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Pediatric Reference Intervals

From Dr. Jasmina Ahluwalia: Dear George, I wonder if you could help me. Is there is a recent reference range available for the pediatric population for the coagulation screening tests, factor assays, protein C, protein S and antithrombin assays on the ACL TOP systems? I did come across one on the STAGO and Sysmex systems but can’t get to any related to the IL systems.  Thanks in advance.

Hello, Dr. Ahluwalia, and thank you for your question. I know of no pediatric reference intervals in hemostasis published since 1988, when the late Dr. Maureen Andrew published comprehensive lists in the journal Blood. Excerpts are available from the University of Alabama at Birmingham coagulation web site,, Test Interpretation and Therapy. In 2012, the American Association for Clinical Chemistry undertook a new pediatric reference interval process, as described in Clinical Laboratory News, however I haven’t seen a completion date for the project. Meanwhile, I’ve sent messages to colleagues at Werfen Instrumentation Laboratory (IL) to learn if they have any additional specifics that they can share.

Additional information, Monday, October 26, 2015:

Dr. Paul Riley, Stago-US provided the attached series of citations to age-related reference intervals, some of which are instrument and reagent-specific:


Additional information, Wednesday, October 28, 2015; we’ve received a statement from IL:

IL is collaborating in a multi-center study that will demonstrate the results obtained at multiple sites for various pediatric reference intervals using IL test systems and reagents. The publication date is not yet known, but we’ll be sure to inform you when it’s available.”

This also arrived Saturday, November 14, from Alan Neal, Pathlab in New Zeland. “Hi I have found this article of use:” Klarmann D, Eggert C, Geisen C, et al. Association of ABO(H) and I blood group system development with von Willebrand factor and factor VIII plasma levels in children and adolescents. Transfusion. 2010;50:1571–80.


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