From the Guidelines
Isolated low MCHC is generally not a cause for clinical concern and often doesn't require specific treatment. If you have an isolated low MCHC without other abnormal blood parameters, monitoring is typically recommended rather than immediate intervention. Low MCHC indicates a decreased concentration of hemoglobin in your red blood cells, making them appear paler (hypochromic). This can occasionally be an early sign of iron deficiency before anemia develops, but it's frequently a laboratory artifact or variation.
According to the study by the Centers for Disease Control and Prevention 1, iron-deficiency anemia usually causes greater variation in red blood cell size, which can be detected by an RDW measurement. However, this study is from 1998 and may not reflect the most recent guidelines.
In clinical practice, if your MCHC is only slightly below normal range with no symptoms or other abnormalities, your doctor will likely recommend a follow-up complete blood count in 3-6 months. However, if you have symptoms like fatigue or if other blood parameters are abnormal, further investigation may include iron studies, ferritin levels, and possibly tests for chronic disease or thalassemia. The underlying physiology involves reduced hemoglobin synthesis relative to red blood cell size, which can happen when iron availability is limited or when there are disorders affecting hemoglobin production.
Some key points to consider include:
- Low MCHC can be an early sign of iron deficiency
- It can also be a laboratory artifact or variation
- Monitoring is typically recommended rather than immediate intervention
- Further investigation may be necessary if symptoms or other abnormalities are present
- Iron studies, ferritin levels, and tests for chronic disease or thalassemia may be included in the investigation.
From the Research
Isolated Low MCHC
- Isolated low Mean Cell Hemoglobin Concentration (MCHC) is a condition where the average concentration of hemoglobin in red blood cells is lower than normal.
- According to 2, MCHC is only moderately accurate in diagnosing empty iron stores in children and young adults, and normal values of these tests do not exclude empty iron stores in anemic patients.
- The study 2 found that the area under the ROC curve for MCHC was 0.68-0.87, indicating moderate diagnostic accuracy.
- Iron deficiency anemia, which can cause low MCHC, is the most common nutritional disorder worldwide and accounts for approximately one-half of anemia cases, as stated in 3.
- The diagnosis of iron deficiency anemia is confirmed by the findings of low iron stores and a hemoglobin level two standard deviations below normal, as mentioned in 3.
- Microcytic anemia, which is often characterized by a low MCV and can be caused by iron deficiency, is defined as the presence of small, often hypochromic, red blood cells in a peripheral blood smear, as described in 4.
- There is no direct evidence in the provided studies 3, 4, 2, 5 that specifically addresses isolated low MCHC, but 2 discusses the diagnostic accuracy of MCHC in diagnosing empty iron stores. Study 5 is not relevant to the topic of isolated low MCHC.