From the Research
An isolated high Mean Corpuscular Hemoglobin Concentration (MCHC) is usually a laboratory artifact rather than a true medical condition requiring treatment. No specific medication or intervention is typically needed. The most common causes are hemolyzed blood samples (where red blood cells rupture during collection or processing), lipemia (excess fat in the blood), or certain conditions like hereditary spherocytosis 1. If your MCHC is elevated but other blood parameters are normal, your doctor will likely recommend repeating the test to confirm the finding. True elevations in MCHC are rare because there's a physical limit to how much hemoglobin can fit inside a red blood cell. Some studies suggest that hereditary spherocytosis can be diagnosed using specific parameters such as the percentage of microcytes, percentage of hypochromic cells, reticulocyte counts, and percentage of immature reticulocytes 2, or mean reticulocyte volume (MRV) 3. However, the most recent and highest quality study on the topic of hereditary spherocytosis diagnosis recommends the use of flow cytometry as a screening test using the eosin-5'-maleimide (EMA) binding test 4. If the high MCHC persists on repeat testing, your doctor may order additional tests like a peripheral blood smear to examine red cell morphology. This helps distinguish between laboratory error and true pathology. Hereditary spherocytosis, a genetic condition causing abnormally shaped red blood cells, is one of the few conditions that can cause a genuinely elevated MCHC and may require further evaluation if suspected. Key points to consider in the evaluation of isolated high MCHC include:
- Repeating the test to confirm the finding
- Examining red cell morphology using a peripheral blood smear
- Considering hereditary spherocytosis as a potential cause if the high MCHC persists
- Using flow cytometry with the EMA binding test as a screening tool for hereditary spherocytosis 4.