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Mean Corpuscular Volume (MCV), Mean Cell Volume

July 21, 2024HematologyLab Tests

Table of Contents

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  • Mean Corpuscular Volume (MCV)
        • What sample is needed for Mean Corpuscular Volume (MCV)?
        • What are the indications for Mean Corpuscular Volume (MCV)?
        • How would you define Mean Corpuscular Volume (MCV)?
        • What are the facts about Mean Corpuscular Volume (MCV)?
        • What is the normal Mean Corpuscular Volume (MCV)?
        • What are the causes of increased Mean Corpuscular Volume (MCV)?
      • Macrocytic anemia causes are:
        • What are the causes of decreased Mean Corpuscular Volume (MCV)?
      • Microcytic anemias are seen in:
        • What are the causes when the Mean Corpuscular Volume (MCV) is increased?
      • Questions and answers:

Mean Corpuscular Volume (MCV)

What sample is needed for Mean Corpuscular Volume (MCV)?

  1. The best sample is EDTA blood.
  2. Stable for 6 hours at 25 °C  and 24 hours at 4 °C.
  3. Fetal blood is collected percutaneously from the umbilical area.

What are the indications for Mean Corpuscular Volume (MCV)?

  1. This is one of the blood indices.
  2. This is done to classify and diagnose anemia.
  3. It is a useful screening test for occult alcoholism.

How would you define Mean Corpuscular Volume (MCV)?

  • It represents an average measurement of RBC volume varying from 82 to 98 fL.
  • Mean Corpuscular Volume (MCV) is manually calculated as hematocrit divided by RBC count.
  • It can be measured directly by the automated instrument.

What are the facts about Mean Corpuscular Volume (MCV)?

  1. MCV measures the effect of average RBC size on hematocrit.
  2. Mean Corpuscular Volume (MCV) measures a single RBC’s average volume or size.
  3. If the average size of RBCs increases, the same number of RBCs will have a slightly larger cell mass and a slightly increased hematocrit value. The opposite happens if the average size of RBCs is smaller than normal.
  4. MCV indicates the volume occupied by a single RBC and is measured in a cubic micrometer of the mean volume.
    1. Cubic micrometer = femtoliter ( fL ).
  5. MCV helps to classify various anemias.
  6. Macrocytic RBC:
    1. When the RBC size is larger than normal, more than 100 fL.
  7. Microcytic RBC:
    • When the RBC size is smaller than normal, it is less than 82 fL.
  8. It is considered that the most common cause of macrocytosis is alcoholism with or without cirrhosis.
Mean Corpuscular Volume (MCV): MCV formula and calculation

Mean Corpuscular Volume (MCV): MCV formula and calculation

What is the normal Mean Corpuscular Volume (MCV)?

Source 1

Age fL
Fetal blood
18 to 20 weeks 133.9 ± 8.8
21 to 22 weeks 130.1 ± 6.2
23 to 25 weeks 126.2 ± 6.2
26 to 30 weeks 118.2 ± 5.8
Infants and Child
Cord blood 98 to 118
0.5 month 88 to 140
0ne month 91 to 112
2 month 84 to 106
4 month 76 to 97
6 month 68 to 85
9 month 70 to 85
12 month 71 to 84
0.5 to 2 year 70 to 84
2 to 5 year 73 to 85
5 to 9 year 75 to 87
9 to 12 year 76 to 90
Male  Female
12 to 14 year 77 to 94 73 to 95
15 to 17 year 79 to 95 78 to 98
18 to 44 year 80 to 99 81 to 100
45 to 64 year 81 to 101 81 to 101
65 to 74 year 81to 103 81 to 102

Source 2

  • Adult = 80 to 95 fL.
  • Newborn = 96 to 108 fL

Another source

  • Both sexes = 80 to 100 fL
  • Heavy smoking  increases the MCV as much as 3 fL

What are the causes of increased Mean Corpuscular Volume (MCV)?

Macrocytic anemia causes are:

  1. B12 or folic acid deficiency :
    1. Decreased ingestion.
      1. Laking animal protein.
      2. Vegetarians.
    2. Impaired absorption.
      1. Intrinsic factor deficiency.
      2. Abnormal intrinsic factor molecule.
      3. Patient with partial or total gastrectomy.
      4. Ileal resection.
      5. Sprue.
      6. Celiac disease.
      7. Intestinal lymphoma.
      8. Drug-induced malabsorption.
  2. Parasitic infestation.
    1. Diphyllobothrium latum.
    2. Infected diverticula.
    3. Blind loop.
  3. Increased requirement.
    1. Pregnancy.
    2. Malignancies.
    3. Hyperthyroidism.
    4. Chronic pancreatic disease.
Mean corpuscular volume (MCV): Macrocytic RBCs and hypersegmented polys.

Mean corpuscular volume (MCV): Macrocytic RBCs and hypersegmented polys.

What are the causes of decreased Mean Corpuscular Volume (MCV)?

Microcytic anemias are seen in:

  1. Iron metabolism-related.
    1. Iron deficiency anemia.
    2. Decreased dietary intake.
    3. Malabsorption.
    4. Increased iron loss.
    5. Increased body requirements for iron.
    6. Congenital hypochromic microcytic anemia.
    7. Anemias of chronic diseases.
  2. A defect in heme synthesis.
    1. Idiopathic refractory sideroblastic anemia.
    2. Acquired sideroblastic anemia.
    3. Hereditary sideroblastic anemia.
    4. Autosomal anemia ( X chromosome-linked ).
  3. Disorder of globin synthesis.
    1. Thalassemia.
    2. Hemoglobinopathies.

What are the causes when the Mean Corpuscular Volume (MCV) is increased?

Macrocytic anemias are seen in:

  1. Pernicious anemia (vit.B12 deficiency).
  2. Folic acid deficiency.
  3. Liver diseases.
  4. Alcoholism.
  5. Antimetabolic therapy.
Mean corpuscular volume (MCV): Anemia hypochromic microcytic

Mean corpuscular volume (MCV): Anemia hypochromic microcytic

Mean corpuscular volume (MCV): Anemia Microcytosis

Mean corpuscular volume (MCV): Anemia Microcytosis

What is the differential diagnosis of anemias based on MCV?

MCV (Macrocytosis) MCV (Microcytosis)
Common causes are:

  1. Folic acid or B12 deficiency
  2. Chronic alcoholism
  3. Chronic liver disease
  4. Cytotoxic drugs (Chemotherapy)
  5. Myelodysplastic syndrome
  6. Newborn normal
  7. Reticulocytosis

Less common causes are:

  1. Hypothyroidism
  2. Chronic leukemia
  3. Myelofibrosis
  4. Radiation for cancers
  5. Down’s syndrome
  6. Noncytotoxic drugs like phenytoin, azathioprine and zidovudine
Common causes are:

  1. Alpha or beta thalassemia
  2. Chronic iron deficiency anemia
  3. Anemia of chronic diseases

Less common causes are:

  1. Some cases of sideroblastic anemia
  2. Some abnormal hemoglobin :
    1. HbE
    2. Hb Lepore
  3. Some cases of polycythemia
  4. Some cases of congenital spherocytosis
  5. Some cases of lead poisoning

Questions and answers:

Question 1: What is the MCV for microcytes?
Show answer
Microcytes MCV is <82 fL.
Question 2: What is MCV of the macrocytes?
Show answer
Macrocytes MCV is >100 fL.

Possible References Used
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