From the Guidelines
Low MCV, MCH, and MCHC values in a CBC are indicative of microcytic hypochromic anemia, with iron deficiency being the most common cause, as supported by the study published in the Journal of the National Comprehensive Cancer Network in 2012 1.
Key Points to Consider
- MCV measures the average size of red blood cells, with low values (< 80 fL) indicating microcytic anemia, which can be caused by iron deficiency, thalassemia, anemia of chronic disease, or sideroblastic anemia 1.
- MCH and MCHC values provide additional information about the amount and concentration of hemoglobin in red blood cells, respectively.
- Iron deficiency anemia is often due to poor dietary intake, blood loss, or malabsorption issues, and treatment typically involves iron supplementation and addressing the underlying cause.
Diagnostic Approach
- A comprehensive evaluation of anemia often uses both morphologic and kinetic approaches, with the morphologic approach characterizing anemia based on MCV, and the kinetic approach focusing on the underlying mechanism of anemia, including production, destruction, and loss of red blood cells 1.
- Additional tests, such as serum iron, ferritin, and total iron binding capacity, may be needed to confirm the specific type of anemia and guide appropriate treatment.
Treatment and Management
- Patients with low MCV, MCH, and MCHC values should consult their healthcare provider for proper diagnosis and treatment, which may involve iron supplementation and addressing the underlying cause of the anemia.
- It is essential to identify and treat any underlying conditions that may be contributing to the anemia, such as chronic disease, kidney disease, or inherited anemia, as discussed in the study 1.
From the Research
Low MCV, MCH, and MCHC in CBC
- Low MCV (Mean Corpuscular Volume) indicates that the red blood cells are smaller than normal, which can be a sign of microcytic anemia 2, 3, 4.
- Low MCH (Mean Corpuscular Hemoglobin) and MCHC (Mean Corpuscular Hemoglobin Concentration) also suggest microcytic anemia, as they indicate that the red blood cells have less hemoglobin than normal 2, 3, 4.
- The most common cause of microcytic anemia is iron deficiency anemia, which can be diagnosed by low serum ferritin levels 3, 4, 5, 6.
- Other causes of microcytic anemia include thalassemia, anemia of chronic disease, lead toxicity, and sideroblastic anemia 2, 3, 4, 5.
- Serum ferritin measurement is the first laboratory test recommended in the evaluation of microcytosis, and low ferritin levels suggest iron deficiency 4, 6.
- Further evaluation may include total iron-binding capacity, transferrin saturation level, serum iron level, and possibly hemoglobin electrophoresis to differentiate between different types of microcytic anemia 3, 4, 5.