Mean Corpuscular Hemoglobin concentration (MCHC)

Mean Corpuscular Hemoglobin Concentration (MCHC)

What sample is needed for Mean Corpuscular Hemoglobin concentration (MCHC)?

1. It is done on blood in EDTA (anticoagulant).
2. Whole blood is stable for 6 hours at 25 °C and 24 hours at 4 °C.
3. Fetal blood is collected by percutaneous umbilical blood.

What are the indications for Mean Corpuscular Hemoglobin concentration (MCHC)?

1. This is part of the CBC (Complete blood count).
2. This helps to diagnose the type of anemia.
3. Mostly used to diagnose macrocytic anemia.

How will you define Mean Corpuscular Hemoglobin concentration (MCHC)?

Definition of MCHC:

1. MCH is the average hemoglobin in one RBC.
   1. How much hemoglobin is in each RBC.
2. MCHC is the average concentration of hemoglobin inside the RBC.
   1. How concentrated is the hemoglobin in each RBC.
3. This measures the average hemoglobin concentration or percentage per RBC.
4. The MCHC depends on the relationship between hemoglobin concentration and RBC volume.

3. Based on MCHC, RBCs may be classified into:
   1. Normochromic.
   2. Hypochromic.
4. Both MCH and MCHC values determine the Hemoglobin content in the RBCs.
   1. If MCHC is normal, it is caused by low MCHC and high MCV.
5. Then, RBCs are referred to as normochromic.
   1. If MCHC is less than normal, then RBCs are hypochromic.
6. Hypochromic RBCs with decreased MCHC indicate low hemoglobin.
7. The above-normal level may be seen in alterations of RBC shape, such as spherocytosis, transfusion reaction, and erythroblastosis fetalis.

What factors interfere in estimating Mean Corpuscular Hemoglobin concentration (MCHC)?

1. False increased MCHC is seen in the following conditions:
   1. Abnormally sized RBCs may affect the MCHC.
   2. An increased level of lipids in the blood yields a high result due to high hemoglobin.
   3. Intravascular hemolysis gives free hemoglobin, which is calculated by the autoanalyzer.
   4. Sickle cell anemia.
   5. Hereditary spherocytosis.
   6. Few cases of autoimmune hemolytic anemia.
   7. Severe lipemia of the serum.
   8. Rouleaux formation or agglutination.
   9. In the case of increased concentration of heparin.
2. Decreased MCHC is seen in marked leucocytosis (>50,000/cmm).

What is the normal MCHC?

Source 1

• To convert into SI units, x 10 = g Hb/L

Source 2

• Adult = 32 to 36 g/dL or 32% to 36%
• Newborn = 32 to 33 g/dL or 32% to 33%.

Where would you see normal MCHC values?

• Normochromic anemia (hemolytic anemias).

Where would you see decreased MCHC values?

1. When MCHC is <30 g/dL.
2. Hypochromic microcytic anemias:
   1. Iron deficiency anemia.
   2. Microcytic anemia.
   3. Chronic blood loss.
   4. Thalassemia.

Where would you see increased MCHC values?

1. Hereditary spherocytosis is suspected when MCHC is >36 g/dL.
2. Newborns and infants.
3. Erythroblastosis fetalis.
4. Not an increase in pernicious anemia.

What is the differential diagnosis of MCHC?

Questions and answers:

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