Red blood cell (RBC) indices are calculations derived from the complete blood count that aid in the diagnosis and classification of anemia.
Red blood cell indices help classify types of anemia, a decrease in the oxygen carrying capacity of the blood. Healthy people have an adequate number of correctly sized red blood cells containing enough hemoglobin to carry sufficient oxygen to all the body's tissues. Anemia is diagnosed when either the hemoglobin or hematocrit of a blood sample is too low.
Measurements needed to calculate RBC indices are the red blood cell count, hemoglobin, and hematocrit. The hematocrit is the percentage of blood by volume that is occupied by the red cells. The three main RBC indices are:
The mechanisms by which anemia occurs will alter the RBC indices in a predictable manner. Therefore, the RBC indices permit the physician to narrow down the possible causes of an anemia. The MCV is an index of the size of the RBCs. When the MCV is below normal, the RBCs will be smaller than normal and are described as microcytic. When the MCV is elevated, the RBCs will be larger than normal and are termed macrocytic. RBCs of normal size are termed normocytic.
Failure to produce hemoglobin results in smaller than normal cells. This occurs in many diseases, including iron deficiency anemia, thalassemia (an inherited disease in which globin chain production is deficient), and anemias associated with chronic infection or disease. Macrocytic cells occur when division of RBC precursor cells in the bone marrow is impaired. The most common causes of macrocytic anemia are vitamin B 12 deficiency, folate deficiency, and liver disease. Normocytic anemia may be caused by decreased production (e.g., malignancy and other causes of bone marrow failure), increased destruction (hemolytic anemia), or blood loss. The RBC count is low, but the size and amount of hemoglobin in the cells are normal.
A low MCH indicates that cells have too little hemoglobin. This is caused by deficient hemoglobin production. Such cells will be pale when examined under the microscope and are termed hypochromic. Iron deficiency is the most common cause of a hypochromic anemia. The MCH is usually elevated in macrocytic anemias associated with vitamin B 12 and folate deficiency.
The MCHC is the ratio of hemoglobin mass in the RBC to cell volume. Cells with too little hemoglobin are lighter in color and have a low MCHC. The MCHC is low in microcytic, hypochromic anemias such as iron deficiency, but is usually normal in macrocytic anemias. The MCHC is elevated in hereditary spherocytosis, a condition with decreased RBC survival caused by a structural protein defect in the RBC membrane.
Cell indices are usually calculated from tests performed on an automated electronic cell counter. However, these counters measure the MCV, which is directly proportional to the voltage pulse produced as each cell passes through the counting aperture. Electronic cell counters calculate the MCH, MCHC, hematocrit, and an additional parameter called the red cell distribution width (RDW).
The RDW is a measure of the variance in red blood cell size. It is calculated by dividing the standard deviation (a measure of variation) of RBC volume by the MCV and multiplying by 100. A large RDW indicates abnormal variation in cell size, termed anisocytosis. The RDW aids in differentiating anemias that have similar indices. For example, thalassemia minor and iron deficiency anemia are both microcytic and hypochromic anemias, and overlap in MCV and MCH. However, iron deficiency anemia has an abnormally wide RDW, but thalassemia minor does not.
RBC indices require 3–5 mL of blood collected by vein puncture with a needle. A nurse or phlebotomist usually collects the sample.
Discomfort or bruising may occur at the puncture site. Pressure to the puncture site until the bleeding stops reduces bruising; warm packs relieve discomfort. Some people feel dizzy or faint after blood has been drawn and should be allowed to lie down and relax until they are stable.
Other than potential bruising at the puncture site, and/or dizziness, there are no complications associated with this test. However, certain prescription medications may affect the test results. These drugs include zidovudine (Retrovir), phenytoin (Dilantin), and azathioprine (Imuran). When the hematocrit is determined by centrifugation, the MCV and MCHC may differ from those derived by an electronic cell counter, especially in anemia. Plasma trapped between the RBCs tends to cause an increase in the hematocrit, giving rise to a somewhat higher MCV and lower MCHC.
Normal results for red blood cell indices are as follows:
Chernecky, Cynthia C., and Barbara J. Berger. Laboratory Tests and Diagnostic Procedures. 3rd edition. Philadelphia: W. B. Saunders Company, 2001.
Henry, J.B. Clinical Diagnosis and Management by Laboratory Methods. 20th ed. Philadelphia: W. B. Saunders Company, 2001.
Kee, Joyce LeFever. Handbook of Laboratory and Diagnostic Tests. 4th edition. Upper Saddle River, NJ: Prentice Hall, 2001.
Wallach, Jacques. Interpretation of Diagnostic Tests. 7th edition. Philadelphia: Lippincott Williams & Wilkens, 2000.
National Institutes of Health. [cited April 5, 2003]. http://www.nlm.nih.gov/medlineplus/encyclopedia.html .
Victoria E. DeMoranville Robert Harr Mark A. Best
is it possible for someone to have a small size RBC and not be anemic?..what can be other causes of low size RBC?...
HB 8.4, RBC 4.22, Haematocrit 0.322, MCV 76.2, MCH 20.3, MCHC 26.7, RDW 16.3, Platelet count 145
Any advice would be really appreciated - thank you
320.3 - mchc blood count low 326.5 - 356.0
76.7 - mcv blood test is low 80.7 - 95.5
24.56 - mch blood test low 27.20 - 33.50
Is it fine or something wrong...
Thanks
320.3 - mchc blood count low 326.5 - 356.0
76.7 - mcv blood test is low 80.7 - 95.5
24.56 - mch blood test low 27.20 - 33.50
Is it fine or something wrong...
Thanks
mchc -30.8
mcv - 77
mch - 23.7
pcv - 45.6
haemoblobin - 14
Platelet - 169000
Please let me know if anything is wrong.
MY DAD IS INTENSIVE CARE BECAUSE HE HAS BEEN SICK. THEY SAY HIS RED CELLS ARE 7.9 (SEVERE). THEY PUT RED BLOOD INTO HIM AND IT DISAPPEARED. THEY CAN NOT FIGURE OUT WHERE IT WENT. HE HAS BEEN NOT EATING, PALE, AND SLEEPS ALOT BEFORE GOING INTO HOSPITAL. HE NOW HAS A BREATHING TUBE BECAUSE HIS HEART WAS RACING SO BAD. THEY WANT TO DO A COLONOSCOPY AND ENDOSCOPIC BUT HAVE TO WAIT TILL HE CAN UNDER ANESTHIA. THEY HAVE HIM HEAVILY SEDATED BECAUSE OF BREATHING TUBE. DO YOU KNOW WHERE THE BLOOD WOULD GO. IF IT WAS LIKE LEUKIMIA IT WOULD HAVE SHOW UP ON BLOOD TEST. WOULD IT? PLEASE HELP ME IF YOU COULD.
THANKS VERY MUCH
VIRGINIA LAAG
12/29/101/7/11 1/14/11 1/20/11 1/21/11 2/10/11 2/17/11 3/18/11 4/8/11
RBC 3.07 3.3 3.02 3.19 2.81 3.54 3.85 3.84 4.02
HGB 9.6 10.1 9.4 10.5 8.6 11.6 11.7 11.8 12.3
HCT 30.5 32.3 29.5 30.6 27.3 35 37 36.1 37.2
MCV 99.4 98 97.6 96 97.1 99 96.2 94.1 92.5
MCH 31.3 30.6 31.1 32.9 30.6 32.7 30.4 30.7 30.6
MCHC 31.5 31.3 31.9 34.4 31.5 33.1 31.6 32.7 33.1
RDW 14.9 14.1 14.7 13.1 13.9 15.2 14.5 14.8 14.7
PLT 433 430 413 519 427 335 369 389 349
_MPV 8.3 8.5 8.8 8.6 15.2 9.2 8.7 9
FERRTN 59 84.7 75 38 27
Can you give me an indication of what they are looking for ?.
Best regards John H
total RBC - 4.44 10e6/uL
mchc -35.5 g/dl
mcv - 98.7 fl
mch -35 pg
RDW- 10.8%
haemoblobin - 15.5 g/dl
Platelet - 197 10e3/uL
MPV-6.28 fl
please notify me if there's any thoughts you have regarding my case.ty so much.
indicate the treatment to improve it.
Thank you,
years ago I had a blood test for folic acid and B12.Results: folic and B12 above normal requirements.
I would like to solve the puzzle of why MCH are high. All other results are normal and so docs aren't interested.
Supplement I take daily: SAMe,and a combination supplement of B6. B12 and folic.
In the film Anisopiokiolocytosis (+)giant PLT (++) Acanthocyte(+) Burrcell (+)Fragmented (+)
the patient has the surgery progrss what is the diagnosis and what futher test should be done and what is the most prominent Feature and what is the most Probable Disorder. Thank you very much.
Hemoglobin 11
Haematocrit. Pcv. 36.7
Rbcs 4.73
Mcv 77
Mch. 25
Mchc 33.2
Rdw-cv 15.8
Platelet count 412
Total leucocytic count 10.9
Neutrophils. 64
Lymphocytes 29
Monocytes 5.3
Eosinophils. 0.5
Basophils 0.5
Erythrocyte sedimentation rate
First hour. 16
Second hour 38
And the comment
Rbcs show hypochromia , microcytosis and anisocytosis
What this mean is it bad test
so is it ok for my body if not than what i have to do.
Haemoglobin 13.0
Red cell count 6.0
Total white cell count 7.3
Neutrophils 63.15%
Lymphocytes 24.93%
Monocytes 9.31%
Eosinophils 2.88%
Basophils 0.27%
Haematocrit 0.42
MCV 69
MCH 22
MCHC 31
Platelets 324
My doctor suggest i go for thalassarmia trait test.
Please advise
RBC 4.56
HGB 14.8
HCT 43.7
MCV 95.8
MCH 32.5
MCHC 33.9
PLT 202
RDW-SD 42.2
RDW-CV 12.4
MPV 10.1
NEUT 3.19
LYMPH 2.22
MONO .45
EO .06
BASO .01
MCH 23.9L
MCHC 30.4L
NEUTROPHILS 38L
LYMPS 53H
NEUTROPHILIS ABSOLUTE 1.7L
MY JOINTS ACHE COULD IT BE LINKED TO MY FASTING TEST RESULT AND ANY RECOMODATIONS or SUPPLEMENTS TO USE.
THANK YOU
RBC:4.02
PCV:0.35
MCH:32.3
MCHC:36.7
Lymphocytes: 45
what is the this.
MCHC 30.7 low
Lymphs 49 high
Phosphorus, serum 4.7 high
& MCV 33.9 ??
I also have factor v Leidon disorder , & I'm having problems with my lypmh nodes at present & I do not drink alcohol. Can anyone shed any light on this please.
Many thanks.
Thankyou
Hematocrit 33.2
Mcv 72.7
Mch 22.3
Mchc 30.7
Rdw 15.7
Can anyone tell me what this mean
Hb:8 gm/dl
Platelet:583000 / cumm
MCV: 64 fl
MCH : 17 pg
MCHC : 27%
Haemoblobin is 12.7,
PVC is 39.6,
MCV 86.8,
MCH 27.9,
MCHC is 32.1,
RDW is 15.3
the RDW is high, is that a problem?
can someone tell me what's going on?
RBC =6.19
MCV=74.8
MCH=24.2
RDW=15.5
WBC 9.4
RBC 4.28
HGB 14.1
HCT 41.1
MCV 96.1
MCH 33.1
MCHC 34.4
RDW 13.1
Platelets 321
WBC 2.82
RBC 3.62
Hemoglobin 11.5
Hematocrit 35
MCV 96.7
Basophils 1.4
Absolute Neutrophils 1.38
Could you please give me some possibilities of what could cause thus? Thank you
My CBC report is as under:
HB is 11.8 (low);
ESR - 14 (high);
MCHC - 29.6 (low);
MCH - 25.7 (low)
Are there any complications? What do I do to bring my report to normal? Please suggest.
Hb =10.8
Trbc=32.0
Monocytes =01
my age is 22 year I want to knw wat is this actually can u plz tell is there any complicated
RBC: 5.50
MCV: 72
MCH: 25.3
RDW: 14.3
Should i be worried about my next pediatrician visit?? And does this indicate anything life threating
How serious is my iron deficiency if CBC show the ff:
RBC 6.04
RDW 15.1
MCV 73.1
MCH 24.5
??
MCH - 33.0
Red Cell distribution with SD ( RDW ) 38.96
Lymphocytes - 45.7
PCT 0.16%
MPV - 7.7