CBC Biomarkers: Mean Corpuscular Hemoglobin Concentration (MCHC)

Optimal Takeaways

Mean corpuscular hemoglobin concentration is a calculation of the average hemoglobin in a red blood cell. Low levels are associated with dysfunction, while high levels are often falsely elevated due to extraneous factors.

Standard Range: 32 - 36 g/dL

The ODX Range: 34 - 36 g/dL   

Low MCHC is associated with hypochromic cells, iron-deficiency anemia, and thalassemia (Pagana 2021). Low levels may also be associated with inflammation, cardiac risk, poorer post-MI outcomes (Huang 2016), and depressive symptoms, especially in women (Lee 2017).

High MCHC occurs with hemolysis, spherocytosis (altered RBC shape), and cold agglutination, though these may be falsely elevated values (Pagana 2021). A higher MCHC may also be seen with dehydration, especially intracellular dehydration, RBC disorders including sickle cell anemia, and certain medications including chemotherapy and immunosuppressive drugs (Berda 2017).

Overview

The mean corpuscular hemoglobin concentration (MCHC) measures the average concentration of hemoglobin found in a red blood cell. The maximum amount of hemoglobin that can fit into a red blood cell is 37 grams per deciliter. When higher levels are detected, it is often due to hemolysis, cold agglutination, or an alteration in the shape of size of a red blood cell. A low MCHC is usually associated with insufficiency of hemoglobin and hypochromic anemias, including thalassemia and iron deficiency anemia (Pagana 2021).

A cross-sectional study in men aged 40-77 found that an MCHC below 32.1 g/dL was associated with a diagnosis of anemia (Khan 2013). Some researchers suggest that a low MCHC may reflect inflammation and may be a prognostic marker following acute myocardial infarction (Huang 2016). One large cohort study of 29,526 coronary angiography patients found that the lowest mortality was associated with an MCHC above 34.6 g/dL (Anderson 2007).

References

Berda-Haddad, Y et al. “Increased mean corpuscular haemoglobin concentration: artefact or pathological condition?.” International journal of laboratory hematology vol. 39,1 (2017): 32-41. doi:10.1111/ijlh.12565

Huang, Yuan-Lan, and Zhi-De Hu. “Lower mean corpuscular hemoglobin concentration is associated with poorer outcomes in intensive care unit admitted patients with acute myocardial infarction.” Annals of translational medicine vol. 4,10 (2016): 190. doi:10.21037/atm.2016.03.42

Khan, Zahra, et al. "Hemoglobin, red blood cell count, hematocrit and derived parameters for diagnosing anemia in elderly males." Proceedings of the Pakistan Academy of sciences 50.3 (2013): 217-226.    

Lee, Ju-Mi et al. “Association between Mean Corpuscular Hemoglobin Concentration and Future Depressive Symptoms in Women.” The Tohoku journal of experimental medicine vol. 241,3 (2017): 209-217. doi:10.1620/tjem.241.209

Pagana, Kathleen Deska, et al. Mosby's Diagnostic and Laboratory Test Reference. 15th ed., Mosby, 2021.