CBC Biomarkers: Mean Corpuscular Hemoglobin (MCH)

Optimal Takeaways

Mean corpuscular hemoglobin (MCH) reflects the amount of hemoglobin found in a red blood cell. Larger, macrocytic RBCs will have more hemoglobin, and smaller, microcytic cells will have less. Evaluation of MCH assists in categorizing anemias and RBC-related disorders.

Standard Range: 27 - 33 pg

The ODX Range: 28 - 31.9 pg

Low MCH is associated with microcytic, hypochromic anemia, and thalassemia (Pagana 2019, Pranpanus 2009).

High MCH is associated with macrocytic anemia and hemochromatosis (Pagana 2019, Baron 2000).

Overview

The mean corpuscular hemoglobin reflects the average amount, by weight, of hemoglobin found in a red blood cell. Higher amounts will be found in macrocytic cells and lower amounts in microcytic cells. The MCH, along with the MCV, can help determine which type of anemia may be present (Pagana 2019).

There may be additional reasons for a low MCH. Evaluation of MCH, along with MCV and RDW can help screen for thalassemia, a genetic disorder resulting in low production of hemoglobin and dysfunctional RBCs. A diagnostic cut-off for MCH of less than 27 pg, along with MCV of less than 82 fL and an RDW greater than 15.15% suggests the presence of thalassemia (Song 2021).

On the other hand, an MCH of 34 pg or higher in men or 33 pg or higher in women can be associated with hemochromatosis, a genetic form of iron overload (Barton 2000).

References

Barton, J C et al. “Screening for hemochromatosis in routine medical care: an evaluation of mean corpuscular volume and mean corpuscular hemoglobin.” Genetic testing vol. 4,2 (2000): 103-10. doi:10.1089/10906570050114786

Pagana, Kathleen Deska; Pagana, Timothy J.; Pagana, Theresa N. Mosby's Diagnostic and Laboratory Test Reference. Elsevier Health Sciences. 2019.

Pranpanus, Savitree et al. “Sensitivity and specificity of mean corpuscular hemoglobin (MCH): for screening alpha-thalassemia-1 trait and beta-thalassemia trait.” Journal of the Medical Association of Thailand = Chotmaihet thangphaet vol. 92,6 (2009): 739-43.

Song, Qi-Ling et al. Zhongguo shi yan xue ye xue za zhi vol. 29,3 (2021): 847-852. doi:10.19746/j.cnki.issn.1009-2137.2021.03.030