Sunday, June 14, 2015

Mean Corpuscular Hemoglobin Concentration

Mean Corpuscular Hemoglobin Concentration Mean Corpuscular Hemoglobin Concentration (MCHC) is a measure of the average average concentration or percentage of hemoglobin within a single RBC. Mean Corpuscular Hemoglobin Concentration is calculated from the results of both Hemoglobin test and Hematocrit test. MCHC calculation provide more helpful information about hemoglobin production than what Mean Corpuscular Hemoglobin (MCH) can provide. By knowing the hemoglobin concentration of a Red Blood Cell, it will be possible classify anemia, diagnose its type, and have a better idea of its causes even better than using MCH. Using Mean Corpuscular Hemoglobin, It is possible to identify cases of Hyperchromic Red Blood Cells. Hyperchomic Red Blood Cells look darker than normal under the microscope in Red Blood Cell Morphology study.



Mean Corpuscular Hemoglobin Concentration is one of the Red Blood Cells Indices. To have a better classification of anemia, MCHC is used with other RBC Indices (e.g. Mean Corpuscular Volume). The calculation of Mean Corpuscular Hemoglobin Concentration is also ordered routinely as a part of Complete Blood Cell Count.



MCHC is derived by dividing the patient’s Hemoglobin Level (measured in g/dL) by his or her Hematocrit Level and multiplying the result by 10. The final result will be the average Red Blood Cell Hemoglobin Concentration. For example a patient who has a Hemoglobin level of 16g/dL and a 40% Hematocrit Level his or her MCHC will eaual (16/40) x 100 g/dL or 40 g/dL.



When MCHC values are decreased, the cell has a deficiency of hemoglobin and is said to be hypochromic (frequently seen in iron-deficiency anemia and thalassemia). When values are normal, the anemia is said to be normochromic (e.g., hemolytic anemia). RBCs cannot be considered hyperchromic. Only 37 g/dL of hemoglobin can fit into the RBC.





Causes of False Mean Corpuscular Hemoglobin Concentration Calculation




  • Cell counting machines can wrongfully indicate high Hemoglobin Levels if the patient has High Lipid Levels in blood. These wrong high hemoglobin levels will lead to false calculations of MCHC.

  • Alteration in RBC shape (spherocytosis, acute transfusion reactions, erythroblastosis fetalis) may cause automated counting machines to indicate MCHC levels above normal.








Normal Mean Corpuscular Hemoglobin Concentration


Since newborns normally have larger Red Blood Cells than children and adults. In other words, their Hematocrit Levels are normally higher than children and adults which reduces their MCHC due to the division by Hematocrit level . The following are the Normal MCHC for newborns and adults:



Newborn: 32 to 33 g/dL.



Child or Adult: 32 to 36 g/dL.





Causes of High Mean Corpuscular Hemoglobin Concentration


High Mean Corpuscular Hemoglobin Concentration indicates that Red Blood Cells would look darker or more red under the microscope. The Red Blood Cells will be called Hyperchromic when they look darker than normal. Hyperchomic Red Blood Cells are found in healthy people who live in high altitudes. Dehydration also increases Hemoglobin concentration which leads to Hyperchomic RBCs. Other causes of High Hemoglobin Levels will lead to Hyperchromic Red Blood Cells and High MCHC as well.






Causes of Low Mean Corpuscular Hemoglobin Concentration


Iron-deficiency Anemia and Thalassemia are the most common causes of hypochromatism. Thalassemia minor (heterozygous) may not be clinically evident except by measurement of RBC count, MCV, and MCHC.

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