Clinical laboratory test results have a huge impact on today’s medicine diagnostics as well as treatment choices. The evaluation of patient’s health condition is based on the right interpretation of laboratory tests, comparing test results to the reference ranges. The setting of a reference ranges for the chosen test is a long, difficult and expensive process. Therefore many laboratories use published reference ranges instead of developing their own. One of the biggest problems are is different, not matching reference ranges which are applied not only in different countries, but also in various national healthcare facilities. These differences may subject infants and children unnecessarily to further blood collection, infection risk, pain, anxiety, lengthier stays. Moreover, inadequate pediatric reference ranges may be costly and devastating, and potentially contribute to erroneous/delayed diagnosis of many diseases of childhood and adolescence. Special issues and challenges come into play when establishing reference ranges for use in a pediatric patient population. The application of adult reference ranges is often not valid in a pediatric setting. Differences in physical size, organ maturity, body fluid compartments, rates of growth and development, immune and hormone responsiveness, nutrition and metabolism are among the many factors that can intluence normal test values in children. Establishment of pediatric reference ranges ranging from birth to adolescence is important for clinical interpretation. Reference ranges are integrated into the clinical interpretation of the laboratory test results. Therefore the accuracy and periodic renewal of pediatric reference ranges is vital in case to avoid the diagnostic and treatment errors.
