Blood Guidelines

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From Website:

http://safety.gsa.gov/gsa/heartland/pbs_pmfm/6pmf/respirator/respro/medical/blood.htm

Blood Guidelines Values taken from Laboratory Test Handbook 4th ed. References are based on CLIA (Clinical Lab Improvement Act) requirements

Click on the test name to read information about the test

Test Name

Reference Range

Units

Automated Chemistry Panel

Glucose

between 65 and 115

mg/dl

Bun

between 5 and 26

mg/dl

Creatinine

between 0.6 and 1.5

mg/dl

Uric Acid

between 3.5 and 9.0

mg/dl

Sodium

between 135 and 147

meq/l

Potassium

between 3.5 and 5.3

meq/l

Chloride

between 96 and 109

meq/l

Phosphorus

between 2.5 and 4.5

mg/dl

Calcium

between 8.5 and 10.6

mg/dl

Total Protein

between 6.0 and 8.5

g/dl

Albumin

between 3.5 and 5.5

g/dl

Globulin - A/G ratio

between 0.5 and 4.5

g/dl

Total bilirubin

between 0.1 and 1.2

mg/dl

Alkaline phosphatase (ALP)

between 40 and 150

IU/L

SGOT (AST=Aspartate Aminotransferase)

between 0 and 45

IU/L

SGPT (ALT=Alanine Aminotransferase)

between 0 and 50

IU/L

LDH (lactate dehydrogenase)

between 0 and 240

U/L

GGT (gamma glutamyl transferase)

between 0 and 85

IU/L

Iron

between 40 and 180

MCG/DL

Triglyceride

between 0 and 199

mg/dl

Cholesterol total

between 0 and 199

mg/dl

HDL - cholesterol

between 35 and 150

mg/dl

LDL - cholesterol (calculated)

between 0 and 130

mg/dl

LDL/HDL ratio

between 0 and 3.6

mg/dl

CBC

WBC (white blood cell count)

between 4.0 and 10.5

Thous/mm3

RBC (red blood cell count)

between 4.10 and 5.60

Mill/mm3

HGB (hemoglobin)

between 12.5 and 17

g/dl

HCT (hematocrit)

between 36 and 50

%

MCV (mean corpuscular volume)

between 80 and 98

FL

MCH (Mean corpuscular hemoglobin volume)

between 27 and 34

PG

MCHC (Mean corpuscular hemoglobin concentration)

between 33.5 and 35.5

%

Neutrophils

between 40 and 74

%

Lymphocytes

between 14 and 46

%

Monocytes

between 4 and 13

%

Eosinophils

between 0 and 7

%

Basophils

between 0 and 3

%

Platelet count

between 140 and 415

Thous/mm3

RDW (red cell distribution width)

between 11.7 and 15

%

1. Glucose in blood - Fasting Test This is an insensitive method to screen for diabetes mellitus in the unstressed, ambulatory nonpregnant adult. Normal range for adults is 60 - 115 mg/dl and this range INCREASES with ages older than 50 yrs old (i.e., as you get beyond 50 this "normal" range increases). Generally values between 115 and 140 mg/dl require re-examination, but if consistent imply glucose (sugar) intolerance. Values above 140 on at least 2 occasions, indicate late onset diabetes. Other causes of high glucose include nonfasting specimen (person ate too recently), recent I.V. infusions of glucose, stress states such as myocardial infarction, convulsive episodes, trauma and general anesthesia, cushing's disease, severe liver disease, pancreatitis. Also, some medications are reported to affect glucose results (e.g., corticoids, diuretics, thiazide and others).

Hypoglycemia (low blood sugar) is defined as 47 - 60 mg/dl range for adults. HOWEVER, young, lean healthy women may have levels as low as 40 mg/dl

2. BUN (blood urea nitrogen) This test is useful to assess renal (kidney) function, especially in combination with creatinine. Normal values range from 5 - 20 mg/dl and this range increases slightly over 40 years of age.

What it is: [ BUN ]The end product of protein metabolism, urea is synthesized by the liver. Urea nitrogen reflects the ratio between urea production and clearance (increased levels may be due to increase production, or decreased clearance).

What high values mean High BUN occurs in kidney disease, acute renal failure. With urinary tract obstruction BUN increases. Borderline high values may occur after recent ingestion of high protein meals. Muscle wasting may also cause an elevation.

What Low BUN means Occurs in late normal pregnancy, with decreased protein intake with intravenous fluids, with some antibiotics and in severe liver damage.

Limitations Creatinine is usually more specific for glomerular function but may be less sensitive to some types of early kidney disease. Uremia and other similar dysfunctions are best evaluated with creatinine as well as urea nitrogen.

3. Creatinine, serum The most common test to determine proper kidney function, providing a rough approximation of glomerular filtration. Normal range for adult males is up to 1.2 mg/dl for adult females up to 1.1 mg/dl. Male values usually higher since the amount is determined partially by muscle mass. Since the cleansing rate increases during pregnancy, serum creatinine should be slightly lower for pregnant women. The elderly also have lower levels, as reflected by decreased muscle mass.

What high Creatinine values mean kidney disease, urinary tract obstruction, reduced renal blood flow including congestive heart failure, shock and dehydration, rhabdomyolysis (potentially fata disease of skeletal muscle).

What low Creatinine values mean Debilitation, small stature, decreased muscle mass, some complex cases of liver disease may cause low values (poor diet and muscle loss).

Limitations Creatinine only becomes abnormal when about half or more of the nephrons (vital tubular kidney structure) have stopped functioning, so it is NOT a sensitive to early kidney disease. Kidney failure is usually underestimated by this test in patients with cirrhosis of the liver. Also, increased levels may result from noncreatinine substances such as: meat ingestion, glucose(sugar), uric acid, fructose(sugar in fruits), guanidine, vitamin C and numerous cephalosporin antibiotics. High creatinine has also been reported in people with methanol (wood alcohol) poisoning/intoxification.

4. Uric Acid This is the end product of purine (parent substance of adenine, guanine and other "bases") metabolism, and is used to identify a variety of pathologic entities including gout (inherited disorder, primarily in men characterized by sever recurrent acut arthritis resulting from sodium urate crystal deposits in connective tissues). Normal range in adults is 3.4 - 7 mg/dl for males and 2.4-6.0 mg/dl for females.

What high Uric Acid values mean May mean kidney disease with kidney failure and dehydration, as well as gout. However, high values do not necessarily confirm a case of gout. Only about 10%-15% of elevated uric acid cases are caused by gout. Some medicines cause increased values such as: diuretics (to eliminate water), pyrazinamide, ethambutol, nicotinic acid, and aspirin in low doses. Elevated levels could also mean excessive cell destruction (such as for cancer patients), lead poisoning (saturnine gout), acidosis (more acid condition of the body). People with high triglycerides, diabetes or obesity may also experience high uric acid levels.

What low Uric Acid values mean Some medicines apparently also cause lower uric acid levels, such as aspirin (high doses), corticosteroids, massive doses of Vitamin C, x-ray contrast agents (dyes for taking x-rays). Also, insufficient eating of purine and protein containing foods; tea or coffee.. Low sodium and low uric acid are found in cases of liver disease.

Limitations Interferences may be caused by vitamin C, caffeine and theophylline. Uncommonly, gout may occur without elevated uric acid levels.

5. Sodium Sodium with its accompanying anions (e.g., chloride, sulfate...) is the most important EXTRAcellular osmotically (i.e., passing across cell membranes) active solution. Sodium ion (Na+) is extremely importan in maintenance of water and osmotic pressure equilibrium within the human cells. Normal levels for adults is between 135 and 145 mmol/Liter. This test is used to evaluate electrolyte and acid/base balance, water balance and water intoxification or dehydration.

What high Sodium values mean (hypernatremia) This is common in people who are dehydrated or are using a diuretic (helps avoid water retention). Some symptoms will include fever burns, sweating. Cushing's syndrome, vomiting and diarrhea can all result in high values. Dehydration may be verified by increased hematocrit. Apparent mildly lowever sodium levels with very high glucose can actually mean too high sodium levels.

What low Sodium values mean (hyponatremia) This occurs with nephrotic syndrome (kidney nephron degeneration), cachexia (general wasting away or weight loss as part of any chronic disease), intravenous glucose infusion (IV), congestive heart failure, cystic fibrosis and mineralocorticoid (one of the steroids of the adrenal cortex that influences salt metabolism) deficiency, hypothyroidism (low thyroid activity). Sodium levels below 115 mmol/L can lead to significant nerve dysfunction with cerebral edema (fluid on the brain) and increased intracranial pressure (pressure on the skull).

6. Potassium The major INTRAcellular cation (K+) is very commonly measured as one of the serum or plasma electrolytes and as a urinary electrolyte as well. Normal adult values range from 3.5 to 5.0 mmol/L. This is used to evaluate electrolyte balance, and is particularly important for elderly patients. It is an important tool for monitoring hypertension (high blood pressure).

What high Potassium values mean Generally reflects poor kidney excretion, movement of potassium from tissues (like blood cell destruction), or excessive intake. High values can be found in people with ACE inhibitors, 's disease, acidosis, insulin lack and in kidney diseases. Systemic heparin therapy can increase potassium levels also.

What low Potassium values mean People with hypertension (high blood pressure) will typically have low values. Increase in corticosteroid use, deprivation of potassium in diet can also lower potassium as well as any condition that results in dehydration.

Limitations

False high readings can occur if the specimen sits for several hours unattended. Also hemolysis (red blood cell destruction) during sample processing can also lead to very high false reading.

7. Chloride Used as part of the electrolyte evaluation, this is needed to calculate the anion gap. Like sodium this is used to measure acid/base, water balance and ketosis.

What high Chloride values mean Dehydration tends to make levels increase, as well as with administration of ammonium chloride and with kidny tubular acidosis. Excessive infusion of saline (salt solution by IV) can also cause levels to increase. Chloride tends higher in people with hyperparathyroidism (overly active parathyroid).

What low Chloride values mean Overhydration (too much water), congestive heart failure, syndrome of inappropriate secretion of ADH, vomiting, gastric suction, chronic respiratory acidosis, 's disease, and salt-losing nephritis can all lead to lowered chloride.

Limitations Interference from bromide occurs in hospital patients. Chloride is usually measured with sodium and potassium and carbon dioxide.

8. Phosphorus This metal plays a pivotal role in cell physiology. Its metabolism is regulated principally by the kidney tubules. Normal adult levels range from 2.5 to 4.5 mg/dl. Less than 1.0 mg/dl is a "panic level", although values may vary as much as 2.0 mg/dl per day.

What high Phosphorus levels mean dehydration, exercise, youth and hypovolemia (decreased amount of blood in the body), liver disease, pulmonary embolism, kidney failure, diabetes with ketosis (elevated ketone production in the body) can all cause high readings.

What low Phosphorus levels mean Malnourishment, antacids, diuretics, and long-term steroid use can all cause lower levels. There's an association of poor glucose metabolism (i.e., diabetes) and lowered phosphorus levels. Vitamin D deficiency can also lead to low levels. Symptoms can effect neuromuscular, gastrointestinal, skeletal and cardiopulmonary systems.

Limitations Phosphorus may not be a good indicator of hyperparathyroid conditions.

9.Calcium This test applies to the chloride/phosphorus ratio. Range for normal adults is 8.2 to 10.2 mg/dl. This decreases slightly with older age. This also assumes normal albumin concentration.

What high Calcium levels mean High calcium can be due to hyperparathyroidism, some types of cancers (myeloma, leukemia), sarcoidosis (disease whereby granulomas or fibrosis develops in the lungs), advanced chronic liver disease, and certain medications (e.g., calcium salts, lithium, thiazide, diuretics and estrogens...).

What low Calcium levels mean Low albumin, low total protein usually result in decreases of calcium blood levels. High phosphorus, kidney dysfunction, hypoparathyroidism (slow parathyroid activity), Vitamin D deficiency (rickets), acute pancreatitis and some medications (barbiturates, calcitonin,gastrin, corticosteroids, insulin, tetracycline...) can also cause lowered calcium levels.

Limitations

Sodium citrate, EDTA, sodium fluoride all interfere with the results. Gross hemolysis falsely gives high readings

10. Total Protein This test is commonly done with albumin and globulin which gives the A/G ratio. It is used to evaluate nutritional status and protein altering diseases, and edema (fluid buildup). Normal levels for adults range from 6.0 to 8.0 g/dl.

What high Total Protein levels mean Dehydration, autoimmune hepatitis, cirrhosis, myeloma, sarcoidosis, lupus(collagen disease) and other chronic inflammation instances can all cause high protein levels in the blood.

What low Total Protein levels mean pregnancy, intravenous fluids, chronic alcoholism, heart failure, kidney syndromes, Crohn's disease, starvation, burns and severe skin disease can all lead to low protein values. Very low protein (less than 4 g/dl) and low albumin cause edema (fluid build-up)

Limitations Venous stasis (stagnation of the blood in the veins) while getting blood taken can lead to increased values. Hemolysis can also lead to high protein.

11. Albumin This test is used to evaluate nutritional status, blood oncotic pressure, liver disease, kidney disease and other chronic illnesses. Normal ranges for adults are 3.5 to 4.8 g/dl up to age 31, at which point the range gradually decreases.

What high Albumin levels mean This indicates dehydration. Should be also increase in hemoglobin, hematocrit in such cases.

What low Albumin levels mean Malnutrition, liver or kidney disease will show lower values. In older people very low levels are an independent indicator of mortality (death) risk. Panic levels on the low end are anything below 1.5 g/dl.

Limitations Levels decrease in people resting in the supine position (laying down on your back).

12. Globulin - A/G ratio This is the other part of the A/G ratio test along with albumin. Globulin is calculated as: Total protein - albumin = globulin. Normal values are anything equal to or above 1.

What low Globulin - A/G ratio levels mean Cirrhosis and other liver diseases, kidney syndromes, myeloma, sarcoidosis, severe infections and inflammations and colitis can all result in low A/G levels.

Limitations More chemically precise A/G raio is derived from protein electrophoresis. The chemical method is very inaccurate when A/G ratios are below 0.8.

13. Total Bilirubin This is used to monitor diseases of the liver. Normal values range from 0.3 to 1.0 mg/dl

What high Total Bilirubin levels mean Liver disease (hepatitis, cirrhosis...)alcoholism (along with high AST, GGT, MCV or some combination), infectious mononucleosis (along with high LDH, lymphocytes), anorexia, anemia and congestive heart failure can all cause high values.

Limitations Differential diagnosis of liver diseases require total and direct bilirubin values, as well as other tests. Visibly hemolyzed serum can cause erroneous values.

14. Alkaline Phosphatase (ALP) ALP activity normally originates from liver and bone, but can also include intestines and placenta (pregnant women). ALP is excreted in the bile. This test provides a useful but nonspecific indication of liver or bone disease. If ALP is elevated a GGT result is suggested to determine the source of the ALP. Normal ranges in adults are 50 to 120 Units/L with adult males slightly higher than females.

What high Alkaline Phosphatase (ALP) levels mean There are many causes for high ALP including: not fasting before blood draw, liver or bone cancer, rickets, Paget's disease, hyperthyroidism (over active thyroid), chronic alcohol ingestion (along with high AST and/or bilirubin, GGT or MCV), biliary obstruction, Gilbert's syndrome, hepatitis, diabetes, infectious mononucleosis, tumors, pulmonary infarct (death of lung tissue), peptic ulcer, congestive heart failure and some drugs (birth control agents, phenothiazines, hypoglycemic agents, erythromycin, and others producing hypersensitivity or toxic cholestasis (obstruction of bile ducts)).

What low Alkaline Phosphatase (ALP) levels mean Low values may be due to hypothyroidism (slow acting thyroid), malnutrition, hypophosphatasia (abnormally low amount of ALP in blood condition) and some medications (clofibrate, azathioprine and estrogens).

Limitations Normal ranges are dependent on methodology, age and sex.

15. Aspartate Aminotransferase (AST, SGOT) A wide range of disease entities alter AST (also called SGOT) with origin from many organs. Normal adult levels range from 20 to 48 units/L.

What high Aspartate Aminotransferase (AST, SGOT) levels mean Chronic alcohol ingestion, acute viral hepatitis, other liver diseases, Reye's syndrome, infectious mononucleosis, trauma, striated muscle disease, myocardial infarction and many medicines (phenothiazines, erythromycin, progesterone, steroids, and opiates) can all lead to high levels.

What lowAspartate Aminotransferase (AST, SGOT) levels mean Uremia, Vitamin B6 deficiency, metronidazole can all cause lowered levels.

Limitations Gross hemolysis can cause false high values.

16. Alanine Aminotransferase (SGPT, ALT) This is commonly looked at with AST to evaluate liver function (i.e., hepatitis and shock). This is more sensitive for detection of hepatocyte injury than biliary obstruction, and more specific than AST for liver injury. Also used in combination with anti-HB as indirect screening for non-A, non-B hepatitis in blood donors. Normal adults levels range from 10 to 35 units/L. Males have slightly higher values than females.

What high Alanine Aminotransferase (SGPT, ALT) levels mean Can mean some sort of liver damage if other enzymes (AST, GGT) are also elevated. Obesity can result in higher levels.

Limitations Grossly hemolyzd samples can give erroneous high results. ALT is less sensitive than AST to alcoholic liver disease.

17. Lactate Dehydrogenase (LDH) This is an enzyme that catalyzes the interconversion of lactate and pyruvate. It's found in all cells of the body and exists in 5 forms. Normal adult ranges are 90 to 156 units/L. Over 43 years of age, the range is 90 to 176 units/L.

What high Lactate Dehydrogenase (LDH) levels mean High values can represent hypoxic cardiorespiratory diseases, hemolytic anemia, infectious mononucleosis, general inflammation, lowered thyroidism, myocardial infarction, liver diseases, chronic alcoholism (usually associated with some combination of elevated MCV, triglycerides, AST, ALT, GGT and bilirubin).

Limitations Hemolysis elevates the results, oxalate inhibits LD, Vitamin C can decrease values.

18. Gamma Glutamyl Transferase (GGT) This is a biliary enzyme especially useful in diagnosis of obstructive jaundice, intrahepatic cholestasis and pancreatitis. Also used in the interpretation of increases in alkaline phosphatase.

What high Gamma Glutamyl Transferase (GGT) levels mean biliary cirrhosis, biliary obstruction, glycogen storage disease.

Limitations Tylenol (acetaminophen) toxicity has been reported to cause increased levels. High alkaline phosphatase and normal GGT does not rule out liver disease.

19. Iron (Fe) Differential diagnosis of anemia, especially with hpochromia and/or low MCV. Usually measured also with ferritin, transferrin, TIBC and saturated iron. Normal adult levels range from 50 to 160 ug/dl for males, slightly lower for females (5% to 10% lower).

What high Iron (Fe) levels mean iron poisoning, sideroblastic anemias, hemolytic anemias, hemachromatosis and acute liver disease (all with other parameters either high or low).

What low Iron (Fe) levels mean iron deficiency, anemia of chronic disease.

Limitations Except for iron poisoning, serum iron without TIBC or transferrin is limited value. Low values may not indicate iron deficiency in acute infection with leukocytosis and may be misleading in chronic infection, inflammation and malignancy cases.

20. Triglycerides A family of complex lipids (fats) composed of glycerol esterified with 3 fatty acids of the same or different lengths. Triglycerides constitute 95% of tissue storage fat, since triglycerides are not soluble in blood and therefore transported as chylomicrons or as VLDL. Adult values are considered no risk if below 250 mg/dl. However, values increase with age as follows:

Age range

Percentiles (values in mg/L)

5

50

95

White Males

25-29 years old

450

1150

2500

30-34 years old

500

1300

2650

35-39 years old

550

1450

3200

40-54 years

550

1500

3200

55-64 years old

600

1400

2900

over 65 years old

550

1350

2600

Black Males

30-39 years old

420

910

2240

40-49 years old

520

970

2940

50-59 years old

n/a

1050

n/a

over 60 years old

n/a

960

n/a

White females

35-39 years old

400

950

1950

40-44 years old

450

1050

2100

45-49 years old

450

1100

2300

50-54 years old

550

1200

2400

55-64 years old

550

1250

2500

Over 65 years old

600

1300

2400

What high Triglycerides levels mean Could be hyperlipidemia (high blood fat condition), occasional cases of diabetes (late onset), pancreatitis. Also high levels may occur with hypothyroidism, kidney syndromes, glycogen storage disease and viewed as a risk factor for atherosclerotic and coronary arterial disease (although somewhat controversial regarding coronary artery disease). The combination of low HDL and high triglycerides is important to project the outcome following coronary bypass surgery.

Limitations If triglycerides are over 400 mg/dl, LDL cannot be calculated accurately. Most common reason for high values is inadequate fasting.

21. Cholesterol, Total A causal relationship exists between high cholesterol and risk for coronary heart disease, but other factors are also relevant. Normal ranges for adults are as follows: Age range Moderate Risk High Risk 20-29 yrs old >200 mg/dl >220 mg/dl 30-39 yrs old >220 mg/dl >240 mg/dl over 40 yrs old >240 mg/dl >260 mg/dl

What high Cholesterol levels mean Along with low HDL and other risk factors (weight, smoker, previous coronary bypass), is considered risk factor for coronary heart disease, or heart attack.

Limitations Values are altered by weight loss, pregnancy, acute illness. Elderly individuals (in their late 70's and older), probably should NOT be screened for total cholesterol.

22. High Density Lipoprotein (HDL) Cholesterol This is a class of heterogeneous particles of varying sizes and densities, which contains lipid (fat) and protein. Two subclasses of HDL predominate: HDL2 and HDL3. HDL may function in so-called "reverse transport" of cholesterol to the liver. There is a strong relationship between high HDL and low coronary heart disease (20-30% of all cholesterol is HDL), and this is why it is called "good cholesterol". Adult values less than 35 mg/dl (men) and less than 40 mg/dl (women) are considered a risky level.

What low HDL levels mean Potentially higher risk for heart attack or coronary heart disease when in conjunction with other risk factors such as total cholesterol, hypertension and risky behavior (obesity, smoking...).

Limitations Increased levels are reported with estrogens and birth control pills. Clofibrate and Atromid-S therapy cause increases levels. There may be interferences from very high triglyceride levels.

23. Low Density Lipoprotein (LDL) Cholesterol - CALCULATED The concentration of cholesterol in this lipoprotein is positively correlated with coronary heart disease (heart attack) risk. High LDL is a direct risk factor for coronary atherosclerosis. Normal adult values are anything up toe 130 mg/dl. Values over 160 mg/dl are considered critical (i.e., may require intervention or treatment).

What high LDL levels mean Potential risk for heart attack or coronary heart disease.

Limitations If triglycerides are over 400 mg/dl, LDL cannot be calculated accurately.

24. Ratio of LDL/HDL Cholesterol This ratio provides a better signal for risk than either single result.

CBC

26. White blood cell count (WBC) Different types of white cells are included in the total count which is used to evaluate myelopoiesis, bacterial and viral infections, toxic metabolic processes and to diagnose/evaluate leukemia conditions. Normal values range from 4500 to 11,000 /mm3. Values below 2500 /mm3 or above 30,000 /mm3 should be considered "panic" levels.

27. Red Blood Cell Count (RBC) This is used to evaluate anemia, bleeding or polycythemia. Normal values range from 4.6-6 x 106/mm3 for males and 3.9 to 5.5 x 106/mm3 for females. Lowered values may be due to bleeding or hemolysis, failure of bone marrow production. RBCs are normally highe in people at high altitudes (in order to carry more oxygen to body).

28. Hemoglobin This procedure determines the concentration of hemoglobin (Hgb) in whole blood, which is the major component of the red cell and transports oxygen. It is important in detection of anemia and polycythemia and in the calculation of MCH and MCHC. Normal values range from 14.4 to 16.6 for males and 12.7 to 14.7 g/dl for females. Hgb may be falsely high if white WBC count is >50,000 cells/mm3.

29. Hematocrit This is the percent of whole blood that is red blood cells. This is important in the detection and follow-up of anemia and polycythemia. It is also used in calculation of MCV and MCH. Normal adult male values range from 42 to 52%, females: 35 to 47%. Low levels can indicate anemia, blood loss and other conditions.

30. RDW, MCH, MCV, MCHC

Part of red blood cell indices, along with RBC, MCH, MCV. This is mathematically measured from hemoglobin, hematocrit, and red blood count. Normal adult values are as follows:

MCV

MCH

MCHC

RDW

males

80-100

25.4---34.6

31---37

11.5---14.5

females

79-98

25.4---34.6

30---36

11.5---14.5

This is used to evalute red cell parameters, the differential diagnosis of anemia, iron deficiency, hereditary spherocytosis, thalassemia, chronic lead poisoning, vitamin B12 or B6 deficiency and anemia.

31. Neutrophils A general indicator of immunity for the body. Lowered levels could indicate an immunity deficiency.

32. Lymphocytes General measurement of the body's immunity, since lymphocytes are T-cells which fight off infection. These values change drastically in Aids and other autoimmune diseases.

33. Eosinophils Aids in the diagnosis of allergy, drug reactions, parasite infections, collagen disease, hodgkins disease and myeloproliferative (myelin = nerve sheath) diseases. Manual method for analysis has an inherent error of 20-30%. Normal values are 50-350 /mm3. These values are decreased with hyperadrenalism (overactive adrenal glands).

34. Platelet Count This is important in the assessment of bleeding, thrombotic, and malignant neoplastic processes, marrow function assessment and in some autoimmune disease studies. Normal ranges are 150 - 450 thous/mm3. Anything below 50 or above 1,000 thous/mm3 values are considered panic values. Clumping may cause low values.

Chemistry