Mean corpuscular hemoglobin concentration
The mean corpuscular hemoglobin concentration (MCHC) is a measure of the concentration of
It is calculated by dividing the hemoglobin by the
Interpretation
A low MCHC can be interpreted as identifying decreased production of hemoglobin. MCHC can be normal even when hemoglobin production is decreased (such as in iron deficiency) due to a calculation artifact. MCHC can be elevated ("hyperchromic") in
Complicating conditions
Because of the way
For example, for some patients with cold agglutinins, when their blood gets colder than 37 °C, the red cells will clump together. As a result, the analyzer may incorrectly report a low number of very dense red blood cells. This will result in an impossibly high number when the analyzer calculates the MCHC. This problem is usually picked up by the laboratory before the result is reported. The blood can be warmed until the cells separate from each other, and quickly put through the machine while still warm.[citation needed]
There are four steps to perform when a suspect increased MCHC (>370 g/L or >37.0 g/dL) is received from the analyzer:[citation needed]
- Remix the EDTA tube—if the MCHC corrects, report corrected results
- Incubation at 37 °C—if the MCHC corrects, report corrected results and comment on possible cold agglutinin
- Saline replacement: Replace plasma with same amount of Lipemia and Auto-immune antibodies—if the MCHC corrects, report corrected results and comment on Lipemia
- Check the slide for spherocytosis (e.g. in hereditary spherocytosis, among other causes)
Worked example
Measure | Units | Conventional units | Conversion |
---|---|---|---|
Hct | 40% | ||
Hb | 100 grams/liter | 10 grams/deciliter | (deci- is 10−1) |
RBC | 5E+12 cells/liter | 5E+6 cells/μL | (micro is 10−6) |
MCV = (Hct/100) / RBC | 8E-14 liters/cell | 80 femtoliters /cell
|
( femto- is 10−15)
|
MCH = Hb / RBC | 2E-11 grams/cell | 20 picograms /cell
|
( pico- is 10−12)
|
MCHC = Hb / (Hct/100) | 250 grams/liter | 25 grams/deciliter | (deci is 10−1) |
See also
References
- ^ MedlinePlus Encyclopedia: RBC indices
- ^ Blood Test Results - Normal Ranges Archived 2012-11-02 at the Wayback Machine Bloodbook.Com. Retrieved on Jan 7, 2009
- ^ MedicineNet > Definition of MCHC Archived 2011-08-06 at the Wayback Machine Last Editorial Review: 7/21/1999
- PMID 20431699.
- ISBN 978-1-84214-147-2.