CH-2.21 Analyte Reference Interval Instrumentation ......CH-2.21 Analyte Reference Interval...

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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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


Normal diet3 - 78

nmol/ 24hrs


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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


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


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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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


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



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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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


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



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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


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


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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



**VHF patients only


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


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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


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


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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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


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.


Cannabinoid Screen –Urine (THC)



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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


0.0 - 3.0

%

*Established by CLS and AHS Calgary Zone Respiratory Services


Carcinoembryonic Antigen (CEA) - Blood

IMMUNO CHEM


0.0 - 5.0 µg/L

Carcinoembryonic Antigen (CEA) - Fluid

IMMUNO CHEM


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


Page 12 of 48


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


Chloride – Stool FMC Cobas 8000Indirect potentiometric assay using an ion-selective electrode


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)


Cholinesterase Go to: Pseudocholinesterase (Acetycholinesterase is a sendout to DynaLife Dx)

Chromogranin AIMMUNO

CHEMTriturus Enzyme Immunoassay < 111 ng/mL


Page 13 of 48

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


Age< 6 y6-150 y

Value18-2721-31

mmol/L


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


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


Page 14 of 48


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


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


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



Page 15 of 48


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


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.


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


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


Page 16 of 48


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


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)


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


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


Page 18 of 48

F


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


Page 19 of 48


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


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


Male

11-63

Female

8-35U/L


Gastrin IMMUNO

CHEMSiemens Immulite 2000 Chemiluminescent assay Fasting >10 hours: < 100 ng/L


Page 20 of 48

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


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


Page 21 of 48


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


Page 22 of 48


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


Page 23 of 48

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


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


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


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.


I

Analyte Site Instrumentation Method Reference Interval Units NotesImmunofixation Electrophoresis (IFE) - Blood/Urine

DSC Capillarsys/Hydrsys Electrophoresis No Reference Interval


Page 25 of 48


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


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


Page 26 of 48


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


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


0.5-2.2 mmol/L


Page 27 of 48


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


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


Page 28 of 48


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


DSC FMC Cobas 8000

RRL Cobas 6000Colorimetric method with Xylidyl Blue

Magnesium - Blood

BMSH VCH

CMGH DDHS HRH SDHS


0.65-1.05 mmol/L

Magnesium - Stool FMC Cobas 8000Colorimetric method with Xylidyl Blue


Magnesium - Urine DSC Cobas c701-c502Colorimetric method with Xylidyl Blue

3.0- 5.5 mmol/ day


Page 29 of 48


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


Page 30 of 48


Methanol FMCAgilent 7890B Gas

Chromatograph analyzerGas Chromatography No Reference Interval mmol/L

Methemoglobin (MTHB)

FMC RRLCMGH DDHSHRHSDHS


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


Methotrexate ACH Cobas 6000Homogeneous Enzyme Immunoassay


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


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


Page 31 of 48


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


Page 32 of 48

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


Page 33 of 48

O


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

%



**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


Osmolal Gap FMC RRL CalculationOGAP = measured osmolality –calculated osmolality

No Reference Intervalmmol/k

g

Refer to CH-43.07 Osmometer

Reporting


Page 34 of 48


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


Page 35 of 48

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


ArterialVenous

Capillary

35 - 4840 - 5238 - 45

mm Hg



**VHF patients only

FMC RRL

BMSH CMGHDDHS HRHSDHS

GEM 4000 Potentiometric sensor

**ACH **SHC


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


ArterialVenous

Capillary

7.35-7.457.31-7.417.35-7.45

*Established by AHS Calgary Zone respiratory Services


**VHF patients only


pH - CSFFMCSHC



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



pH – StoolDSC

UrinalysisManual Multistix reagent strip for pH 7.0-8.0

Refer to GL-15.03 pH - Stool

pH - Urine Go to Urinalysis


Page 36 of 48


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


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


Page 37 of 48

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


**VHF patients only


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


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.


Potassium – Stool FMC Cobas 8000Indirect potentiometric assay using an ion-selective electrode.



Page 38 of 48

Analyte Site Instrumentation Method Reference Interval Units NotesDSC Cobas c701-c502FMC Cobas 8000

24 hour: 26 - 123 mmol/dPotassium - Urine

RRL Cobas 6000


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


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


> 25 % 9 % 12 % 16 %


Page 39 of 48


DSC FMC Cobas 8000

RRL Cobas 6000Colorimetric assay utilizing biuret reagent

BMSH CMGH

DDHS HRH SDHS

Vitros Colorimetric assayProtein, Total - Blood

***ACH ***SHC


Age1 – 365 d1 – 4 y5 – 150 y

Value54-79 59-7963-80

g/L


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


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


Page 40 of 48

R


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


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


>10 kIU/L indicates past exposure to Rubella Virus

kIU/L

S


FMC Cobas 8000


Salicylate

SMCHC CCHC BMSH

CMGH CLH HRH OGH SDHS VHC


Therapeutic range: 0.70 - 1.80 (anti-inflammatory)

mmol/L


Page 41 of 48


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


HCTL CRL Vitros Direct potentiometric assay Sodium - Blood

***ACH ***SHC

i-STAT SystemIon-selective electrode (ISE) potentiometry

133 - 145 mmol/L


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)


DSC FMC Cobas 8000Sodium - Fluid

RRL Cobas 6000Indirect potentiometric assay using an ion-selective electrode.


Sodium - Stool FMC Cobas 8000Indirect potentiometric assay using an ion-selective electrode.


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.


Refer to CH-2.41 Fractional Sodium –DSC FMC RRL


Page 42 of 48


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.


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


Page 43 of 48

T


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


Page 44 of 48


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


Page 45 of 48


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)


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)


Page 46 of 48

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


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 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


Page 47 of 48


Urea - Urine DSC Cobas c701-c502NADH to NAD oxidation reaction measured photometrically


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


Valproate (Depakene) FMC Cobas 8000Homogeneous enzyme immunoassay.


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


Page 48 of 48

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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