MCHC, i.e. the average concentration of hemoglobin in the red blood cell – norms, excess, treatment

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The MCHC is an indicator of the average concentration of hemoglobin in the red blood cell. The determination of this concentration is an integral part of the routine morphological examination. We perform the MCHC examination most often in the diagnosis of anemia. What are the indications for testing the level of MCHC and what diseases may indicate abnormalities?

MCHC in morphology

Mean Corpuscular Hemoglobin Concentration (MCHC) is a parameter used in standard blood counts. It is measured next to the average red blood cell volume (MCV), the average red blood cell hemoglobin mass (MCH) and the RDW, i.e. the width of the red blood cell volume distribution. These parameters allow us to assess the functionality of red blood cells in our body, which is very important because they are responsible for the transport of oxygen.

The red pigment (hemoglobin) present in erythrocytes binds oxygen in the lungs and then delivers it to the organs of the human body. It is important that erythrocytes are produced in the bone marrow and their average survival time is about 120 days. After this time, the used cells are destroyed in the spleen, and the hemoglobin contained in them is transformed, during which the globin is broken down into amino acids.

Parameter MCHC morphology is used, among others to complete the morphological classification of anemia. For its correct calculation, it is necessary to know the amount of hematocrit and hemoglobin – for this reason, it is impossible to independently assess the average concentration of hemoglobin in the red blood cell. For example, an abnormal MCHC morphology may indicate anemia, a rare genetic disorder, fluid overload, or dehydration.

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A few words about blood counts

It is a simple and the most frequently performed blood test that plays an important role in diagnosing many ailments. Due to routine blood counts, it is possible to identify viral, bacterial or inflammatory infections. For this reason, it is recommended to have a complete blood count at least once a year. During the study, the following are analyzed:

1. trombocyty,
2. leukocytes,
3. erythrocytes.

Blood cells and platelets are tested quantitatively and qualitatively. All the necessary information is described using appropriate indicators. In the case of erythrocytes (red blood cells), it is the MCHC, as well as the already mentioned MCH, MCV or RDW. The functioning and structure of white blood cells and platelets also requires the knowledge of additional markers. Only the analysis of the complete blood count gives a complete picture of the patient’s blood condition.

See also: What are red blood cells fresh in the urine?

Indications for the assessment of the MCHC

The examination of the mean concentration of hemoglobin in the red blood cell is most often performed in the diagnosis of anemia and as part of control prophylactic examinations. They are also performed when dehydration is suspected and during monitoring of treatment with pharmacological agents that affect the circulatory system and cellular fragments in the blood. Symptoms that indicate anemia are:

1. rapid breathing,
2. weakness,
3. dizziness,
4. pale skin,
5. fainting
6. increased heart rate
7. decrease in libido,
8. menstrual disorders
9. dyspnoea,
10. numbness in the arms and legs.

Also, weight loss, fever, chills and pain in various places are indications for a blood count.

In turn, the symptoms of dehydration that arouse anxiety and are an indication for ordering the MCHC morphology are: oliguria, excessive thirst, dry mouth and tongue mucosa, dark (amber) urine, lack of appetite, bad mood, drowsiness and a bloated abdomen.

The course of the MCHC study

Material for the MCHC test: plasma.

Preparation for the MCHC study: on an empty stomach (at least 8 hours). In order to avoid a false result, avoid eating fatty meals, drinking alcohol and coffee on the day before the test. However, on the day of blood collection, excessive physical exertion and smoking are contraindicated.

The course of the study: one-time blood sampling from a vein in the arm.

Time to wait for the result: 1 Day.

MCHC standards is calculated as the quotient of the concentration of hemoglobin and hematocrit, usually given as millimoles per liter (mmo / l) or gram per deciliter (g / dl).

19,2-23,6 mmol / l (31-38 g of hemoglobin per 100 ml of blood cells) – normochromic blood cells. We define blood cells with MCHC below normal as hypochromic. When the norm is exceeded, blood cells are called hyperchromic. The test result should be compared with the standards of the laboratory where the determination was made. The results should not be assessed independently – the interpretation should be made by a physician.

Causes of high MCHC

There are several potential causes of high MCHC. It often occurs in people with conditions that make red blood cells fragile or easily damaged.

Causes of high MCHC include, but are not limited to:

1. autoimmune hemolytic anemia This is a condition where the immune system mistakenly attacks its own red blood cells. Sometimes high MCHC develops on its own, but it can also occur alongside lupus or lymphoma. This also happens when you are taking certain medications,
2. macrocytic anemia – a type of blood disorder where some red blood cells are much larger than usual. In some cases, B-12 deficiency can cause macrocytic anemia,
3. hereditary spherocytosis – a genetic mutation that makes the membranes of red blood cells fragile. This condition is usually passed on from parent to child.
4. severe burns – burns can cause haemolytic anemia and high MCHC,
5. Liver disease – the liver stores and processes hemoglobin, so people with liver disease often struggle with anemia. If their liver is damaging red blood cells, a person may have high MCHC.
6. overactive thyroid gland – problems with the thyroid gland often lead to changes in red blood cells,
7. medications – in some cases, high levels of MCHC have been found in people taking immunosuppressants or chemotherapy.

Read: Cutaneous lymphoma – what is it?

MCHC – symptoms of elevated MCHC

High MCHC is not a condition in itself, but it may indicate one of the conditions listed above. The symptoms of these conditions vary.

Symptoms of autoimmune hemolytic anemia can include:

1. tiredness,
2. jaundice
3. weakness,
4. paleness,
5. abdominal discomfort,
6. enlarged spleen,
7. fast heartbeat.

The symptoms of macrocytic anemia are similar to those of hemolytic anemia, but also include:

1. weight loss
2. loss of appetite
3. brittle hair and nails,
4. diarrhea
5. problems with concentration,
6. problems with memory.

Symptoms of a sick liver often include the usual symptoms of anemia, and:

1. nausea,
2. vomiting,
3. abdominal pain in the right upper quadrant.

People with hereditary spherocytosis may have symptoms of anemia and may also accumulate gallstones.

People with high MCHC due to hyperthyroidism may experience:

1. feelings of excessive hunger,
2. tiredness,
3. weight loss
4. palpitations,
5. anxiety,
6. weakness.

Also read: The XNUMXst Century Epidemic – Palpitations

MCHC below normal

Low average concentration of hemoglobin in the red blood cells (hypochromia) is the most common result:

1. iron deficiency (improper diet, malabsorption),
2. water and electrolyte disturbances (due to dehydration or hyperhydration causing thinning of the blood). The symptom of body fluid overload is a decrease in hemoglobin and a decrease in MCHC in the blood and other intracellular and extracellular fluids,
3. gastrointestinal bleeding
4. gastrointestinal cancer,
5. long-term use of non-steroidal anti-inflammatory drugs,
6. stomach ulcers,
7. Thalassemia, or thyroid anemia that reduces hemoglobin synthesis (symptoms of this condition include dizziness and headaches, pale skin and chest pain).

It also happens that the result of a test of mean hemoglobin concentration in the red blood cell is adulterated. It happens because:

1. you have had your period
2. the woman is pregnant (the pregnant woman’s blood is characterized by low hemoglobin concentration),
3. when the subject consumed a large amount of products containing large amounts of iron before making the test.

If any of the above-mentioned circumstances applies to you, please inform your doctor who will interpret the result of your blood count.

How to treat MCHC disorders?

MCHC disorder alone is not an indication for treatment implementation. All blood count parameters and the general condition of the patient should be taken into account. It is necessary to consult a doctor who decides about further tests and possible treatment.

Specific management of abnormal MCHC is only possible after a specific diagnosis has been made by the doctor. Autoimmune hemolytic anemia is usually treated with corticosteroids such as prednisone. Initially, a large dose is prescribed, and as treatment progresses, it is reduced. In severe cases of haemolytic anemia, doctors may recommend that the spleen be removed.

Increasing your vitamin B-12 and folate levels can also help treat people with macrocytic anemia. Dietary sources of vitamin B12 and folate include:

1. poultry,
2. eggs,
3. Red meat,
4. seafood,
5. lentils,
6. green vegetables,
7. yeast.

If a person has hereditary spherocytosis they may be ordered to:

1. Blood transfusion,
2. removal of the spleen,
3. removal of the gallbladder.

People with severe burns will require treatment in the hospital to prevent infection and shock if necessary. If severe burns cause high MCHC, doctors will likely order a blood transfusion.