What test would you order to request MCV (Mean Corpuscular Volume) and MCHC (Mean Corpuscular Hemoglobin Concentration) values?

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Complete Blood Count (CBC) Test for MCV, MCHC, and Other Red Blood Cell Indices

To request MCV, MCHC, and other red blood cell indices, you should order a Complete Blood Count (CBC) test. 1 This is the standard laboratory test that provides these parameters along with other important hematologic measurements.

What a CBC Test Includes

A CBC test provides comprehensive information about blood cells, including:

  • Red Blood Cell (RBC) Count: Number of red blood cells per volume of blood

  • Hemoglobin (Hb): Oxygen-carrying protein in red blood cells

  • Hematocrit (Hct): Percentage of blood volume occupied by red blood cells

  • Red Blood Cell Indices:

    • Mean Corpuscular Volume (MCV): Average size of red blood cells
    • Mean Corpuscular Hemoglobin (MCH): Average amount of hemoglobin per red blood cell
    • Mean Corpuscular Hemoglobin Concentration (MCHC): Average concentration of hemoglobin in a given volume of red blood cells
    • Red Blood Cell Distribution Width (RDW): Measure of variation in red blood cell size
  • White Blood Cell (WBC) Count: Total number of white blood cells

  • Platelet Count: Number of platelets per volume of blood

Clinical Utility of Red Blood Cell Indices

The red blood cell indices (MCV, MCH, MCHC) are particularly useful for:

  • Classifying anemias: These parameters help distinguish between different types of anemia 1
  • Diagnosing iron deficiency: Low MCV, MCH, and MCHC values may indicate iron deficiency anemia 2
  • Identifying thalassemias: Very low MCV (<70 fl) with normal RDW is suggestive of thalassemia trait 1
  • Detecting chronic disease: Normal/low MCV with normal/elevated ferritin may indicate anemia of chronic disease 1

Diagnostic Accuracy of Red Blood Cell Indices

The diagnostic accuracy of these parameters varies:

  • For iron deficiency anemia, studies show moderate diagnostic accuracy with areas under the ROC curve of:

    • 0.71 for hemoglobin
    • 0.67 for MCH
    • 0.71 for MCHC
    • 0.73 for RDW 2
  • These parameters are more accurate in diagnosing iron deficiency anemia than iron deficiency without anemia 3

When to Order a CBC

A CBC should be ordered:

  • As part of routine health assessment
  • When evaluating symptoms of anemia (fatigue, pallor, shortness of breath)
  • When monitoring known hematologic disorders
  • At least annually in patients with chronic kidney disease 1
  • More frequently (every 3-6 months) in patients with unstable clinical course or evidence of previous hemoglobin decline 1

Interpretation Considerations

When interpreting CBC results, be aware that:

  • Normal values of MCV, MCH, and MCHC do not exclude iron deficiency in anemic patients 3
  • Additional testing (serum ferritin, transferrin saturation) may be needed to confirm iron deficiency 1
  • The diagnostic accuracy of these parameters may vary by age and clinical context 3

In summary, when you need to assess MCV, MCHC, and other red blood cell parameters, ordering a Complete Blood Count (CBC) is the appropriate laboratory test to request.

References

Guideline

Diagnosis and Management of Anemia

Praxis Medical Insights: Practical Summaries of Clinical Guidelines, 2025

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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