54

Pediatric reference ranges

54

Pediatric reference ranges

54

Pediatric reference ranges

54

Pediatric reference ranges

  54 Reference intervals and orienting ranges for Clinical Chemistry and Laboratory Medicine in fetuses, newborn and adolescents

D. Klarmann, G. Hintereder, L. Thomas

The reference intervals, orienting ranges and decision limits of laboratory investigations provide physicians with objective data for clinical interpretation of a laboratory result. The combination of presumptive diagnosis with the reference interval based laboratory test result are fundamental for accurate diagnosis and differentiation of medical disorders. The directive 98/79 CE of the European community was imposed on the manufacturers of the diagnostic in vitro industry to provide reference intervals of laboratory reagent kits on the package insert in 1998 /12/. Many international organisations recommended providing such information. In 2005, a joint meeting gathered the Committee on Reference Limits and Decision Limits of the International Federation of Clinical Chemistry (IFCC). It was decided to revise the original document on the determination of reference values published in 1995 by the National Committee for Clinical Laboratory Standards (NCCLS). Finally, the working group was set up with members designated by the Clinical Laboratory Standard Institute (CLSI). The goal of the joint committee was to revise former documents. The updated document was published in 2008 under the guarantee of the IFCC and CSLI and was entitled “Defining, Establishing and Verifying Reference Intervals in the Clinical Laboratory: Approved Guideline – Third Edition – C28-A3“ /3/.

In the document of the IFCC, statistical methods for the determination of reference limits and reference intervals were determined /1/:

Reference intervals may be replaced by decision limits for differentiation of healthy and sick, e.g., LDL-cholesterol, glycated hemoglobin. Continuous reference intervals from birth to adulthood are not available for most laboratory analytes because of ethical and practical constraints of defining reference intervals using a population of healthy community children. Because access to blood samples from healthy children is limited by ethical and practical constraints. Newborn and infant children are most affected by these restrictions /4/.

The following efforts have been made to resolve these issues:

In addition to Tables 54-1 to 54-3 further important reference ranges are given in the literature:

Representations of the reference intervals are provided in Tables 54-1, 54-2 and 54-3. The protocol for obtaining reference values and determining reference intervals was not complied with in all studies. With exception of the KIGGS study /516/ no reference ranges according to the recommendations of IFFC are shown. Tables 54-1 to 54-3 show essentially orientational ranges, because important recommendations (patient number, methodology according to CSLI Document C28-3) were not taken into account /4/.

The authors recommend searching Caliper Pediatric Reference Interval Database for reference ranges not shown in Tables 54-1 to 54-3.

Table 54-1 Reference intervals and orienting ranges of “normal” for clinical chemistry analytes

Tests

Age
(d, days;
m, months;
y, years)

Sex

(M, male;

F, female)

Reference interval

Median

Comment

25-0H vitamin D

ug/L (nmol/L)

1.5–2 y

M

9.2–51.6 (23–129)

27.2 (68)

Children ≥ 1.5 y: Interval of 3% and 97% percentiles of the German survey on children‘s health (KIGGS study) are shown. Laboratory investigations were carried out using Dia Sorin chemiluminescence immunoassay. Samples of children (M = 5108; F = 4908) of representative locations all over Germany were selected. Lit. /5/

F

7.6–49.6 (19–124)

25.6 (64)

2.5–3 y

M

6.8–46.0 (17–115)

24.8 (62)

F

6.8–43.2 (17–108)

21.6 (54)

4–6 y

M

4.8–41.2 (12–103)

18.0 (45)

F

5.2–39.2 (13–98)

17.6 (44)

7–9 y

M

4.4–39.2 (11–98)

17.2 (43)

F

4.8–36.0 (12–90)

16.4 (41)

10–13 y

M

4.8–36.8 (12–92)

16.8 (42)

F

4.0–33.6 (10–84)

19.6 (49)

14–17 y

M

4.0–40.8 (10–102)

14.8 (37)

F

3.6–48.0 (9–120)

16.4 (41)

Alkaline
phosphatase

U/l (ukatal/L)

1–7 d

M+F

< 357 (< 5.96)

d: The ranges are presented. Laboratory investigations were carried out using Dade Behring Dimension RXL. About 60 outpatient and inpatient children were examined. Lit. /11/

y: Interval of 2.5% and 97.5% percentiles. Determination at 37 °C according to IFCC. Samples of 75–142 outpatient and inpatient children were examined. Lit. /12/

0–1 y

M+F

89–370 (1.49–6.2)

> 1–3 y

M+F

91–334 (1.52–5.6)

4–6 y

M+F

97–316 (1.61–5.3)

7–12 y

M

110–316 (1.83–5.3)

F

120–340 (2.00–5.7)

13–17 y

M

75–363 (1.25–6.1)

F

49–328 (0.82–5.5)

ALT (GPT)

U/L (ukatal/L)

1–7 d

M+F

< 54.0 (< 0.90)

d: The ranges are presented. Laboratory investigations were carried out using Dade Behring Dimension RXL. About 60 outpatient and inpatient children were examined. Lit. /11/

y: Interval of 3% and 97% percentiles. Determination with pyridoxal phosphate at 37 °C according to IFCC. Samples of 75–206 outpatient and inpatient children were examined. Lit. /12/

0–1 y

M+F

4.2–49.2 (0.07–0.82)

> 1–3 y

M+F

6.6–29.4 (0.11–0.49)

4–6 y

M+F

4.8–39.0 (0.08–0.65)

7–12 y

M+F

7.2–43.8 (0.12–0.73)

13–17 y

M+F

7.8–45.0 (0.13–0.75)

AST (GOT)

U/l (ukatal/L)

1–7 d

M+F

< 96 (< 1.60)

d: The ranges are presented. Laboratory investigations were carried out using Dade Behring Dimension RXL. About 60 outpatient and inpatient children were examined. Lit. /11/

y: Interval of 3% and 97% percentiles. Determination with pyridoxal phosphate at 37 °C according to IFCC. Samples 76–209 outpatient and inpatient children were examined. Lit. /12/

0–1 y

M+F

14.4–77 (0.24–1.29)

> 1–3 y

M+F

19.3–71 (0.32–1.19)

4–6 y

M+F

15.0–53 (0.25–0.89)

7–12 y

M+F

18.6–48 (0.31–0.80)

13–17 y

M+F

15.0–41.4 (0.25–0.69)

C–reactive
protein (CRP)

mg/L

1–7 d

M+F

0.27–6.9

d + y: Interval of 0% and 95.0% percentiles.Laboratory investigations were carried out using Roche Hitachi 917, standardized according to CRM 470. Samples of 32–113 children were examined. Lit. /21/

8 d – < 1 y

M+F

0.10–3.47

1–3 y

M+F

0.24–5.88

4–6 y

M+F

0.29–7.53

7–9 y

M+F

0.24–4.67

10–12 y

M+F

0.23–5.71

13–15 y

M+F

0.13–7.40

16–18 y

M+F

0.19–5.09

Calcium, ionized

mg/dL (mmol/L)

Cord blood

M+F

4.72–5.68 (1.18–1.42)

d + y: Interval of 2.5% and 97.5% percentiles. Laboratory investigations were carried out using ion selective electrode measurement. Lit. /24/

1 d

M+F

3.92–4.88 (0.98–1.28)

3 d

M+F

4.12–4.92(1.02–1.24)

5 d

M+F

4.44–5.28 (1.10–1.38)

1–20 y

M+F

4.14–5.26 (1.05–1.32)

Calcium, total

mg/dL (mmol/L)

0–5 d

M+F

7.9–10.7 (1.96–2.66)

d: Interval of 2.5% and 97.5% percentiles. Laboratory investigations were carried out using Kodak Ektachem analyzer and ortho-cresolphthalein complexone test. Lit. /23/

y: Interval of 3% and 97% percentiles. Laboratory investigations were carried out using Roche Hitachi 717 and ortho-cresolphthalein complexone test. Samples of (M = 7298; F = 6953) children were examined. Lit. /5/

Taking Abbott Architect as the comparative system and Beckman Coulter, Ortho, Roche and Siemens as the test systems, the value of calcium can not be transferred based on statistical criteria. Lit. /37/

1.5–2 y

M+F

9.8–11.2 (2.40–2.78)

3–6 y

M+F

9.5–11.1 (2.36–2.75)

7–10 y

M+F

9.3–11.0 (2.32–2.74)

10–14 y

M+F

9.3–10.9 (2.33–2.72)

14–17 y

M+F

9.2–10.9 (2.30–2.72)

Chloride

(mmol/L)

0–7 d

M+F

96–111

d + m + y: Interval of 2.5% and 97.5% percentiles. Laboratory investigations were carried out using Kodak Ektachem Analyzer. Samples of 100 children were examined in every age group. Lit. /22/

8 d – 1 m

M+F

96–110

1–6 m

M+F

96–110

6 m – 1 y

M+F

96–108

> 1 y

M+F

96–109

Cholesterol

mg/dL (mmol/L)

1–2 y

M+F

112–199 (2.89–5.15)

y: Interval of 5% and 95% percentiles of the German survey on children‘s health (KIGGS study) are shown. Laboratory investigations were carried out using Hitachi 917 fully enzymatic cholesterol-oxidase-PAP method. Samples of (M = 5108; F = 4908) children of representative locations all over Germany were selected. Lit. /5/

Consensus: Recommended upper value according to the National Cholesterol Education Program (NCEP) < 200 mg/dl (5.17 mmol/l)

3–6 y

M+F

123–213 (3.18–5.51)

7–10 y

M+F

129–213 (3.34–5.51)

11–13 y

M+F

122–211 (3.15–5.46)

14–17 y

M+F

117–212 (3.03–5.48)

CK

U/L (ukatal/L)

0–90 d

M

29–303 (0.48–5.1)

d, m, y: Interval 2.5% and 97.5% percentiles. Determination at 37 °C according to IFCC. Samples of 60 outpatient and inpatient children were examined in every age group. Lit. /12/

F

43–474 (0.72–8.3)

3–12 m

M

25–172 (0.42–2.9)

F

27–242 (0.45–4.0)

1–10 y

M+F

25–177 (0.42–3.0)

11–14 y

M+F

31–172 (0.52–2.9)

15–18 y

M

28–147 (0.47–2.5)

F

31–172 (0.52–2.9)

Cortisol (5–11
morning)

mg/dL (mmol/L)

0–24 m

M+F

10–34 (28–938)

m, y: Interval of 2.5% and 97.5% percentiles. Laboratory investigations were carried out using Immu-I-analyzer of Bayer Diagnostics. Samples of 32 outpatient and inpatient children were examined in every age group. Lit. /19/

2–10 y

M+F

10–33 (28–911)

11–18 y

M+F

10–28 (28–733)

Creatinine

mg/dL (umol/L)

1–7 d

M+F

0.20–1.06 (15–80)

d + y: Interval of 2.5% and 97.5% percentiles. A review compared different creatinine tests. 38–69 outpatient and inpatient children were examined in the age groups. Lit. /17/

8 d – < 1 y

M+F

0.20–0.45 (15–34)

1–3 y

M+F

0.20–0.41 (15–31)

4–6 y

M+F

0.28–0.51 (21–39)

7–9 y

M+F

0.33–0.59 (25–45)

10–12 y

M+F

0.35–0.75 (27–57)

13–15 y

M+F

0.40–0.96 (31–73)

16–18 y

M+F

0.52–0.99 (40–76)

Ferritin

(ug/L)

0–1 y

MF

11.5–327

y: Interval of 2.5% and 97.5% percentiles. Laboratory investigations were carried out using Roche Elecsys electrochemiluminescence immunoassay. Samples of 68–139 outpatient and inpatient children were examined. Lit /12/

> 1–3 y

MF

6.6–61

4–6 y

MF

6.7–60

7–12 y

MF

11.2–99

13–17 y

MF

12.3–89

Folic acid
in red cells

ug/L (nmol/L)

< 1 y

M

6.3–22.7 (14.3–51.5)

Children ≥ 1.5 y: Interval of 3% and 97% percentiles of the German survey on children‘s health (KIGGS study) are shown. Laboratory investigations were carried out using Diastat HPLC method. Samples of (M =2525; F = 2380) children of representative locations all over Germany were selected. Lit /5/

F

7.2–22.4 (16.3–50.8)

2–3 y

M

1.7–15.7 (3.9–35.6)

F

2.5–15.0 (5.7–34.0)

4–6 y

M

2.7–14.0 (6.1–31.9)

F

2.5–13.0 (5.3–29.4)

7–9 y

M

2.4–13.4 (5.4–30.4)

F

2.3–11.9 (5.2–27.0)

10–12 y

M

1.0–10.2 (2.3–23.1)

F

1.5–10.8 (3.4–24.9)

13–18 y

M

1.2–7.2 (2.7–16.3)

F

1.2–8.8 (2.7–19.9)

FT3

ng/L

3.5–6 y

M

3.0–5.1

y: Interval of 3.0% and 97.0% percentiles of the German survey on children‘s health (KIGGS study) are shown. Laboratory investigations were carried out using Roche Elecsys electrochemiluminescence immunoassay. Samples of (M = 6723; F = 6365) children of representative locations all over Germany were selected. Lit. /5/

F

3.2–5.2

7–10 y

M

3.1–5.1

F

3.1–5.2

11–13 y

M

3.1–5.3

F

3.1–4.9

14–17 y

M

3.3–4.9

F

2.8–4.3

FT4

ug/L

5 d

M+F

13–33

d: Interval of 2.5% and 97.5% percentiles. Laboratory investigations were carried out using Abbott IMX microparticle fluorescence immunoassay. Samples of 141 inpatient children were investigated. Lit. /20/

y: Interval of 3.0% and 97.0% percentiles of the German survey on children‘s health (KIGGS study) are shown. Laboratory investigations were carried out using Roche Elecsys electrochemiluminescence immunoassay. Samples of (M = 6771; F = 6362) children of representative locations all over Germany were selected. Lit. /5/

3.5–6 y

M

9.8–15.0

F

9.4–15.4

7–10 y

M

9.6–15.2

F

9.8–15.0

11–13 y

M

9.4–14.5

F

8.9–14.4

14–17 y

M

8.7–16.3

F

8.7–15.0

GGT

U/L (ukatal/L)

1–7 d

M+F

18–168 (0.30–2.80)

d: Interval of 2.5% and 97.5% percentiles. Laboratory investigations were carried out at 37 °C using Dade Behring Dimension RXL. Samples of > 60 inpatient and outpatient children were investigated. Lit. /11/

y: Interval 2.5% and 97.5% percentiles. Determination at 37 °C according to IFCC. Samples of 58–142 outpatient and inpatient children were examined. Lit. /12/

Taking Abbott Architect as the comparative system and Beckman Coulter, Ortho, Roche and Siemens as the test systems the value of GGT can not be transferred based on statistical criteria Lit. /37/

0–1 y

M+F

7.8–178 (0.13–2.97)

> 1–3 y

M+F

2.4–21.0 (0.04–0.35)

4–6 y

M+F

3.0–21.0 (0.05–0.35)

7–12 y

M+F

6.0–24.0 (0.10–0.40)

13–17 y

M

9.0–42.6 (0.15–0.71)

F

3.6–25.8 (0.06–0.43)

GLD

U/L (ukatal/L)

1–30 d

M+F

< 10 (0.17)

d, m, y: Interval of 2.5% and 97.5% percentiles. Laboratory investigations were carried out at 25 °C according to the German Association of Clinical Chemistry. Samples of 25 outpatient and inpatient children were examined in every age group. Lit. /14/. A conversion of 25 °C to 37 °C was achieved according to Lit. /13/.

1–6 m

M+F

< 7 (0.12)

7–12 m

M+F

< 6 (0.10)

2–3 y

M+F

< 4 (0.07)

4–16 y

M+F

< 5 (0.08)

HbA1C %

(mmol HbA1C/
mmol Hb)

1.5–2 y

M

3.9–5.6 (19–38)

4.8 (29)

From 1.5 y: Interval of 3% and 97% percentiles of the German survey on children‘s health (KIGGS study) are shown. Laboratory investigations were carried out using Diastat HPLC method. Samples of (M =7217: F = 6881) children of representative locations all over Germany were selected. Lit. /5/

F

3.7–5.6 (17–38)

4.7 (28)

3–6 y

M

4.0–5.6 (20–38)

4.9 (30)

F

4.0–5.5 (20–37)

4.6 (27)

7–10 y

M

4.1–5.7 ( 21–39)

4.6 (27)

F

4.1–5.6 (21–38)

4.6 (27)

11–13 y

M

4.1–5.7 (21–39)

4.6 (27)

F

4.1–5.6 (21–38)

4.6 (27)

14–17 y

M

4.1–5.6 (21–38)

4.9 (30)

F

4.1–5.6 (21–38)

4.8 (29)

HDL-Cholesterol

mg/dL
(mmol/L)

1–2 y

M+F

28.1–68.6 (0.73–1.77)

y: Interval of 5% and 95% percentiles of the German survey on children‘s health (KIGGS study) are shown. Laboratory investigations were carried out using Hitachi 917 fully enzymatic cholestrol-oxidase-PAP method. Samples of (M =7297; F = 6952) children of representative locations all over Germany were selected. Lit. /5/

Consensus: Low HDL-cholesterol according to the National Cholesterol Education Program (NCEP) < 35 mg/dl (0.91 mmol/l).

3–6 y

M+F

35.2–77.4 (0.91–2.00)

7–10 y

M+F

39.6–81.7 (1.02–2.11)

11–13 y

M+F

38.3–80.9 (0.90–2.09)

14–17 y

M+F

36.5–77.4 (0.94–2.00)

Homocysteine

(umol/L)

1.5–2 y

M

3.8–9.9

6.1

From 1.5 y: Interval of 3% and 97% percentiles of the German survey on children‘s health (KIGGS study) are shown. Laboratory investigations were carried out using Abbott IMX fluorescence particle immunoassay. Samples of (M = 7159; F = 6809) children of representative locations all over Germany were selected. Lit. /5/

F

3.6–8.7

5.8

3–6 y

M

3.7–8.8

5.7

F

3.6–8.3

5.6

7–10 y

M

4.1–9.8

6.3

F

3.9–9.5

6.1

11–13 y

M

4.6–12.1

7.2

F

4.3–11.0

6.3

14–17 y

M

5.2–19.8

8.8

F

4.6–13.4

7.8

Iron

ug/dL (umol/L)

Up to 2 y

M

12–133 (2.1–23.8)

y: Interval of 5% and 95% percentiles of the German survey on children‘s health (KIGGS study) are shown. Laboratory investigations were carried out using Hitachi 917 ferrozin method. Samples of (M = 7292; F = 6948) children of representative locations all over Germany were selected. Lit. /5/

F

19–140 (3.4–25.1)

3–6 y

M

17–142 (3.0–25.4)

F

21–139 (3.8–24.9)

7–10 y

M

26–138 (4.7–24.7)

F

28–137 (5.0–24.5)

11–13 y

M

32–150 (5.5–26.9)

F

33–148 (5.8–26.4)

14–17 y

M

36–195 (6.4–35.0)

F

29–173 (5.2–30.9)

Lactate
dehydrogenase

U/L (ukatal/L)

0–1 y

M+F

196–438 (3.27–7.3)

y: Interval of 2.5% and 97.5% percentiles o f the German survey on children‘s health (KIGGS study) are shown. Laboratory investigations were carried out at 37 °C according to IFCC. Samples of 75–204 inpatient and outpatient children were investigated. Lit. /12/

> 1–3 y

M+F

105–338 (1.75–5.6)

4–6 y

M+F

107–314 (1.78–5.2)

7–12 y

M+F

112–307 (1.87–5.1)

13–17 y

M+F

115–287 (1.94–4.78)

LDL-Cholesterol

mg/dL (mmol/L)

1–2 y

M+F

55–134 (1.422–3.46)

y: Interval of 5% and 95% percentiles of the German survey on children‘s health (KIGGS study) are shown. Laboratory investigations were carried out using Roche Hitachi 917 fully enzymatic cholesterol oxidase-PAP method. Samples of (M = 7291; F = 6942) children of representative locations all over Germany were selected. Lit. /5/

Consensus: Normal LDL-cholesterol according to the National Cholesterol Education Program (NCEP) < 130 mg/dl (3.36 mmol/l).

3–6 y

M+F

60–141 (1.552–3.65)

7–10 y

M+F

60–138 (1.552–3.57)

11–13 y

M+F

55–136 (1.422–3.52)

14–17 y

M+F

54–135 (1.396–3.49)

Lipase

U/L (ukatal/L)

< 1 y

M+F

0–29 (0–0.49)

y: Interval of 2.5% and 97.5% percentiles. The method at 37 °C using Hitachi 917 analyzer is based on the splitting of methylresorufinester. Samples of 40–121 inpatient and outpatient children were invetigated in the age groups. Lit. /15/

1–12 y

M+F

10–37 (0.17–0.61)

13–18 y

M+F

11–46 (0.19–0.76)

Magnesium

mg/dL
(mmol/L)

Newborn

M+F

1.1–2.6 (0.45–1.07)

y: Interval of 3% and 97% percentiles of the German survey on children‘s health (KIGGS study) are shown. Laboratory investigations were carried out using Roche Hitachi 917 xylidylblue method. Samples of (M = 7279; F = 6932) children of representative locations all over Germany were selected. Lit. /5/

Taking Abbott Architect as the comparative system and Beckman Coulter, Ortho, Roche and Siemens as the test systems the value of magnesium can not be transferred based on statistical criteria Lit. /37/

1.5–2 y

M

1.1–2.1 (0.45–0,82)

F

1.1–2.1 (0.45–0,82)

3–17 y

M+F

1.1–2.1 (0.45–0.82)

Pankreatic
Amylase

(U/L)

< 1 y

M+F

0–8 (0–0.13)

y: Interval of 2.5% and 97.5% percentiles. The method at 37 °C using Roche Hitachi 917 analyzer is based on G7 amylase method according to IFCC. Samples of 40–121 inpatient and outpatient children were investigated. Lit. /15/

1–12 y

M+F

5–31 (0.09–0.52)

10–18 y

M+F

7–39 (0.11–0.65)

Phosphor

mg/dL
(mmol/L)

1–30 d

M+F

3.9–7.7 (1.25–2.50)

d, m: Ammonium phosphomolybdat method. Lit. /34/

y: Interval of 3% and 97% percentiles of the German survey on children‘s health (KIGGS study) are shown. Laboratory investigations were carried out using Roche Hitachi 917 ammonium phosphomolybdat method. Samples of (M = 7294; F = 6944) children of representative locations all over Germany were selected. Lit. /5/

Taking Abbott Architect as the comparative system and Beckman Coulter, Ortho, Roche and Siemens as the test systems the value of phosphor can not be transferred based on statistical criteria Lit. /37/

1–12 m

M+F

3.5–6.6 (1.15–2.15)

1.5–2 y

M

4.7–6.6 (1.51–2.15)

F

4.6–6.6 (1.49–2.15)

3–6 y

M

4.4–6.2 (1.41–1.99)

F

4.4–6.2 (1.42–1.99)

7–10 y

M

4.3–5.9 (1.39–1.91)

F

4.2–6.0 (1.37–1.93)

11–13 y

M

4.1–5.8 (1.32–1.87)

F

4.1–6.2 (1.32–1.99)

14–17 y

M

3.9–5.3 (1.27–1.71)

F

3.6–5.0 (1.16–1.61)

Potassium

(mmol/L)

0–7 d

M+F

3.2–5.5

d, m, y: Interval of 2.5% and 97.5% percentiles. Laboratory investigations were carried out using Kodak Ektachem Analyzer. Samples of 100 inpatient children were investigated. Lit. /22/

8 d – 1 m

M+F

3.4–6.0

1–6 m

M+F

3.5–5.6

6 m– 1 y

M+F

3.5–5.1

> 1 y

M+F

3.3–4.6

Protein (total)

(g/L)

1.5–2 y

M+F

61–76

y: Interval of 2.5% and 97.5% percentiles. Laboratory investigations were carried out using Roche Hitachi 917 Biuret reaction without deproteinization of serum. Samples of (M = 7254; F = 6905) children of representative locations all over Germany were selected. Lit. /5/

3–6 y

M+F

63–81

7–10 y

M+F

66–82

11–13 y

M+F

68–83

14–17 y

M+F

68–85

Selen

umol/L

< 30 d

M+F

0.19–1.35

d, m, y: Interval of 2.5% and 97.5% percentiles. Laboratory investigations were carried out using elektrothermal atomic absorption spektrophotometry (ET-AAS). Samples of (M = 532; F = 478) children were investigated. Lit. /35/

1–2 m

M+F

0.19–1.27

2–4 m

M+F

0.13–1.18

4–12 m

M+F

0.17–1.47

1–5 y

M+F

0.43–1.63

5–18 y

M+F

0.53–1.57

Sodium

(mmol/L)

0–7 d

M+F

133–146

d, m, y: Interval of 2.5% and 97.5% percentiles. Laboratory investigations were carried out using Kodak Ektachem Analyzer. Samples of 100 children were investigated in every age group. Lit. /22/

8 d – 1 m

M+F

134–144

1–6 m

M+F

134–142

6 m – 1 y

M+F

133–142

> 1 y

M+F

134–143

Soluble
transferrin
receptor (sTFR)

mg/L

0–1 y

M+F

1.55–5.7

y: Interval of 2.5% and 97.5% percentiles of the German survey on children‘s health (KIGGS study) are shown. Laboratory investigations were carried out using Roche Elecsys electrochemiluminescence immunoassay. Samples of 46–189 inpatient and outpatient children were investigated. Lit. /12/

> 1–3 y

M+F

1.65–5.6

4–6 y

M+F

1.47–5.4

7–12 y

M+F

1.95–5.5

13–17 y

M+F

1.76–5.9

Trace elements
(expected values
in serum)

M+F

Cobalt (Co)

< 1 ug/L

Expected values for adults and children: Lit. /18/

M+F

Chromium (Cr)

< 1 ug/L

M+F

Copper (Cu)

1 mg/L

M+F

Iron

1 mg/L

M+F

Manganese (Mn)

< 1 ug/L

M+F

Molybdenum (Mo)

< 1 ug/L

M+F

Nickel (Ni)

< 1 ug/L

M+F

Selenium (Se)

80 ug/L

M+F

Silicon (Si)

< 10 ug/L

M+F

Tin (Sn)

< 1 ug/L

M+F

Vanadium (V)

< 1 ug/L

M+F

Zink (Zn)

1 mg/l

Triglycerides

mg/dL
(mmol/L)

1–2 y

M+F

45–247 (0.51–2.82)

y: Interval of 5% and 95% perzentiles of the German survey on children‘s health (KIGGS study) are shown. Laboratory investigations were carried out using Roche Hitachi 717 GPO-PAP method. Samples of (M 89-100; F  92-101) children of representative locations all over Germany were selected. Lit. /16/

Consensus: Normal triglycerides according to the National Cholesterol Education Program (NCEP) < 150 mg/dl (1.71 mmol/l).

3–6 y

M+F

42–220 (0.47–2.52)

7–10 y

M+F

42–217 (0.47–2.48)

11–13 y

M+F

42–227 (0.47–2.59)

14–17 y

M+F

44–235 (0.50–2.67)

TSH

mU/L

5 d

M+F

0.5–7.9

d: Interval of 2.5% and 97.5% percentiles. Laboratory investigations were carried out using Abbott IMX micro particle fluorescence Immunoassay. Samples of 141 inpatient children were investigated. Lit. /20/

y: Interval of 3.0% and 97.0% percentiles of the German survey on children‘s health (KIGGS study) are shown. Laboratory investigations were carried out using Roche Elecsys electrochemiluminescence immunoassay. Samples of (M = 6723; F = 6366) children of representative locations all over Germany were selected. Lit. /5/

3.5–6 y

M

1.0–5.5

F

1.0–5.2

7–10 y

M

1.0–5.2

F

1.0–5.2

11–13 y

M

0.9–4.8

F

0.9–4.5

14–17 y

M

0.8–4.0

F

0.7–4.0

Uric acid

mg/dL
(umol/L)

1–30 d

M

1.0–4.6 (59–271)

Up to 1 y: Interval of 2.5% and 97.5% percentiles. Laboratory investigations were carried out at 37 °C using Dade Behring Dimension RXL uricase-PAP method. Samples of > 100 inpatient and outpatient children were investigated in every age group. Lit. /19/ (Abstract)

F

1.2–3.9 (71–232)

31 d–1 y

M

1.1–5.4 (65–319)

F

1.2–5.6 (71–330)

1.5–3 y

M+F

2.2–5.2 (131–309)

3.6 (214)

From 1.5 y: Interval of 3% and 97% percentiles of the German survey on children‘s health (KIGGS study) are shown. Laboratory investigations were carried out using Roche Hitachi 917 uricase PAP reaction. Samples of (M =7298; F = 6951) children of representative locations all over Germany were selected. Lit. /5/

3–6 J

M+F

2.3–5.3 (137–315)

3.6 (214)

7–10 y

M

2.3–5.6 (137–333)

3.7 (220)

F

2.4–5.7 (143–339)

3.8 (226)

11–14 y

M

2.5–7.7 (149–458)

4.6 (274)

F

2.6–6.2 (155–369)

4.3 (256)

15–17 y

M

3.7–8.0 (220–476)

5.1 (303)

F

2.8–6.0 (167–357)

4.2 (250)

Vitamin B12

ng/L (pmol/L)

0–1 y

M

228–1515 (168–1118)

Up to 1 y: Interval of 2.5% and 97.5% percentiles. Lit. /36/

From 3.5 y: Interval of 3% and 97% percentiles of the German survey on children‘s health (KIGGS study) are shown. Laboratory investigations were carried out using Roche Elecsys electrochemiluminescence immunoassay. Samples of (M = 6349; F = 6701) children of representative locations all over Germany were selected. Lit. /5/

F

293–1210 (216–891)

3.5–6 y

M

457–1825 (338–1347)

991 (738)

F

484–1882 (357–1340)

1009 (745)

7–10 y

M

427–1610 (315–1188)

890 (675)

F

427–1562 (319–1153)

874 (645)

11–13 y

M

366–1322 (270–976)

740 (546)

F

360–1397 (262–1031)

738 (545)

14–17 y

M

291–1154 (215–852)

587 (433)

F

291–1167 (215–861)

602 (444)

Table 54-2 Reference intervals and orienting ranges of “normal” for hematological analytes

Parameter

Age (d, days; w, weeks; m, months;

y, years)

Sex

(M, male;

F, female)

Median

Reference interval

Comment

Eosinophil
count
(109/L)

Fetuses

Up to week 27: Interval of 2.5% and 97.5% percentiles. Laboratory investigation was carried out using Coulter S Plus II. Samples of 17 fetuses were investigated. Lit. /30/

  • 16–19 w

M+F

0.02

< 0.06

  • 20–27 w

M+F

0.08

< 0.10

Newborn

M+F

0.4

< 1.00

Children

From the age of 4 years: Interval of 3% and 97% percentiles. Laboratory investigations were carried out using Coulter STKR. Samples of 25–108 children were investigated. Lit. /31/

  • 4–6 y

M+F

0.24

0.06–0.90

  • 7–8 y

M+F

0.27

0.08–1.0

  • 9–12 y

M+F

0.21

0.06–1.12

  • 13–14 y

M+F

0.18

0.05–0.61

  • 15–19 y

M+F

0.17

0.05–0.57

Erythrocyte
count (1012/L)

Fetuses

Up to week 17: Interval of 2.5% and 97.5% percentiles. Laboratory investigations were carried out using Coulter S plus. Samples of 116 fetuses were investigated .Lit. /26/

  • 15 w

M+F

2.2–3.2

  • 16 w

M+F

2.3–3.2

  • 17 w

M+F

2.6–3.6

  • 18–21 w

M+F

2.4–3.8

Up to 30 weeks: Interval of 2.5% and 97.5% percentiles. Laboratory investigation was carried out using Coulter S plus II .Samples of 2860 fetuses were investigated. Lit. /27/

  • 22–25 w

M+F

2.7–4.3

  • 26–29 w

M+F

2.5–5.1

  • > 30 w

M+F

4.3–6.3

Children

Up to 12 months: Interval of 2.5% and 97.5% percentiles. Laboratory investigation was carried out using Coulter S plus II. Capillary blood of 440 children was investigated. Lit. /28/

  • 1 d

M+F

3.9–5.9

  • 0.3 m

M+F

3.3–5.3

  • 1 m

M+F

3.1–4.3

  • 2 m

M+F

3.5–5.1

  • 4 m

M+F

3.9–5.5

  • 6 m

M+F

4.0–5.3

  • 9–12 m

M+F

4.5

3.7–5.3

  • 1.5–2 y

M+F

4.6

4.0–5.1

From the age of 1.5 years: Interval of 3% and 97% percentiles of the German survey on children‘s health (KIGGS study) are shown. Laboratory investigation was carried out using Abbott Cell-Dyn 3500. Samples of (M = 7204; F = 6869) children of representative locations all over Germany were investigated. Lit. /5/.

  • 3–6 y

M

4.6

4.0–5.1

F

4.7

4.0–5.1

  • 7–10 y

M

4.6

4.0–5.2

F

4.7

4.0–5.1

  • 11–13 y

M

4.6

4.1–5.3

F

5.0

4.1–5.3

  • 14–17 y

M

4.5

4.2–5.7

F

4.5

4.0–5.0

Hematocrit
(Fraction)

Fetuses

Up to 1.5 years: Interval of 2.5% and 97.5% percentiles. Laboratory investigation was carried out using Coulter S plus II. Capillary blood of 116 fetuses was investigated. Lit. /2526/.

In a study  /38/ the effect of prenatal age on hematocrit is described between 22 and 40 weeks. For every week advance in gestational age (GA) the hematocrit increased according to the formula hematocrit = 0.2859 + (GA × 0.006359).

  • 15 w

M+F

0.28–0.42

  • 16 w

M+F

0.34–0.42

  • 17 w

M+F

0.31–0.43

  • 18–21 w

M+F

0.31–0.45

  • 22–25 w

M+F

0.31–0.47

  • 26–29 w

M+F

0.32–0.50

  • > 30 w

M+F

0.30–0.58

Cord blood

M+F

0.48–0.56

Children

  • 1 d

M+F

0.44–0.68

  • 2–6 d

M+F

0.40–0.70

  • 1–2 w

M+F

0.38–0.70

  • 2–3 w

M+F

0.38–0.60

  • 3–7 w

M+F

0.36–0.46

  • 7–12 w

M+F

0.30–0.38

  • 10–12 m

M+F

35

0.35–0.43

  • 1.5–3 y

M

35

0.31–0.39

From the age of 1.5 years: Interval of 3% and 97% percentiles of the German survey on children‘s health (KIGGS study) are shown. Laboratory investigation was carried out using Abbott Cell-Dyn 3500. Samples of (M = 7206; F = 6870) children of representative locations all over Germany were investigated. Lit. /5/.

F

35

0.31–0.39

  • 4–6 y

M

35

0.32–0.42

F

36

0.32–0.40

  • 7–10 y

M

36

0.33–0.42

F

36

0.33–0.42

  • 11–13 y

M

40

0.34–0.44

F

38

0.34–0.43

  • 14–17 y

M

42

0.36–0.48

F

39

0.35–0.44

Hemoglobin
concentration

g/dL (mmol/L)

Fetuses

Up to week 17: Interval of 2.5% and 97.5% percentiles. Laboratory investigation was carried out using Coulter S plus cyanomethemoglobin method. Capillary blood of 116 fetuses was investigated. Lit. /26/

  • 15 w

M+F

10.9 (6.77)

9.5–12.3 (5.90–7.64)

  • 16 w

M+F

12.5 (7.76)

10.9–14.1 (6.77–8.76)

  • 17 w

M+F

12.4 (7.70)

10.6–14.0 (6.58–8.69)

  • 18–21 w

M+F

11.7 (7.27)

9.5–14.1 (5.90–8.76)

Up to week 30: Interval of 2.5% and 97.5% percentiles. Laboratory investigation was carried out using Coulter S plus cyanomethemoglobin method. Samples of capillary blood of 2860 fetuses was investigated. Lit. /27/

In a study /38/ the effect of prenatal age on hemoglobin is described between 22 and 40 weeks. For every week advance in gestational age (GA) the hemoglobin concentration in the blood increased according to the formula hemoglobin = 9.92 + (GA × 0.2087)

  • 22–25 w

M+F

12.2 (7.57)

9.4–14.7 (5.84–9.13)

  • 26–29 w

M+F

12.9 (8.01)

10.1–15.7 (6.27–9.75)

  • > 30 w

M+F

13.6 (8.45)

9.2–18.0 (5.71–11.18)

Cord blood

M+F

13.5–20.7 (8.38–12.86)

Children

Up to 13.5 months: Interval of 2.5% and 97.5% percentiles. Laboratory investigation was carried out using Coulter S plus cyanomethemoglobin method. Samples of capillary blood of 760 children were investigated. Lit. /29/

  • 2–6 d

M+F

15.0–24.0 (9.32–14.90)

  • 14–23 d

M+F

12.7–18.1 (7.89–11.24)

  • 24–37 d

M+F

10.3–17.9 (6.40–11.12)

  • 40–50 d

M+F

9.0–16.6 (5.59–10.31)

  • 2.0–2.5 m

M+F

9.2–15.0 (5.71–9.32)

  • 3.0–3.5 m

M+F

9.6–12.8 (5.96–7.95)

  • 5–7 m

M+F

10.1–12.9 (6.27–8.01)

  • 8–10 m

M+F

10.5–12.9 (6.52–8.01)

  • 11–13.5 m

M+F

10.7–11.3 (6.64–7.02)

  • 1.5–3 y

M+F

10.8–12.8 (6.71–7.95)

From the age of 1.5 years: Interval of 3% and 97% percentiles of the German survey on children‘s health (KIGGS study) are shown. Laboratory investigations were carried out using Abbott Cell-Dyn 3500 cyanomethemoglobin method. Samples of (M = 7205 and F = 6870) children of representative locations all over Germany were investigated. Lit. /5/.

  • 3–6 y

M

12.3 (7.64)

10.5–13.8 (6.52–8.57)

F

12.3 (7.64)

10.6–13.7 (6.58–8.51)

  • 7–10 y

M

12.8 (7.95)

11.2–14.3 (6.96–8.88)

F

12.7 (7.89)

11.2–14.2 (6.96–8.82)

  • 11–13 y

M

13.2 (8.20)

11.6–15.0 (7.20–9.32)

F

12.6 (7.82)

11.6–14.5 (7.20–9.00)

  • 14–17 y

M

14.5 (9.00)

12.1–17.0 (7.51–10.56)

F

13.7 (8.51)

11.6–14.8 (7.20–9.19)

Leukocyte
count
(103/uL)

Fetuses

Fetuses and newborn: Interval of 2.5% and 97.5% percentiles. Laboratory investigation was carried out using Coulter S Plus. Samples of of 17 fetuses were investigated. Lit. /29/

  • 16–19 w

M+F

3.1–6.3

  • 20–27 w

M+F

2.5–6.2

Newborn

M+F

8.1–20.1

Children

From the age of 4: Interval of 3% and 97% percentiles Laboratory investigation was carried out using Coulter STKR. Samples of 25–108 children were investigated. Lit. /30/

  • 4–6 y

M

7.5

4.8–11.5

F

7.0

5.0–12.1

  • 7–8 y

M

7.0

4.5–10.5

F

7.4

5.2–11.7

  • 9–10 y

M

6.2

4.4–10.6

F

6.9

4.7–10.0

  • 11–12 y

M

6.1

4.0–9.6

F

6.7

4.8–10.4

  • 13–14 y

M

6.0

4.2–9.3

F

6.6

4.5–10.7

  • 17–18 y

M

6.1

4.2–12.2

  • 15–19 y

F

6.9

4.2–10.6

Lymphocyte
count
(103/uL)

Fetuses

Fetuses and newborn: Interval of 2.5% and 97.5% percentiles. Laboratory investigation was carried out using Coulter S Plus. Samples of of 17 fetuses were investigated. Lit. /29/

  • 16–19 w

M+F

1.9

0.5–3.3

  • 20–27 w

M+F

2.6

1.2–4.0

Newborn

M+F

5.6

3.6–7.6

Children

From the age of 4: Interval of 3% and 97% percentiles Laboratory investigation was carried out using Coulter STKR. Samples of 25–108 children were investigated. Lit. /30/

  • 4–6 y

M+F

2.2

1.7–4.2

  • 7–8 y

M+F

2.6

1.7–4.1

  • 9–10 y

M

2.4

1.6–4.0

F

2.4

1.7–3.9

  • 11–12 y

M+F

2.3

1.5–3.7

  • 13–14 y

M+F

2.4

1.4–3.6

  • 15–16 y

M+F

2.2

1.3–3.4

  • 17–19 y

M+F

2.2

1.3–3.0

Mean cellular
hemoglobin
concentration
of erythro­cytes
(g/L)

Blood cord

M+F

310–350

Children

Up to year 3: Interval of 2.5% and 97.5% percentiles. Laboratory investigation was carried out using Coulter S Plus. Samples of 2860 children were investigated. Lit. /23/

  • 1 d

M+F

310–350

  • 0.3 m

M+F

260–340

  • 1 m

M+F

250–340

  • 2 m

M+F

260–340

  • 3–3.5 m

M+F

260–340

  • 5–7 m

M+F

260–340

  • 8–10 m

M+F

280–320

  • 11–13.5 m

M+F

280–320

  • 1.5–3 y

M+F

260–340

  • 3–6 y

M

341

322–355

From the age of 3 years: Interval of 3% and 97% percentiles of the German survey on children‘s health (KIGGS study) are shown. Laboratory investigation was carried out using Abbott Cell-Dyn 3500 method. Samples of (M = 7206 ; F = 6870) children of representative locations all over Germany were investigated. Lit. /5/.

F

339

323–355

  • 7–10 y

M

347

325–356

F

349

325–355

  • 11–13 y

M

341

326–356

F

345

325–354

  • 14–17 y

M

342

327–357

F

339

325–353

Mean
corpuscular
erythrocyte
volume
(femtoliter)

Fetuses

Up to week 17: Interval of 2.5% and 97.5% percentiles. Laboratory investigation was carried out using Coulter S Plus. Samples of 15–21 fetuses were investigated. Lit. /21/

  • 15 w

M+F

127–159

  • 16 w

M+F

119–167

  • 17 w

M+F

121–153

  • 18–21 w

M+F

119–143

Up to week 30: Interval of 2.5% and 97.5% percentiles. Laboratory investigation was carried out using Coulter S Plus. Samples of 2860 fetuses were investigated. Lit. /26/

  • 22–25 w

M+F

109–141

  • 26–29 w

M+F

103–134

  • > 30 w

M+F

97–132

Children

Up to 13.5 months: Interval of 2.5% and 97.5% percentiles. Laboratory investigation was carried out using Coulter S Plus. Samples of 2860 fetuses were investigated. Lit. /27/

  • 1 T

M+F

98–122

  • 0.3 m

M+F

84–128

  • 1 m

M+F

82–126

  • 2 m

M+F

81–121

  • 3–3.5 m

M+F

77–113

  • 5–7 m

M+F

73–109

  • 8–10 m

M+F

74–106

  • 11–13.5 m

M+F

74–102

  • 1.5–2 y

M+F

73–101

From year 1.5: Interval of 3% and 97% percentiles of the German survey on children‘s health (KIGGS study) are shown. Laboratory investigation was carried out using Abbott Cell-Dyn 3500 method. Samples of (M = 7204 ; F = 6869) children of representative locations all over Germany were investigated. Lit. /5/.

  • 3–6 y

M

80

71–86

F

81

72–86

  • 7–10 y

M

82

75–88

F

83

75–89

  • 11–13 y

M

83

77–89

F

84

77–90

  • 14–17 y

M

85

78–93

F

86

78–93

Mean cellular
hemoglobin
content
(picogram)

Fetuses

Up to year 3: Interval of 2.5% and 97.5% percentiles. Laboratory investigation was carried out using Coulter S Plus. Samples of 2860 children were investigated. Lit. /27/

  • 15 w

M+F

127–159

  • 16 w

M+F

119–167

  • 17 w

M+F

121–153

  • 18–21 w

M+F

119–143

  • 22–25 w

M+F

109–141

  • 26–29 w

M+F

103–134

  • > 30 w

M+F

97–132

Children

  • Blood cord

M+F

101–125

  • 1 d

M+F

98–122

  • 0.3 m

M+F

84–128

  • 1 m

M+F

82–126

  • 2 m

M+F

81–121

  • 3–3.5 m

M+F

77–113

  • 5–7 m

M+F

73–109

  • 8–10 m

M+F

74–106

  • 11–13.5 m

M+F

74–102

  • 1.5–3 y

M+F

73–101

  • 3–6 y

M

80

71–86

From the age of 4 years: Interval of 3% and 97% percentiles of the German survey on children‘s health (KIGGS study) are shown. Laboratory investigation was carried out using Abbott Cell-Dyn 3500 method. Samples of (M = 7206 ; F = 6870) children of representative locations all over Germany were investigated. Lit. /5/.

F

81

72–86

  • 7–10 y

M

82

75–88

F

83

75–89

  • 11–13 y

M

83

77–89

F

84

77–90

  • 14–17 y

M

85

78–93

F

86

78–93

Monocyte
count
(103/uL)

Fetuses

Fetuses and newborn: Interval of 2.5% and 97.5% percentiles. Laboratory investigation was carried out using Coulter S Plus. Samples of 17 children of every age group were investigated. Lit. /29/

  • 16–19 w

M+F

0.1

< 0.30

  • 20–27 w

M+F

0.2

< 0.40

Newborn

M+F

0.9

0.1–1.7

Children

From the age of 4 years: Interval of 3% and 97% percentiles. Laboratory investigation was carried out using Coulter S Plus. Samples of 25–108 children were investigated. Lit. /30/

  • 4–6 y

M+F

0.62

0.33–1.16

  • 7–8 y

M+F

0.60

0.33–1.21

  • 9–10 y

M+F

0.58

0.33–1.00

  • 11–12 y

M

0.55

0.31–0.92

F

0.61

0.36–1.00

  • 13–14 y

M

0.53

0.26–0.87

F

0.59

0.38–1.00

  • 15–19 y

M

0.55

0.33–0.86

F

0.65

0.35–1.06

Neutrophil
leukocyte
count
(103/uL)

Fetuses

Fetuses and newborn: Interval of 2.5% and 97.5% percentiles. Laboratory investigation was carried out using Coulter S Plus. Samples of 17 children of every age group were investigated. Lit. /29/

  • 16–19 w

M+F

0.2

0.1–0.3

  • 20–27 w

M+F

0.2

0.1–0.3

Newborn

M+F

6.5

3.1–9.9

Children

From the age of 4 years: Interval of 2.5% and 97.5% percentiles. Laboratory investigation was carried out using Coulter S Plus. Samples of 25–108 children were investigated Lit. /30/

  • 4–6 y

M+F

3.2

1.8–7.6

  • 7–8 y

M+F

3.4

1.8–7.4

  • 9–10 y

M

2.7

1.7–6.1

F

3.2

1.7–6.4

  • 11–12 y

M

2.7

1.6–5.6

F

2.7

1.6–5.6

  • 13–14 y

M

2.6

1.7–5.4

F

3.3

1.8–7.2

  • 15–18 y

M

2.9

1.8–6.1

F

3.4

1.8–6.5

Reticulocyte
count (103/uL)

Absolute

Relative (%)

* Absolute and relative values. Laboratory investigation was carried out using FACS Calibur. Samples of 14–63 children in every age group were determined. Lit. /28/.

** Absolute and relative values. Laboratory investigation was carried out using Sysmex R-1000. Samples of 30–750 children in every age group were determined. Lit. /28/.

  • 0–14 d

M+F

239–404*

1.6–8.3

  • 14 d – 1 y

M+F

46–138*

1.1–3.0

  • 1–3 y

M+F

50–141*

1.1–5.0

  • 3–8 y

M+F

45–163*

0.95–.03

  • 8–12 y

M+F

55–154*

1.18–3.78

  • > 12 y

M+F

59–146*

1.32–4.91

  • Newborn

M+F

49–150**

1.1–5.5

  • Premature babies

M+F

40–171**

0.9–6.5

  • 1–16 y

M+F

50–65**

0.6–1.9

Thrombo­cyte
count (103/uL)

Fetuses

Fetuses and newborn: Interval of 2.5% and 97.5% percentiles.Laboratory investigation was carried out using Coulter S Plus. Samples of 17 children in every age group were investigated. Lit. /29/

According to a study /39/ platelet counts increased with advancing gestational age (GA). At GA of 22 weeks the thrombocyte count of 200 × 109/l increased in mean platelet count by 2089/ul every week..

  • 16–19 w

M+F

123–237

  • 20–27 w

M+F

176–260

Newborn

M+F

214–381

Children

From the age of 4 years: Interval of 3% and 97% percentiles. Laboratory investigation was carried out using Coulter S Plus. Samples of 40–107 children were investigated in every age group. Lit. /30/

  • 4 + 5 y

M

259

256–351

F

268

265–382

  • 6 y

M

250

248–349

F

253

253–257

  • 7 y

M

246

180–349

F

234

159–361

  • 8 y

M

240

171–343

F

239

195–321

  • 9 y

M

246

162–310

F

247

178–307

  • 10 y

M

230

148–355

F

242

180–314

  • 11 y

M

234

159–342

F

243

162–317

  • 12 y

M

233

159–342

F

238

162–317

  • 13 y

M

237

159–342

F

251

171–355

  • 14 y

M

231

160–332

F

263

171–355

  • 17+18 y

M

263

175–331

  • 18–19 y

F

241

159–318

Table 54-3 Reference intervals and orienting ranges of “normal“ for hemostaseological analytes

Parameter

Age (d. days; w. weeks; m. months;

y. years)

Sex

Reference

interval

Median

Comment

Activated partial
thromboplastin
time (APTT)
(sec.)

Fetuses

Fetuses and newborn: Interval of 2.5% and 97.5% percentiles. Laboratory investigation was carried out using Organon Technika coagulation test. Samples of 22 fetuses/newborn were investigated in the age groups. Lit. /31/

  • 19–23 w

M+F

83–250

168.8

  • 24–29 w

M+F

87–210

154.0

  • 30–38 w

M+F

76–128

104.8

Newborn

M+F

35–52

44.3

Children d: Interval of 2.5% and 97.5% percentiles. Laboratory investigation was carried out using Organon Technika coagulation test. Samples of 44-77 children were investigated in the age groups. Lit. /3233/

Children m, y: Interval of 2.5% and 97.5% percentiles. Laboratory investigation was carried out using Siemens BCS/BCT coagulation test. Samples of 40–242 children were investigated in the age groups. Lit. /40/

Children

  • 1 d

M+F

31.3–54.5

42.9

  • 5 d

M+F

25.4–59.8

42.6

  • 1–3 m

M+F

26.5–52.5

39

  • 4–6 m

M+F

31.0–46.0

36

  • 7–12 m

M+F

25.0–42.0

35

  • 13 m – 4 y

M+F

28.0–43.0

33

  • 5–9 y

M+F

27.0–42.0

34

  • 10–18 y

M+F

28.0–45.0

34

Antithrombin
(U/mL)

Children

1 m to 18 y: Interval of 2.5% and 97.5% percentiles. Laboratory investigation was carried out using Siemens BCS/BCT coagulation test. Samples of 40-242 children were investigated in the age groups. Lit. /40/

The concentration of pooled plasma of healthy persons is 1.0 U/ml.

  • 1–3 m

M+F

048–1.28

0.93

  • 4–6 m

M+F

0.76–1.26

1.04

  • 7–12 m

M+F

0.92–1.34

1.12

  • 13 m – 4 y

M+F

0.93–1.33

1.12

  • 5–9 y

M+F

0.88–1.31

1.10

  • 10–18 y

M+F

0.87–1.27

1.10

Factor V
(U/mL)

Children

Children and adults: Interval of 2.5% and 97.5% percentiles. Laboratory investigation was carried out using Organon Technika coagulation test. Samples of 44–77 children were investigated in the age groups. Lit. /3233/

The concentration of pooled plasma of healthy persons is 1.0 U/ml.

  • 1 d

M+F

0.41–1.44

0.88

  • 5 d

M+F

0.46–1.54

1.00

  • 1 m

M+F

0.48–1.56

1.02

  • 3 m

M+F

0.59–1.39

0.99

  • 6 m

M+F

0.58–1.46

1.02

Adults

M+F

0.62–1.50

1.06

Factor VII
(U/mL)

Children

Children and adults: Interval of 2.5% and 97.5% percentiles. Laboratory investigation was carried out using Organon Technika coagulation test. Samples of 44–77 children were investigated in the age groups. Lit. /3233/

The concentration of pooled plasma of healthy persons is 1.0 U/ml.

  • 1 d

M+F

0.21–1.13

0.67

  • 5 d

M+F

0.30–1.38

0.84

  • 1 m

M+F

0.21–1.45

0.83

  • 3 m

M+F

0.31–1.43

0.87

  • 6 m

M+F

0.47–1.51

0.99

Adults

M+F

0.67–1.43

1.05

Factor VIII:C
(U/mL)

Children

Children 1 m to 18 y: Interval of 2.5% and 97.5% percentiles. Laboratory investigation was carried out using Siemens BCS/BCT one-step factor testing with the use of FVIII-deficient plasma. Samples of 40–242 children were investigated in the age groups. Lit. /40/

The concentration of pooled plasma of healthy persons is 1.0 U/ml.

  • 1–3 m

M+F

0.65–2.01

0.96

  • 4–6 m

M+F

0.70–1.53

0.93

  • 7–12 m

M+F

0.60–1.80

1.17

  • 13 m – 4 y

M+F

0.70–1.95

1.13

  • 5–9 y

M+F

0.74–1.90

1.10

  • 10–18 y

M+F

0.68–2.02

1.19

Factor IX
(U/mL)

Newborn

Newborn, children and adults: Interval of 2.5% and 97.5% percentiles. Laboratory investigation was carried out using Organon Technika coagulation test. Samples of 44–77 children were investigated in the age groups. Lit. /3233/

The concentration of pooled plasma of healthy persons is 1.0 U/ml.

  • 1 d

M+F

0.11–0.71

0.41

  • 5 d

M+F

0.19–0.83

0.51

  • 1 m

M+F

0.20–0.92

0.56

  • 3 m

M+F

0.35–0.99

0.67

  • 6 m

M+F

0.35–1.19

0.77

Adults

M+F

0.70–1.52

1.06

Factor X
(U/mL)

Newborn

Newborn, children and adults: Interval of 2.5% and 97.5% percentiles. Laboratory investigation was carried out using Organon Technika coagulation test. Samples of 44–77 children were investigated in the age groups. Lit. /3233/

The concentration of pooled plasma of healthy persons is 1.0 U/ml.

  • 1 d

M+F

0.35–1.27

0.81

  • 5 d

M+F

0.68–1.58

1.10

  • 1 m

M+F

0.57–1.57

1.07

  • 3 m

M+F

0.75–1.67

1.21

  • 6 m

M+F

0.67–1.63

1.15

Adults

M+F

0.57–1.37

0.97

Fibrinogen
(g/L)

Fetuses

Fetuses: Interval of 2.5% and 97.5% percentiles. Laboratory investigation was carried out using Diagnostica Stago coagulation test according to Clauss. Samples of 22 children were investigated in the age groups. Lit. /31/

  • 19–23 w

M+F

0.57–1.50

0.85

  • 24–29 w

M+F

0.65–1.65

1.12

  • 30–38 w

M+F

1.25–1.65

1.35

Children

Children: Interval of 2.5% and 97.5% percentiles. Laboratory investigation was carried out using Siemens BCS/BCT Multifibrin reagent according to Clauss. Samples of 40–242 children were investigated in the age groups. Lit. /40/

  • 1–3 m

M+F

1.50–3.62

2.38

  • 4–6 m

M+F

1.75–4.16

2.37

  • 7–12 m

M+F

1.98–5.29

2.45

  • 13 m – 4 y

M+F

2.14–3.96

2.55

  • 5–9 y

M+F

2.08–3.98

2.62

  • 10–18 y

M+F

2.12–4.37

2.63

International
Normalized
Ratio (INR)

  • 1–3 m

M+F

0.90–1.17

1.06

Children: Interval of 2.5% and 97.5% percentiles. Laboratory investigation was carried out using Siemens BCS/BCT Thromborel S. Samples of 40–242 children were investigated in the age groups. Lit. /40/

  • 4–6 m

M+F

0.96–1.17

1.04

  • 7–12 m

M+F

0.95–1.13

1.04

  • 13 m – 4 y

M+F

0.94–1.13

1.05

  • 5–9 y

M+F

0.98–1.14

1.08

  • 10–18 y

M+F

0.98–1.20

1.10

Protein C
(U/mL)

  • 1–3 m

M+F

0.27–0.80

0.51

Children: Interval of 2.5% and 97.5% percentiles. Laboratory investigation was carried out using Siemens BCT/BCS Berichrom Protein. Samples of 40–242 children were investigated in the age groups. Lit. /40/.

The concentration of pooled plasma of healthy persons is 1.0 U/ml.

  • 4–6 m

M+F

0.40–0.92

0.65

  • 7–12 m

M+F

0.47–1.13

0.75

  • 13 m – 4 y

M+F

0.67–1.30

0.89

  • 5–9 y

M+F

0.66–1.28

0.93

  • 10–18 y

M+F

0.60–1.42

0.92

Prothrombin
time (sec.)

Fetuses

Fetuses: Interval of 2.5% and 97.5% percentiles. Laboratory investigation was carried out using Diagnostica Stago coagulation test. Samples of 22 children were investigated in the age groups. Lit. /31/

  • 19–23 w

M+F

19–45

32.5

  • 24–29 w

M+F

19–44

32.2

  • 30–38 w

M+F

16–30

22.6

Children

M+F

12–24

16.7

Children: Interval of 2.5% and 97.5% percentiles. Laboratory investigation was carried out using Siemens BCS/BCT Thromborel S. Samples of 40–242 children were investigated in the age groups. Lit. /40

  • 1–3 m

M+F

10.6–14.9

13.1

  • 4–6 m

M+F

11.3–14.9

13.0

  • 7–12 m

M+F

11.4–14.0

13.1

  • 13 m – 4 y

M+F

11.2–14.4

13.0

  • 5–9 y

M+F

11.9–14.4

13.3

  • 10–18 y

M+F

12.1–14.6

13.5

Thrombin­ time
(sec.)

Fetuses

Fetuses: Interval of 2.5% and 97.5% percentiles. Laboratory investigations were carried out using Diagnostica Stago coagulation test. Samples of 22 children were investigated in the age groups. Lit. /31/

  • 19–23 w

M+F

22–44

34.2

  • 24–29 w

M+F

24–28

26.2

  • 30–38 w

M+F

17–23.3

21.4

Children

Children and adults: Interval of 2.5% and 97.5% percentiles. Laboratory investigation was carried out using Organon Technika coagulation test. Samples of 44–77 children were investigated in the age groups. Lit. /3233/

  • 1 d

M+F

19–28.3

23.5

  • 5 d

M+F

18.0–29.2

23.1

  • 1 m

M+F

19.4–29.2

24.3

  • 3 m

M+F

20.5–29.7

25.1

  • 6 m

M+F

19.8–31.1

25.5

Adults

M+F

19.7–30.3

25.0

Von Willebrand
Factor-Antigen
(vWF: Ag)
(U/mL)

Children

Children 1 m to 18 y: Interval of 2.5% and 97.5% percentiles. Laboratory investigation was carried out using Siemens BCS/BCT vWF: Ag Kit. Samples of 40–242 children were investigated in the age groups. Lit. /40/

The concentration of pooled plasma of healthy persons is 1.0 U/ml.

  • 1–3 m

M+F

0.78–1.91

1.43

  • 4–6 m

M+F

0.65–2.18

1.10

  • 7–12 m

M+F

0.60–1.57

1.05

  • 13 m – 4 y

M+F

0.53–1.60

0.89

  • 5–9 y

M+F

0.57–1.87

0.90

  • 10–18 y

M+F

0.51–1.93

0.99

Von Willebrand
Factor
(vWF: RCo)
(U/mL)

Children

Children 1 m to 18 y: Interval of 2.5% and 97.5% percentiles. Laboratory investigations were carried out using Siemens BCS/BCT VWF-reagent . Samples of 40–242 children were investigated in the age groups. Lit. /40.

The concentration of pooled plasma of healthy persons is 1.0 U/ml.

  • 1–3 m

M+F

0.60–2.20

1.36

  • 4–6 m

M+F

0.52–2.09

1.05

  • 7–12m

M+F

0.48–1.53

0.96

  • 13 m – 4 y

M+F

0.43–1.63

0.87

  • 5–9 y

M+F

0.40–1.97

0.87

  • 10–18 y

M+F

0.45–1.81

0.89

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