Mean Corpuscular Hemoglobin (MCH), Mean Cell Hemoglobin

July 21, 2024Hematology Lab Tests

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Mean Corpuscular Hemoglobin (MCH)

What sample is needed for Mean Corpuscular Hemoglobin (MCH)?

This test is done on blood in EDTA (anticoagulant).

What are the indications for Mean Corpuscular Hemoglobin (MCH)?

It is done as part of blood indices.
It is done to diagnose anemia. It has limited value in diagnosing anemia.

What are the precautions for Mean Corpuscular Hemoglobin (MCH)?

Remember that the abnormal size of the RBC may affect the value.
The presence of cold agglutinins gives a false raised value.
Raised WBC count also affects the value.

How will you define Mean corpuscular hemoglobin (MCH)?

Mean corpuscular hemoglobin (MCH) is obtained by dividing hemoglobin by RBC count.
It represents the average amount of hemoglobin/RBCs.

Mean corpuscular hemoglobin (MCH) calculation

What is the significance of the Mean Corpuscular Hemoglobin (MCH)?

This is the mean weight of average hemoglobin in one RBC.

Mean corpuscular hemoglobin (MCH)

MCH and MCHC values determine the hemoglobin contents in the RBCs.
MCH adds very little value to other blood indices.
The RBC size influences MCH.
A large RBC with normal hemoglobin will contain a greater weight of hemoglobin than a small RBC with normal hemoglobin.
MCH also depends upon the amount of hemoglobin in relation to the size of the RBC; for example, hypochromic RBCs have less hemoglobin than normochromic RBCs.
In short, macrocytosis leads to increased MCH, and microcytosis and hypochromia decrease MCH.

What is the normal value of MCH?

Source 1

Age	pg/cell
Fetal blood
18 to 20 weeks	43.14 ± 2.7
21 to 22 weeks	41.39 ± 3.32
23 to 25 weeks	40.48 ± 2.88
26 to 30 weeks	37.04 ± 3.67
Infants and Child
Cord blood	31 to 37
0.5 month	30 to 37
0ne month	29 to 36
2 month	27 to 34
4 month	25 to 32
6 month	24 to 30
9 month	25 to 30
12 month	24 to 30
1 to 2 year	22 to 30
3 to 5 year	25 to 31
6 to 8 year	25 to 31
9 to 11 year	26 to 32
	Male	Female
12 to 14 year	26 to 32	26 to 32
15 to 17 year	27 to 32	26 to 34
18 to 44 year	27 to 37	27 to 34
45 to 64 year	27 to 35	27 to 34
65 to 74 year	27to 34	27 to 35

Source 2

Adult = 27 to 31 pg (picogram).
Newborn = 32 to 34 pg (picogram)

Another source

26 to 34 pg

MCH values in different conditions:

MCH	MCH value
Normal	27 to 31 pg/RBC
Low	<27 pg/RBC
High	>30 pg/RBC

What conditions will interfere with estimating Mean Corpuscular Hemoglobin (MCH)?

Lipemia.
Cold agglutinins.
Increased white blood cells (Leucocytosis = >50,000/cmm).
In vivo hemolysis.
In case of high concentration of heparin.
Monoclonal proteins in the blood.

What are the causes of increased Mean corpuscular hemoglobin (MCH)?

Macrocytic anemia and in newborns.
Infants and newborns.

Macrocytic RBCs and hypersegmented polys.

What are the causes of decreased Mean Corpuscular Hemoglobin (MCH)?

Microcytic anemia.
Hypochromic anemia.

Microcytic hypochromic RBC

Questions and answers:

Question 1: What is the value of MHC for the diagnosis of anemia?

Show answer

Question 2: What is an effect of hemolysis on MCH?