From the Guidelines
These lab results indicate microcytic hypochromic anemia with iron deficiency, which can significantly impact morbidity, mortality, and quality of life if left untreated. The low MCH (Mean Corpuscular Hemoglobin) and MCHC (Mean Corpuscular Hemoglobin Concentration) values suggest that the red blood cells contain less hemoglobin than normal, and the concentration of hemoglobin in the red blood cells is reduced, respectively 1. The high Unsaturated Iron-Binding Capacity (UIBC) indicates that the body has increased capacity to bind iron but not enough iron is available, consistent with iron deficiency 1.
Key Findings
- Low MCH and MCHC values are indicative of hypochromia, which is a reliable marker of iron deficiency 1
- High UIBC suggests increased capacity to bind iron, but not enough iron is available 1
- Iron deficiency can lead to microcytic hypochromic anemia, which can cause symptoms such as fatigue, weakness, and shortness of breath
Clinical Implications
- Iron deficiency can have significant implications on morbidity, mortality, and quality of life if left untreated 1
- Treatment usually involves iron supplementation, and identifying and addressing the underlying cause of the iron deficiency 1
- Ferrous sulfate 325mg daily is a common treatment for iron deficiency, and serum ferritin levels should be monitored to assess response to treatment 1
Important Considerations
- Serum ferritin (SF) is the most specific test for iron deficiency in the absence of inflammation, and an SF level of <15 μg/L is indicative of absent iron stores 1
- An SF cut-off of 45 μg/L has been suggested as providing the optimal trade-off between sensitivity and specificity for iron deficiency in practice 1
From the Research
Significance of Low MCH and MCHC
- Low Mean Corpuscular Hemoglobin (MCH) and Mean Corpuscular Hemoglobin Concentration (MCHC) are indicative of iron deficiency anemia, as they reflect a decrease in the amount of hemoglobin present in red blood cells 2, 3.
- MCH and MCHC are important parameters in the diagnosis of iron deficiency anemia, as they can help distinguish it from other types of anemia 2.
- A study found that MCH and MCHC had high discriminating powers for iron deficiency anemia, with area under the ROC curve (AUC) values of 0.81 and 0.80, respectively 2.
Significance of High UIBC
- High Unsaturated Iron-Binding Capacity (UIBC) is also a marker of iron deficiency, as it indicates an increase in the amount of transferrin available to bind iron 4.
- UIBC is an important parameter in the diagnosis of iron deficiency, as it can help identify individuals with iron depletion or iron deficiency anemia 5, 4.
- A study found that UIBC was elevated in patients with iron deficiency anemia, and that it could be used as a diagnostic tool to identify individuals with iron deficiency 4.
Diagnostic Implications
- The combination of low MCH and MCHC, and high UIBC, can be used to diagnose iron deficiency anemia, particularly in individuals with microcytic, hypochroming anemia 2, 3, 4.
- It is essential to consider these parameters in conjunction with other laboratory tests, such as serum ferritin and transferrin saturation, to confirm the diagnosis of iron deficiency anemia 5, 3.
- A comprehensive diagnostic approach is necessary to identify individuals with iron deficiency anemia, as the condition can have significant health implications if left untreated 5, 3, 6.