MCHC stands for mean corpuscular hemoglobin concentration.
MCHC is part of the red cell indices, together with MCH and MCV. Those parameters reflect the size and hemoglobin content of red cells.
They have traditionally been used to aid in the differential diagnosis of anemia.
The mean corpuscular hemoglobin concentration (MCHC) is the average concentration of hemoglobin in red blood cells.
MCHC is the average concentration of hemoglobin in a given volume of packed red blood cells, or in other words, the ratio of hemoglobin mass to the volume of red cells.
What are red blood cells?
Red blood cells play an important role in your health by carrying fresh oxygen throughout the body.
Calculation of MCHC:
MCHC is not measured directly but is calculated from the hemoglobin (Hb) and hematocrit (Hct) concentrations:
MCHC = Hb (in g/dL)/Hct (%)
What is Hemoglobin?
Hemoglobin is the protein molecule that allows red blood cells to carry oxygen to tissues within your body.
What is Hematocrit?
A hematocrit test measures how much of your blood is made up of red blood cells. Hematocrit is the ratio of the volume of red blood cells to the total volume of blood. Your blood is made up of red blood cells, white blood cells, and platelets.
Difference between MCHC and MCH:
Although closely related, mean corpuscular hemoglobin concentration (MCHC) and mean corpuscular hemoglobin (MCH) are distinct measurements. While MCH represents the average amount of hemoglobin in a single red blood cell, MCHC reflects the hemoglobin concentration in a given unit of packed red blood cells. As with MCV and MCH, calculating the MCHC can help you assess anemia and other blood disorders.
Note on errors in hemoglobin concentration and red cell indices:
Errors can occur in automated measurements of the Hb and red cell indices. Such erroneous results are usually suspected from a markedly elevated MCV, a markedly abnormal MCHC or a discrepancy between MCHC and MCH. Such errors can be caused by poorly mixed specimen, marked elevations in lipid levels, or raised WBCs among other things.
Your MCHC can fall into low, normal, and high ranges even if your red blood cell count is normal.
- Low MCHC: Hypochromic
- Normal MCHC: Normochromic
- High MCHC: Hyperchromic
The MCHC basically tells you whether your red blood cells have more or less hemoglobin than what would be expected.
More about MCHC and anemia:
An example of a type of anemia that exhibits normochromic is pernicious anemia, which is caused by a lack of vitamin B12 in the body. An MCHC result below 32 means that the red blood cells contain less than the normal concentration of hemoglobin or are hypochromic, a condition that occurs with iron-deficiency anemia and thalassemia. Because there is a physical limit to the amount of hemoglobin that can fit into an RBC, an MCHC level above 35 is rare.
References:
Lee JM, Nadimpalli SB, Yoon JH, Mun SY, Suh I, Kim HC. Association between Mean Corpuscular Hemoglobin Concentration and Future Depressive Symptoms in Women. Tohoku J Exp Med. 2017 Mar;241(3):209-217. doi: 10.1620/tjem.241.209. PMID: 28320987.
Sarma PR. Red Cell Indices. In: Walker HK, Hall WD, Hurst JW, editors. Clinical Methods: The History, Physical, and Laboratory Examinations. 3rd edition. Boston: Butterworths; 1990. Chapter 152. Available from: https://www.ncbi.nlm.nih.gov/books/NBK260/
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When the MCHC is high, the red cells are referred to as being hyperchromic.
Possible causes of a high MCHC (which is uncommon) include:
- Autoimmune hemolytic anemia, a condition in which the body’s immune system attacks its own red blood cells.
- A type of hereditary hemolytic anemia called spherocytosis has been associated with high MCHC.
- Anemia caused by a deficiency of vitamin B12 or folic acid is also known to cause high MCHC values.
Other causes of high MCHC include:
- Alcoholism
- Certain medications, such as anticonvulsant drugs
- Hypothyroidism
- Intestinal disturbances and malabsorption issues
- Liver disease
- Malnutrition
- Megaloblastic anemia
MCHC may also be higher in pregnant women, but values usually return to normal after giving birth.
Potential treatment:
Whether hyperchromic or hypochromic, treatment is primarily focused on treating the underlying condition. Iron supplementation and the increased dietary of intake of iron can help treat iron deficiency anemia, but an iron supplement is not recommended for people who are not iron deficient (excess iron can be stored in the liver and heart). Blood transfusions or bone stem cell transplants may be used in more severe cases.
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When the MCHC is low, the cells are referred to as being hypochromic.
Possible causes include iron deficiency anemia (low Ferritin and high Transferrin). Any number of conditions can cause iron deficiency anemia, including pregnancy, blood loss, poor iron absorption in the gut (caused, for example, with Celiac disease or Crohn's disease), and poor nutritional intake of iron.
Low values can also be associated with:
- Acute or chronic bleeding due to menstruation, physical trauma, surgery, or ulcers, for example.
- Cancer
- Decreased oxygen availability
- Deficiency in copper or vitamin B6 (pyridoxine)
- Hemolytic anemia
- Kidney failure
- Lead poisoning
- Removal of the spleen (splenectomy)
- Rheumatoid arthritis
- Sickle cell anemia
- Thalassemia
Potential symptoms:
A slightly low MCHC does not always produce noticeable symptoms and may not always be a sign of illness. Some people are unaware that they have low hemoglobin until they have a routine blood screening.
Hemoglobin is responsible for the red color in blood and for circulating oxygen around the body. The lack of oxygen caused by a low hemoglobin concentration may cause fatigue and other anemia symptoms.
Low MCHC is not always a cause for concern. Your doctor will evaluate all of your CBC test results in order to make a clear determination about what is causing your abnormal value.
Women with low MCHC have a greater risk of developing symptoms of depression, and it might be a better predictor than low hemoglobin.
Potential treatment:
Whether hyperchromic or hypochromic, treatment is primarily focused on treating the underlying condition. Iron supplementation and the increased dietary of intake of iron can help treat iron deficiency anemia, but an iron supplement is not recommended for people who are not iron deficient (excess iron can be stored in the liver and heart). Blood transfusions or bone stem cell transplants may be used in more severe cases.
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Haemoglobin (g/L), Hematocrit (Female range), Hematocrit (HCT) / Packed Cell Volume (PCV), Hemoglobin, Hemoglobin (Female range), Mean Cell Volume, Mean Corpuscular Hemoglobin (MCH), Mean Corpuscular Hemoglobin Concentration (MCHC), Mean Corpuscular Volume (MCV), Mean Platelet Volume (MPV), Platelet count / Platelets, Platelet Distribution Width (PDW), Platelet-large cell ratio (P-LCR), RBC (Female range), RDW-CV (Red Cell Distribution Width) in %, RDW-SD (Red Cell Distribution Width) in fL, Red Blood Cells (Erythrocytes / RBC), White blood cells (Leukocytes / WBC)
