000
UV assay No Reference Interval U/L
Lactate Dehydrogenase -Fluid
DSC Cobas 8000 UV assay No Reference Interval U/L
Lactose Tolerance DSC Cobas 8000 Hexokinase-UV assay
A deficiency of lactase, or a malabsorption problem, is shown by a flat or almost flat curve, with the rise in glucose over the fasting level being less than 1.1 mmol/L
mmol/L
DSCLDL Cholesterol, Calculated BMSH
CalculationCalculation using results from CHOL, TRIG and HDL cholesterol.
Age< 18 y18 - 150 y
Value< 2.840.00 – 3.40
mmol/L
Leflunomide metabolite
Ana Tox Agilent LC 1100Liquid Chromatography with DAD
No reference interval µg/mL
Refer to CH10-2.15 Leflunomide Metabolite –HPLC DAD
Leukocytes - Urine Refer to Urinalysis
CH-2.21 Analyte Reference Interval Instrumentation Methodology Chart Rev 49.01
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Analyte Site Instrumentation Method Reference Interval Units Notes
DSC FMC Cobas 8000
RRL Cobas 6000Enzymatic Colorimetric assay
Lipase HCTL CRL
Vitros Two-point rate assay
Age< 16 y 16-150 y
Value0-600-80
U/L
DSC FMC Cobas 8000Lipase - Fluid
RRL Cobas 6000Enzymatic colorimetric assay No Reference Interval U/L
Lipoprotein (a) DSC Cobas c701-c502 Immunoturbimetric 0.00-0.30 g/L
FMC Cobas 8000 Colorimetric assayLithium
HRH Vitros Colorimetric assay
Therapeutic range:0.80 - 1.50 (acute therapy) 0.60 - 1.20 (chronic therapy)
mmol/L
Female1d – 10yFollicularLutealMid-cycle peakPost-menopause
0-6 1-131-178-7616-54
Male
Luteinizing Hormone (LH)
DSC Cobas 8000`Chemiluminescent sandwich principle technology
1 d – 10 y11 y – 70 y71 y – 150 y
0-6 1-93-35
IU/L
M
Analyte Site Instrumentation Method Reference Interval Units Notes
DSC FMC Cobas 8000
RRL Cobas 6000Colorimetric method with Xylidyl Blue
Magnesium - Blood
BMSH VCH
CMGH DDHS HRH SDHS
Vitros Colorimetric assay
0.65-1.05 mmol/L
Magnesium - Stool FMC Cobas 8000Colorimetric method with Xylidyl Blue
No Reference Interval mmol/L
Magnesium - Urine DSC Cobas c701-c502Colorimetric method with Xylidyl Blue
3.0- 5.5 mmol/ day
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Analyte Site Instrumentation Method Reference Interval Units Notes
Meat Fibres, Qualitative – Stool
DSC Urinalysis
Manual Microscopic < 6 meat fibers/hpf
Refer to GL-15.02 Fat Globules and Meat Fibres -Stool
Metanephrines -Plasma
ANA TOXAgilent LC 1100 with MS 6410
Tandem Mass SpectrometryPlasma Normetanphrine <0.90
Plasma Metanephrine <0.50 nmol/L
Refer to CH10-1.24Metanephrine in Plasma – 6410 6460
Normetanephrine (24 hour)Age Male Female< 3 y Not Available3 y - 8 y 0.2-0.9 0.2-0.89 y - 12 y 0.5-2.3 0.3-1.513 y - 17 y 0.5-2.5 0.3-1.618 y - 29 y 0.6-2.130 y - 39 y 0.6-2.340 y - 49 y 0.6-2.550 y - 59 y 0.7-2.660 y - 69 y 0.8-2.870 y - 150 y 0.8-3.1
µmol/d
Random Normetanephrine < 3 y 75-5843 y - 8 y 57-4439y - 12 y 33-25513y - 17 y 23-176
µmol/ mol Ur Creat
Metanephrine (24 hour)Age Male Female< 3 y Not Available3 y -8 y 0.2-0.5 0.1-0.79y - 12 y 0.3-1.0 0.2-0.613 y - 17 y 0.4-1.1 0.2-0.918 y- 150 y 0.2-1.3 0.2-0.9
µmol/d
Random Metanephrine< 3 y 47-2403 y - 8 y 37-1919 y - 12 y 24-120
Metanephrines -Urine
ANA TOXAgilent LC 1100 with
MS 6410Tandem Mass Spectrometry
13 y - 17 y 17-88
µmol/ mol Ur Creat
Refer also to CH10-1.22
Metanephrine in Urine- 6410 6460
Methadone Metabolite Screen -Urine
Refer to CH-2.22 Drugs of Abuse
CH-2.21 Analyte Reference Interval Instrumentation Methodology Chart Rev 49.01
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Analyte Site Instrumentation Method Reference Interval Units Notes
Methanol FMCAgilent 7890B Gas
Chromatograph analyzerGas Chromatography No Reference Interval mmol/L
Methemoglobin (MTHB)
FMC RRLCMGH DDHSHRHSDHS
GEM 4000 CO-Oximetry
Age< 8 y
8 y – 150 y
ValuesNo Reference Interval
0.0 – 1.5
%
Established by AHS Calgary Zone Respiratory ServicesThis analyte is part of a panel test
Therapeutic Level interpretation dependent on institutional protocols, type of therapy (intermediate vs high dose) and individual patient factors.Dosage Time Toxic
Low After 1 week > 0.04
High After 24 h > 5.0
High After 48 h > 0.5
Methotrexate ACH Cobas 6000Homogeneous Enzyme Immunoassay
High After 72 h > 0.05
µmol/L
Microalbumin Go to Albumin - UrineMitochondrial Antibody
IMMUNO CHEM
ManualIndirect Immunoflorescence Slide
NegativeAlso known as Tissue Antibodies
Monotest
IMMUNO CHEM
RRL HEM
HCTL CRL
ManualMonogen particle agglutination methodology
Negative
Mysoline Refer to Primidone
N
Analyte Site Instrumentation Method Reference Interval Units Notes
Sprinter-Sprinter XLIndirect Immunoflorescence Slide
ANCA Slide Interpretation: negative TitreNeutrophil Cytoplasmic Antibody (ANCA -PR3 & MPO)
IMMUNO CHEM
BioPlex Multiplex Flow AssayAnti-MPO antibody: <1.0Anti-PR3 antibody: <1.0
AI(Antibody
Index)Nitrite - Urine Go to: Urinalysis
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Analyte Site Instrumentation Method Reference Interval Units Notes
DSC Cobas 8000
<18 y No Reference Interval
Lipid Profile acceptable limits relative to dyslipidemia and atherosclerosis risk:Total Cholesterol Acceptable < 4.40 mmol/LHDL-C Acceptable > 1.16 mmol/LLDL-C Acceptable < 2.84 mmol/LTriglycerides Acceptable < 0.85 mmol/L (0-9 y) OR < 1.02 mmol/L (10-17 y)Non-HDL-C Acceptable < 3.10
Non – HDL Cholesterol
BMSH Vitros
Calculation
*18 -150 y 0.0 – 4.2
Low Risk (FRS < 10%)Treatment advised if LDL-C ≥ 5.0mmol/LTreatment target: > 50% reduction LDL-C
Intermediate Risk (FRS 10 - 19%)Treatment advised if LDL-C ≥ 3.5mmol/L OR Non-HDL-C ≥ 4.3 mmol/L OR ApoB ≥ 1.2 g/L; Consider treatment for men ≥ 50 and women ≥ 60 yrs with one additional CV risk factorTreatment targets: LDL-C < 2.0 mmol/L OR decrease by > 50% OR Non-HDL-C < 2.6 mmol/L OR ApoB < 0.8 g/L
High Risk (FRS ≥ 20% or presence of high risk features)Treatment advised in all patientsTreatment targets: LDL-C < 2.0 mmol/L OR decrease by > 50% OR Non-HDL-C < 2.6 mmol/L OR ApoB < 0.8 g/L
mmol/L
*For patients 30 yof age or older, the Framingham Risk Score (FRS), modified for family history, is recommended for risk assessment (2016 CCS Guideline, Can J Cardiol 2016)
FRS Calculation Resources can be found at www.myhealth.alberta.ca/Alberta/Pages/Heart-Disease-Risk-Calculator.aspx
N-Telopeptide (NTx)IMMUNO
CHEMTriturus Enzyme immunoassay
Male and pre-menopausal women: 5.0 - 65.0
nmol/ mmol creat
CH-2.21 Analyte Reference Interval Instrumentation Methodology Chart Rev 49.01
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Analyte Site Instrumentation Method Reference Interval Units NotesIMMUNO
CHEMCobas e601
FMC Cobas 8000PLC RGH
SHCCobas 6000
Chemiluminescence assay
ACHC CCHC BMSH OHWC
mini VIDASImmunoassay sandwich method with a final fluorescent detection (ELFA)
NT-proBNP
CLH CMGH DDHS
HRH OGH SDHS VCH
Stratus CS
Two-site sandwich assay, solid phase Radial Partition Immunoassay (RPIA) technology
0 - 300 ng/L
Nuclear Antibody (ANA)
IMMUNO CHEM
Sprinter-Sprinter XLIndirect Immunoflorescence Slide
Negative Titre
CH-2.21 Analyte Reference Interval Instrumentation Methodology Chart Rev 49.01
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O
Analyte Site Instrumentation Method Reference Interval Units Notes
FMC RRLBMSH CMGH
DDHS HRHSDHS
GEM 4000 Co-Oximetry
**ACH **SHC
i-STAT System
O2 Saturation = Oxyhemoglobin / (oxyhemoglobin + deoxyhemoglobin) Calculated from pO2, pCO2 and pH.
Arterial
Venous
Age
< 29 d29 d – 150 y
< 29 d29 d – 150 y
*Value
92 - 9688 - 100
85-8850-80
CLH GEM 3500 Derived analyte
O2 Saturation (Oxyhemoglobin)
OGHVCH
i-STAT System
O2 Saturation = Oxyhemoglobin / (oxyhemoglobin + deoxyhemoglobin)Calculated from pO2, pCO2 and pH.
Arterial
Venous
Capillary
83 – 108
60 – 85
< 70
%
*Established by AHS Calgary Zone Respiratory Services
This analyte is part of a panel test
**VHF patients only
i-STAT CG4+ CartridgeAssumes normal hemoglobin affinity for oxygen and normal amounts of dysfunctional hemoglobins (carboxy, met and sulfhemoglobin)
Occult Blood - Stool
DSC Urinalysis
FMC RRL Chem
DDHS HRH SDHS
Manual
The Hemoccult test is based on the oxidation of guaiac by hydrogen peroxide to a blue colored compound
Negative
Effective January 1st, 2014 this test is only available for hospital inpatients and emergency patients.Refer to GL-15.01 Occult Blood in Stool
Oncology Cortisol FMC Cobas 8000Electrochemiluminescent immunoassay
No Reference Interval nmol/L
Opiate Screen –Urine
Refer to CH-2.22 Drugs of Abuse Tests
Osmolal Gap FMC RRL CalculationOGAP = measured osmolality –calculated osmolality
No Reference Intervalmmol/k
g
Refer to CH-43.07 Osmometer
Reporting
CH-2.21 Analyte Reference Interval Instrumentation Methodology Chart Rev 49.01
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Analyte Site Instrumentation Method Reference Interval Units Notes
Osmolality – Blood 280 - 300
Osmolality – Fluid No Reference Interval
Osmolality - Urine
FMC RRL
50 - 1200
Osmolality – Stool FMC
Advanced Osmometer Model 2020
Advanced Micro-Osmometer 3320
Advanced Automated Osmometer Model
A2O
Advanced Osmometers determine osmolality by means of freezing point measurement.
284 - 430
mmol/kg
Age Sex Iron
< 18 y Male 5-25
< 18 y Female 5-25
18 y – 150 y Male 8-30
Overdose Iron ACH Cobas 6000 Colorimetric assay
18 y – 150 y Female 6-28
µmol/L
Oxycodone Screen -Urine
Refer to CH-2.22 Drugs of Abuse
P
Analyte Site Instrumentation Method Reference Interval Units NotesParathyroid Hormone (PTH)
IMMUNO CHEM
Liaison XL Chemiluminescence (CLIA) 7 - 37 ng/L
FMC Cobas 8000Parathyroid Hormone - Intra Operative RGH Cobas 6000
Chemiluminescence (CLIA) No Reference Interval ng/L
FMC Cobas 8000Parathyroid Hormone - Total Thyroidectomy (PTHTT)
RGH Cobas 6000Chemiluminescence (CLIA) No Reference Interval ng/L
Testing done post-op of a total thyroidectomy
Parietal Cell AntibodyIMMUNO
CHEMManual Indirect Immunoflorescence Slide Negative
Also known as Tissue Antibodies
CH-2.21 Analyte Reference Interval Instrumentation Methodology Chart Rev 49.01
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Analyte Site Instrumentation Method Reference Interval Units NotesFMC RRL
BMSH CMGH DDHS
HRH SDHS
GEM 4000 Potentiometric sensor
**ACH **SHC
i-STAT SystemMeasured by direct potentiometry - Nernst equation
ArterialVenous
Capillary
30 - 4036 - 4635 - 45
CLH GEM 3500 Potentiometric
pCO2 - Blood
OGHVCH
i-STAT SystemMeasured by direct potentiometry - Nernst equation
ArterialVenous
Capillary
35 - 4840 - 5238 - 45
mm Hg
This analyte is part of a panel test
i-STAT CG4+ Cartridge
**VHF patients only
FMC RRL
BMSH CMGHDDHS HRHSDHS
GEM 4000 Potentiometric sensor
**ACH **SHC
i-STAT SystemMeasured by direct potentiometry - Nernst equation
Arterial
Venous
Capillary
Age
< 29 d29d-150y
All
< 29 d29d-150y
*Value
7.35 -7.457.36 – 7.44
7.30 – 7.40
7.32 – 7.427.32 – 7.38
CLH GEM 3500 Potentiometric sensor
pH - Blood
OGHVCH
i-STAT SystemMeasured by direct potentiometry - Nernst equation
ArterialVenous
Capillary
7.35-7.457.31-7.417.35-7.45
*Established by AHS Calgary Zone respiratory Services
This analyte is part of a panel test
**VHF patients only
i-STAT CG4+ Cartridge
pH - CSFFMCSHC
GEM 4000Potentiometric sensor which is located in a cartridge
No Reference Interval
ACH, PLC and RGH - Deliver specimens to Respiratory Therapy
pH - Other Fluid FMC RRL Manual
ColorpHast reagent strips use an indicator combination to produce distinctive color changes for pH 0-14.
No Reference IntervalRefer to CH-6.50 pH in Fluid – FMC RRL
pH - Pleural FluidRespiratory -ACH FMCPLC RGH
GEM 4000Potentiometric sensor which is located in a cartridge
No Reference Interval
pH – StoolDSC
UrinalysisManual Multistix reagent strip for pH 7.0-8.0
Refer to GL-15.03 pH - Stool
pH - Urine Go to Urinalysis
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Analyte Site Instrumentation Method Reference Interval Units Notes
Phenobarbitol ACH Cobas 6000Kinetic Interaction of Microparticles in Solution (KIMS) Immunoassay
Therapeutic range: 65 - 170 µmol/L
FMC Cobas 8000
RRL Cobas 6000
Kinetic Interaction of Microparticles in Solution (KIMS) Immunoassay Phenytoin
HRH SDHS Vitros Multiple-point immuno-rate assay
Therapeutic Range:< 4 m 25 - 554 m – 150 y 40 - 80
µmol/L
Phenytoin, Free FMC Cobas 8000Kinetic Interaction of Microparticles in Solution (KIMS) Immunoassay
Therapeutic range: 4.0-8.0 µmol/L
DSC FMC Cobas 8000
RRL Cobas 6000Molybdate UV assay
Phosphate - Blood SMCHC BMSH CMGH
DDHS HRH SDHS
Vitros Colorimetric
Age1 d – 30 d1 m – 4 m5 m – 12 m1 y – 4 y5 y – 9 y10 y – 14 y15 y – 19 y20 y – 150 y
Value1.60-3.101.50-2.60 1.30-2.201.10-2.10 1.10-2.00 1.00-1.90 0.90-1.60 0.80-1.50
mmol/L
DSC FMC Cobas 8000Phosphate - Fluid
RRL Cobas 6000Molybdate UV assay No Reference Interval mmol/L
Phosphate – Urine DSC Cobas c701-c502 Photometric (Molybdate UV) 16.0 - 48.0 mmol/d
Phosphate/ Creatinine Ratio, Urine
DSC Cobas c701-c502 Calculation No Reference Interval
Random Urine PBG Range (µmol/L)
Risk Association to Acute Intermittent Porphyria
3-9 No Risk
10-88 Moderate Risk
89-176 High Risk
Porphobilinogen ANA TOXAgilent 8453
SpectrophotometerAnion Exchange with Erlich's Color Reaction
> 176 Highest Risk
µmol/LRefer to
CH-45.03 Porphobilinogen
CH-2.21 Analyte Reference Interval Instrumentation Methodology Chart Rev 49.01
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Analyte Site Instrumentation Method Reference Interval Units NotesFMC
RRL BMSH CMGH
DDHS HRHSDHS
GEM 4000 Amperometry
**ACH **SHC
i-STAT System Amperometry
Arterial
Venous
Capillary
Age
< 29 d29d-150y
All
< 29 d29d-150y
*Value
50 - 7070 - 88
30 - 50
30 - 4035 - 45
CLH GEM 3500 Amperometry
pO2 - Blood
OGHVCH
i-STAT System Amperometry
ArterialVenous
CapillaryAll
70 - 9030 - 50
40 - 100
*Established by AHS Calgary Zone respiratory Services
This analyte is part of a panel test
**VHF patients only
i-STAT CG4+ Cartridge
Porphyrin, Quantitative - Urine
ANA TOXAgilent 8453
SpectrophotometerMulticomponent Second Derivative Analysis
Coproporphyrin 24-190Uroporphyrin < 36
nmol/ 24 hours
Refer to CH-45.04
PorphyrinsFMC DSC Cobas 8000
RRL Cobas 6000 Indirect potentiometry assay using an ion-selective electrode
HCTL CRL Vitros Direct potentiometric assay Potassium - Blood
***ACH ***SHC
i-STAT SystemIon-selective electrode (ISE) potentiometry
AgeLess than 4 m
4 – 11 m1 – 150 y
Value4.0 - 6.23.7 - 5.63.3 - 5.1
mmol/L
***VHF patients only
Potassium – Blood (Blood Gases)
FMC RRL GEM 4000 Potentiometric sensor 3.3 – 5.1* mmol/L
*Established by CLS Chemistry Division through literature review (Whole Blood Reference Interval)This analyte is part of a panel test
DSC FMC Cobas 8000Potassium - Fluid
RRL Cobas 6000
Indirect potentiometric assay using an ion-selective electrode.
No Reference Interval mmol/L
Potassium – Stool FMC Cobas 8000Indirect potentiometric assay using an ion-selective electrode.
No Reference Interval mmol/L
CH-2.21 Analyte Reference Interval Instrumentation Methodology Chart Rev 49.01
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Analyte Site Instrumentation Method Reference Interval Units NotesDSC Cobas c701-c502FMC Cobas 8000
24 hour: 26 - 123 mmol/dPotassium - Urine
RRL Cobas 6000
Indirect potentiometric assay using an ion-selective electrode.
Random: No Reference Interval mmol/LPrealbumin DSC Cobas c701-c502 Immunoturbidimetric assay 0.2 - 0.4 g/L
Primidone ACH Cobas 6000Enzyme Multiplied Immunoassay Technique
Therapeutic range: 23 - 55 µmol/L
Female:
< 12 y 0.0 - 0.5
Follicular 0.0 - 2.8
Luteal 5.0 - 76.0
Post-menopause 0.0 - 0.5
Progesterone DSC Cobas 8000Competitive chemiluminescent assay
Male: 0.0 - 0.5
nmol/L
Prolactin DSC Cobas 8000Chemiluminescent sandwich technology
Male0-15
Female0-25
µg/L
Prostate Specific Antigen (PSA)
DSC Cobas 8000Chemiluminescent sandwich assay
Age1 d – 49 y50 y – 59 y60 y – 69 y70 y – 150 y
Male0.00-2.50 0.00-3.50 0.00-4.500.00-6.50
µg/L
In males with total PSA concentrations of 4-10 µg/L the possibility of finding cancer on needle biopsy by age in years is:
% Free PSA
50-59 y 60-69 y 70-150 y
< 11 % 49 % 58 % 65 %
11-18 % 27 % 34 % 41 %
19-25 % 18 % 24 % 30 %
Prostate Specific Antigen, Fractionated/Free
DSC Cobas 8000Chemiluminescent sandwich assay
> 25 % 9 % 12 % 16 %
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Analyte Site Instrumentation Method Reference Interval Units Notes
DSC FMC Cobas 8000
RRL Cobas 6000Colorimetric assay utilizing biuret reagent
BMSH CMGH
DDHS HRH SDHS
Vitros Colorimetric assayProtein, Total - Blood
***ACH ***SHC
Piccolo Express Colorimetric assay
Age1 – 365 d1 – 4 y5 – 150 y
Value54-79 59-7963-80
g/L
***VHF patients only
DSC Cobas c701-c502Gen. 3 turbidimetric endpoint assay utilizing benzethonium chloride.
FMC Cobas 8000
RRL Cobas 6000Turbidmetric Assay
Protein, Total - CSF
BMSH Vitros Colorimetric assay
Age< 31 d31 d – 150 y
Value0.14-1.12 0.15-0.45
g/L
DSC FMC Cobas 8000Protein, Total - Fluid
RRL Cobas 6000Colorimetric assay utilizing biuret reagent
No Reference Interval g/L
Protein, Qualitative Urine
Go to Urinalysis
Protein, Total Quantitative - Urine
DSC Cobas c701-c502Gen. 3 turbidimetric endpoint assay utilizing benzethonium chloride.
0.00 - 0.15 g/24 hours
Protein/Creatinine Ratio, Urine
DSC Cobas c701-c502 Calculation No Reference Interval
Protein Electrophoresis -Serum and Urine
Go to Electrophoresis, Protein – Serum or Electrophoresis, Protein - Urine
Pseudocholinesterase (Anaesthetic)(See also Dibucaine number)
DSC Calculation
S-butyrylthiocholine iodide using dibucaine as an inhibitor. To determine the dibucaine number (DN), cholinesterase activity is measured with and without dibucaine.
5.3 - 12.9 KU/L
Refer to CH-55.07 Cobas c701-c502
Calculations
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R
Analyte Site Instrumentation Method Reference Interval Units Notes
Reducing Substances –Stool(STRED)
ACH Manual
The Benedict’s Solution detects reducing substances in urine using the color changes of the copper ions.
Negative
Stool reducing substances test is restricted to Acute Care sites (NICU, PICU) and pediatric gastroenterology inpatients at Alberta Children’s Hospital
Renin IMMUNO
CHEMLiaison XL Chemiluminescence
In healthy adults (18-65 y) with normal salt intake:4.4 - 46.0 upright at least 30 minutes2.8 - 40.0 supine at least 30 minutes
mIU/L
Reticulin AntibodyIMMUNO
CHEMManual
Indirect Immunoflorescence Slide
NegativeAlso known as Tissue Antibodies
Rheumatoid Factor, Quantitative - Blood (RF)
DSC Cobas c701-c502 Immunoturbidimetric assay 0-20.0 kU/L
Rheumatoid Factor, Qualitative - Blood (RF)
BMSH Manual Pulse Scientific RF Latex Kit Negative
Rheumatoid Factor -Fluid
DSC Cobas c701-c502 Immunoturbidimetric assay No Reference Interval kU/L
Rubella Antibodies, Immune Status (IgG)
IMMUNO CHEM
ArchitectChemiluminescent Microparticle Immunoassay technology (CMIA)
>10 kIU/L indicates past exposure to Rubella Virus
kIU/L
S
Analyte Site Instrumentation Method Reference Interval Units Notes
FMC Cobas 8000
RRL Cobas 6000UV assay
Salicylate
SMCHC CCHC BMSH
CMGH CLH HRH OGH SDHS VHC
Vitros Colorimetric assay
Therapeutic range: 0.70 - 1.80 (anti-inflammatory)
mmol/L
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Analyte Site Instrumentation Method Reference Interval Units Notes
Sex Hormone Binding Globulin
IMMUNO CHEM
Siemens Immulite 2000 Chemiluminescent assay Male10-55
Female20-100
nmol/L
Sirolimus ANA TOXAgilent LC with ABsciex
MSTandem Mass Spectrometry
Results interpreted by clinician. Interpretation is dependent upon various factors such as transplant type, time post transplant, and concomitant immunosuppressive therapy.
µg/L
DSC FMC Cobas 8000RRL Cobas 6000
Indirect potentiometric assay using an ion-selective electrode.
HCTL CRL Vitros Direct potentiometric assay Sodium - Blood
***ACH ***SHC
i-STAT SystemIon-selective electrode (ISE) potentiometry
133 - 145 mmol/L
***VHF patients only
Sodium – Blood (Blood Gases)
FMC RRL GEM 4000 Potentiometric Sensor 133-145* mmol/L
*Established by CLS Chemistry Division through literature review (Whole Blood Reference Interval)
This analyte is part of a panel test
DSC FMC Cobas 8000Sodium - Fluid
RRL Cobas 6000Indirect potentiometric assay using an ion-selective electrode.
No Reference Interval mmol/L
Sodium - Stool FMC Cobas 8000Indirect potentiometric assay using an ion-selective electrode.
No Reference Interval mmol/L
DSC Cobas c701-c502FMC Cobas 8000
24 hour: 43 - 217 mmol/ daySodium - Urine
RRL Cobas 6000
Indirect potentiometry assay using an ion-selective electrode.
Random: No Reference Interval mmol/L
Sodium, Fractional Excretion
DSC FMC RRL
Calculation
Fractional Sodium is a calculation which includes serum sodium (mmol/L), serum creatinine (mmol/L), urine sodium (mmol/L) and urine creatinine (mmol/L) concentrations in the calculation.
No Reference Interval mmol/L
Refer to CH-2.41 Fractional Sodium –DSC FMC RRL
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Analyte Site Instrumentation Method Reference Interval Units Notes
Smooth Muscle Antibody
IMMUNO CHEM
Manual Indirect Immunoflorescence Slide NegativeRefer to CH-6.43 Tissue Antibodies
Specific Gravity - Fluid FMC ManualThe refractometer measures the refractive index of liquids.
No Reference Interval
Refer to CH-6.53 Specific Gravity in Fluid - FMC
Specific Gravity - Urine Go to: Urinalysis
Normal Range
< 7 m 0-29
7 m – 150 y 0-39
Marginal Range
< 7 m 30-59
7 m – 150 y 40-59Values Consistent with Cystic Fibrosis
Sweat Chloride
60-160
mmol/LSweat Chloride ACH
Wescor Chlorochek Chloridometer
The Chlorochek Chloridometer is a dedicated coulometric-amperometric titrator designed to determine chloride ion concentrations in sweat samples.
Volume > 14 µL
Syphilis - BloodIMMUNO
CHEMArchitect
Abbott Architect i Syphilis TP is based on the ChemiluminescentMicroparticle Immunoassay (CMIA) technology.
Negative no units
CH-2.21 Analyte Reference Interval Instrumentation Methodology Chart Rev 49.01
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T
Analyte Site Instrumentation Method Reference Interval Units Notes
T3, Free DSC Cobas 8000Competitive chemiluminescent technology
Age4 d - 30 d31 d – 1 y2 y – 6 y7 y – 11 y12 y – 17 y18 y - 150 y
Male/Female3.0-8.12.4-9.83.0-9.14.1-7.93.5-7.73.5-6.5
pmol/L
T3, Total DSC Cobas 8000Competitive chemiluminescent technology
Age1-365 d1-15 y16-150 y
Male/Female1.5-4.21.4-3.31.1-2.8
nmol/L
T4, Free DSC Cobas 8000Competitive chemiluminescent technology
10.0 - 25.0 pmol/L
Non-pregnant (Male and Female)
PregnantT4, Total
IMMUNO CHEM
Cobas e601 Chemiluminescence assay59-154 85-190
nmol/L
Tacrolimus ANA TOXAgilent LC with ABsciex MS
Tandem Mass Spectrometry
Results interpreted by clinician. Interpretation is dependent upon various factors such as transplant type, time post transplant, and concomitant immunosuppressive therapy.
µg/L
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Analyte Site Instrumentation Method Reference Interval Units Notes
Testosterone, Bioavailable
IMMUNO CHEM
CalculationAdult Male
4.0-16.0Adult Female
0.1-1.0nmol/L
Refer to CH-37.07 Immulite
Calculations
Testosterone, Free IMMUNO
CHEMCalculation
Adult Male 175-700
Adult Female2-30
pmol/L
Age Male Female1 d - 9 y 0.0 - 1.0 0.0 - 1.0
Tanner Stage 1
0.0 - 1.0 0.0 - 1.0
Tanner Stage 2
0.0 – 15.0 0.0 - 1.0
Tanner Stage 3
2.2 - 27.0 0.0 - 1.0
Tanner Stage 4
6.2 - 26.5 0.0 - 1.0
10-17 y
Tanner Stage 5
6.5 - 29.0 0.2 - 1.3
Testosterone, Total DSC Cobas 8000Competitive chemiluminescent technology
18y - 150 y: 8.0 - 29.0 0.5 - 2.0
nmol/L
Theophylline FMC Cobas 8000Kinetic Interaction of Microparticles in Solution (KIMS) Immunoassay
Age< 32 d32 d – 150 y
Value25-110 55-110
µmol/L
Thiocyanate ANA TOXAgilent 8453
Spectrophotometer
The thiocyanate present in the filtrate is reacted with ferric nitrate in a 0.5 M nitric acid medium. The absorbance of ferric thiocyanate is measured at 470 nm.
Thiocyanate levels up to 0.5 are seen with nitroprusside therapy.Thiocyanate levels greater than 1.4 are reportedly toxic.
mmol/L
Also known as Sodium Nitroprusside, NiprideRefer to CH-45.05 Thiocyanate
ThyroglobulinIMMUNO
CHEMCobas e601 Chemiluminescence assay 0 - 50 µg/L
Thyroglobulin Antibody (Anti-Thyroglobulin -Anti-TG)
IMMUNO CHEM
Cobas e601 Chemiluminescence assay 0 - 35 KIU/L
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Analyte Site Instrumentation Method Reference Interval Units Notes
Thyroid Peroxidase Antibody
IMMUNO CHEM
Cobas e601Competitive chemiluminescent technology
0-34 KIU/L
Also known as Anti-Thyroid Antibodies, Thyroid Antibodies, Anti-Microsomal Antibodies, Anti-Thyroid Peroxidase, and Anti-TPO
Age Male/Female1 d 11.00-36.002 d 8.00-20.003 d 1.00-11.00
Thyroid Stimulating Hormone (TSH)
DSC Cobas 8000Chemiluminescent sandwich assay
4 d - 150 y 0.20-4.00
mIU/L
Tissue Transglutaminase IgA
IMMUNO CHEM
BioPlex Multiplex Flow Assay < 15.0 kIU/LComponent of Celiac Screen
Tissue Transglutaminase IgG
IMMUNO CHEM
BioPlex Multiplex Flow AssayInterpretative ranges:
< 15 – Negative≥ 15 – Positive
kIU/LComponent of Celiac Screen
Pre-dose Post-dose Tobramycin FMC Cobas 8000
Homogenous enzyme immunoassay. 0.0- 1.9 5.0-10.0
mg/L
TransferrinAll ages 2.0-3.6 g/L
Transferrin Saturation IndexTransferrin - Blood DSC Cobas c701-c502 Immunoturbidimetric
<18 y18 y -150 y
0.20 – 0.550.15 – 0.50
Age Male/Female
DSC FMC Cobas 8000
ACH Cobas 6000
Enzymatic colorimetric assay
< 18 y < 1.50
Acceptable limit relative to dyslipidemia and atherosclerosis risk < 0.85 mmol/L (0-9 y) OR < 1.02 mmol/L (10-17 y)
Triglycerides - Blood
BMSH Vitros Enzymatic, end point 18 y - 150 y 0.00 – 1.70
mmol/L
DSC performs routine TriglyceridestestingTriglycerides testing also performed on adults and pediatric patients at ACH/FMC. (neonatal triglycerides -NTRIG)
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Analyte Site Instrumentation Method Reference Interval Units NotesDSC FMC Cobas 8000
Triglycerides - FluidACH Cobas 6000
Enzymatic colorimetric assay No Reference Interval mmol/L
HCTL BMSH OHWC
mini VIDASOne-step immunoassay sandwich method with fluorescent detection (ELFA)
< 0.01
CLH DDHS OGH SDHS
VCHCS Stratus
Two-site immunoenzymatic (sandwich) assay
0.00 - 0.06
HRH CMGH Access Two-site sandwich assay 0.01 - 0.06
Troponin I
**SHC Triage Meter Fluorescence immunoassay <0.02
µg/L
**VHF Patients Only
DSC FMC Cobas 8000Troponin T, High Sensitivity PLC RGH
SHCCobas 6000
Electrochemiluminescence immunoassay
Normal: < 15Borderline Elevation: 15 - 109Clear Elevation: > 109
ng/L
U
Analyte Site Instrumentation Method Reference Interval Units NotesDSC FMC Cobas 8000
RRL Cobas 6000Enzymatic colorimetric
Urate - Blood BMSH CLH CMGH
DDHS HRH SDHS
Vitros Colorimetric assay
Age1 d-17 y18 y - 50 y51 y - 69 y70 y - 150 y
Male140-380210-490210-490210-490
Female140-380140-350160-410160-450
µmol/LAlternate Name -Uric Acid
DSC FMC Cobas 8000Urate - Fluid
RRL Cobas 6000Enzymatic colorimetric No Reference Interval µmol/L
Urate - Urine DSC Cobas c701-c502
Enzymatic colorimetric test with uricase and 4-aminoantipyrine. In the initial step, uric acid is oxidized in a reaction catalyzedby uricase.
1.5 - 4.5 mmol/day
Urate/ Creatinine Ratio, Urine
DSC Cobas c701-c502 Calculation No Reference Interval
DSC FMC Cobas 8000 Kinetic UV assay
RRL Cobas 6000Kinetic UV assay with urease and glutamate dehydrogenase
HCTL CRL VitrosColorimetric assay utilizing urease.
Urea - Blood
**ACH **SHC
Piccolo ExpressKinetic UV assay with urease and glutamate dehydrogenase
Age1-365 d1-14 y15-54 y55-150 y
Male1.5-7.02.0-7.03.0-7.53.0-9.0
Female1.5-7.02.0-7.02.0-7.02.5-8.5
mmol/L**VHF patients only
DSC FMC Cobas 8000Urea - Fluid
RRL Cobas 6000Kinetic UV assay No Reference Interval mmol/L
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Analyte Site Instrumentation Method Reference Interval Units Notes
Urea - Urine DSC Cobas c701-c502NADH to NAD oxidation reaction measured photometrically
No Reference Interval mmol/L
Urea Breath Test for Helicobacter pylori
DSCAP2003/ SerCon
ABCA2 Mass Spectrometry No Reference Interval
Macroscopic
DSC Urinalysis
FMC PLC RGH SHC
Chem
iRICELL (iChem VELOCITY –macroscopic / iQ-200 –microscopic)
iChem 100 (macroscopic) (backup and low volume samples)
Specific gravitypHLeukocytesNitriteProtein (g/L)Glucose (mmol/L)KetonesBlood
1.005 – 1.0305.0-8.5NegNegNegNegNegNeg
Microscopic< 16 y 0-2/hpfWBC16 – 150 y 0-5/hpf< 16 y 0-2/hpfRBC16 – 150 y 0-5/hpf
Granular casts NegWBC casts NegRBC casts Neg
Urinalysis
ACH Chem
HCTL
CRL
Clinitek Advantus (macroscopic)
Microscope (microscopic)
Macroscopic urinalysis includes a physical description of the specimen and performance of a group of chemical screening tests, which may indicate the need for a subsequent microscopic examination to identify and quantitate specific elements.
Waxy casts Neg
Refer to General Lab Procedure Manual Sections 10 Urinalysis12 iRICELL13 Clinitek21 iChem100
Urobilinogen, Qualitative
DSC Urinalysis
iRICELLThe coupling reaction of urobilinogen with a stable diazonium salt in buffer
<17 µmol/L
Refer to General Laboratory Section 10 Urinalysis
V/W
Analyte Site Instrumentation Method Reference Interval Units Notes
Valproate (Depakene) FMC Cobas 8000Homogeneous enzyme immunoassay.
Therapeutic range: 350 - 700 µmol/L
FMC Cobas 8000Vancomycin
RRL Cobas 6000
Kinetic Interaction of Microparticles in Solution (KIMS) Immunoassay
Pre-dose: 10.0- 20.0 mg/L
ViscosityIMMUNO
CHEM Manual
The viscosity assay is flow time relative to water
1.4 - 1.8 no units
CH-2.21 Analyte Reference Interval Instrumentation Methodology Chart Rev 49.01
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Analyte Site Instrumentation Method Reference Interval Units NotesAge Value< 1 y 0.5 to 1.8 1 y - 6 y 0.7 to 1.57 y - 12 y 0.9 to 1.713 y - 17 y 0.9 to 2.5
Vitamin A ANA TOX Agilent LC 1100Liquid Chromatography with DAD
17 y - 150 y 1.5 to 3.5
µmol/L
Alternate Name – Retinol
Refer to CH10-2.20 Vitamin A
and E
Vitamin B12 DSC Cobas 8000Competitive Chemiluminescence Assay
155 - 700 pmol/L
Vitamin D, 1,25 DiHydroxy
IMMUNO CHEM
Liaison XL Chemiluminescence (CLIA) 60-208 pmol/L
Vitamin D, 25 HydroxyIMMUNO
CHEMLiaison XL Chemiluminescence (CLIA)
Severe Deficiency: < 25Moderate to Mild Deficiency: 25-80Optimum Levels: 80-200Toxicity Possible: > 250
nmol/L
Age Value< 1 y 5 to 20 1 - 6 y 7 to 217 - 12 y 10 to 21
Vitamin E ANA TOX Agilent LC 1100Liquid Chromatography with DAD
13-150 y: 12 to 45
µmol/LRefer to CH10-2.20 Vitamin A and E
Water Deprivation ACH FMC No Reference Interval
Refer to CH-6.51 Water Deprivation-ACH FMC
Water Load FMC
Cobas analyzer, osmometer and
urinalysis analyzer
Two “panels” of tests are ordered
No Reference IntervalRefer to CH-6.52 Water Load-FMC
RELATED DOCUMENTS
CH-2.11 Critical Values for Acute Care Community and Rural SitesCH-2.22 Drugs of Abuse TestingCH-2.24 Half-Life and Time to Steady StateHE-1.11 Hematology Critical Values or HE-1.21 CBC Reference Intervals
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