MCHC

MCHC is the mean corpuscular hemoglobin concentration or the amount of hemoglobin contained in a red blood cell, relative to the volume of the cell. In other words, it’s a measure of hemoglobin’s concentration in a single RBC. MCHC blood test helps to make the diagnosis of certain blood conditions, including anemia, liver and thyroid disease.

When is an MCHC blood test ordered?

This investigation is part of complete blood count (CBC) panel. This investigation may be ordered as part of the general physical examination, or on presentation of suspicious symptoms, to monitor a condition after diagnosis or to check how effective a drug or treatment is. A number of diseases can be screened through a complete blood count alone.

MCHC normal range

The normal range of mean corpuscular hemoglobin concentration is between 31-37 grams per deciliter (g/dL). The values may increase or decrease depending on certain health conditions.

What causes high MCHC?

The causes of high MCHC are:

• Macrocytic anemia: in this type of anemia, the size of the red blood cells (RBCs) is bigger than normal due to deficiency of certain nutrients—including vitamin B9 and vitamin B12.
• Autoimmune hemolytic anemia: this autoimmune condition is characterized by hemolysis secondary to antibodies that attack the RBCs. This condition can develop on its own or be part of another autoimmune disorder such as lymphoma or systemic lupus erythematosus (SLE). Rarely, this can be due to certain medications like penicillin.
• Liver disease: hemoglobin is processed by the liver and any form of liver disease, therefore, impacts the hemoglobin concentration. In case of liver disease, there can be anemia and high MCHC.
• Hereditary spherocytosis: this is a genetic disease involving the RBCs, whereby the cell membrane of the RBCs is fragile and can break easily. The condition can vary in severity, with mild forms getting better with diet rich in folic acid, and the severe forms needing transfusion of blood or even splenectomy. If the condition causes gall stones, then cholecystectomy—removal of the gall bladder—may be needed, as well.
• Certain medications: drugs like immunosuppressants or chemotherapeutic agents MCHC is often raised.
• Hyperthyroidism: these metabolic hormones can affect the RBCs and thus the MCHC.
• Severe burns: in case of burns covering more than 10 percent of the body, there is hemolytic anemia; this causes raised MCHC.

What are the symptoms of high MCHC?

Conditions like hemolytic anemia present with:

• Fainting spells
• Fatigue and pallor
• Jaundice
• Fever
• Abdominal pain
• Enlarged spleen
• Chest pain

Conditions like hereditary spherocytosis presents with:

• Gallstones
• Jaundice
• Anemia
• Enlarged spleen

Presentation of macrocytic anemia is similar to hemolytic anemia, as well as:

• Diarrhea
• Appetite loss and weight loss
• Memory problems
• Brittleness of nails and hair
• Difficulty in concentrating

Hyperthyroidism symptoms include:

• Restlessness
• Sweating
• Palpitations and tachycardia
• Fatigue and weight loss
• Excessive hunger

What causes low MCHC?

Conditions that cause low MCHC include:

• Microcytic anemia: in this type of anemia, the RBCs are smaller than normal, commonly due to iron deficiency.
• Blood loss: such as menorrhagia or peptic ulcer disease can result in persistent blood loss over time that can lead to anemia.
• Hemolysis: can occur due to premature destruction of the normal RBCs and result in anemia.
• Rare conditions: rarely, the MCHC can be low due to conditions like:
• Certain cancers—especially that cause blood loss over time
• Lead poisoning
• Hookworm infestation

What are the symptoms of low MCHC?

Low MCHC presents with:

• Weakness
• Loss of stamina
• Chronic fatigue and tiredness
• Pallor of skin
• Dizziness
• Bruising with little trauma

What are the treatment options?

In case of high MCHC, the condition is improved by treating the underlying cause. Corticosteroids can be used to treat hemolytic anemic disorders, while improved diet with vitamin B9 and B12 can improve the macrocytic anemia. Improvement of liver disease may need lifestyle modification, or surgery if need be. Hyperthyroidism can be treated medically or surgically.

In case of low MCHC, the condition can be improved by intake of iron rich foods including spinach, peas, red meat, seafood and beans. If iron deficiency is not the cause of low MCHC, then complete workup must be done to diagnose the cause especially if it is causing chronic blood loss.