Erythrocyte parameters

Meaning of the abbreviations

MCH = mean corpuscular hemoglobin (mean corpuscular hemoglobin)

MCV = mean corpuscular volume (mean cell volume)

MCHC = mean corpuscular hemoglobin concentration (mean corpuscular hemoglobin concentration)

RDW = Erythrocyte distribution width (red cell distribution width)

introduction

All these abbreviated parameters are used to determine the red blood count, i.e. the red blood cells (Erythrocytes) to be described in more detail.

You come across one in particular Anemia (anemia) is important, since a change in values ​​in one direction and a certain combination of changed values ​​can at least provide an indication of the cause of the anemia.

In anemia, the body has too few red blood cells. These are essential for the Oxygen transport in the body and ensure that all organs and parts of the body are adequately supplied with O2, which is essential for survival.

The oxygen is from hemoglobin bound. Hemoglobin is known as a red pigment and is contained in many red blood cells.
Is used for the body's own production of hemoglobin iron necessary.

Anemia typically shows up as one reduced hemoglobin level or one decreased hematocrit value.

The hematocrit shows the cellular proportion of blood volume and thus mainly gives an indication of the Red blood cell count.
A normal hematocrit value is found in men 40-54% and in women between 37 and 47%.

A normal hemoglobin value is found in men 14-18 g / dl, in women between 12 and 16 g / dl.

MCV

MCV describes that average volume of a red blood cell.
It is calculated from Hematocrit / number of red blood cells and has a standard value of 78-94 fl.

An elevated MCV often goes with one in the same direction increased MCH hand in hand.

So the volume of red blood cells is increased because their hemoglobin content has increased. One speaks of one macrocytic (enlarged cells), hyperchrome (intensifies stained cells) anemia or from one megaloblastic anemia.
This gives an indication of a deficiency Vitamin B12 or folic acid.

Furthermore, a determination of the vitamin level can be carried out and help with the diagnosis.

An isolated elevated MCV value can also indicate a chronic alcohol abuse be.
Often, other abnormal blood values ​​such as the one show up in the laboratory Gamma GT, an enzyme of liver.

However, this is the most specific laboratory parameter with regard to chronic alcohol abuse CDT (Carbohydrate-deficient transferrin).

A lowered MCV most often goes with one also lowered MCH hand in hand. So the red blood cells are smaller and contain less hemoglobin than normal. One speaks of one microcytic (shrunk cells), hypochromic (less red stained cells) anemia.
For this form of anemia it is Iron deficiency the most common cause.

To find out if it's actually a Iron deficiency anemia further parameters such as iron, Ferritin (the stored form of iron), Transferrin (the form of transport of iron) as well as the soluble transferrin receptor (serves to absorb iron into the body) can be determined.

An iron deficiency arises either through loss of iron, for example through bleeding, the most common example is this Menstrual period in women, or due to insufficient iron intake from food.

MCH

MCH describes the average amount of hemoglobin that a red blood cell contains.

It is calculated from Hemoglobin / red blood cell count.

The normal range is included 28-34 pg.

An increase or decrease in the MCH usually goes with one corresponding change in MCV hand in hand.
An increase above the norm denotes a macrocytic, hyperchromic anemia, an anemia with red blood cells that are too big and too colored.

The most common cause of such anemia are a lack of Folic acid or vitamin B12 (Cobalamin).

Rarely, increased MCH and MCV levels can indicate malignant diseases of the blood, for example a Plasmacytoma.

A reduced MCH value in combination with a reduced MCV indicates one microcytic, hypochromic anemia anemia with red blood cells that are too small and too weakly colored.

The cause is with one Iron deficiency anemia. An iron deficiency is generally the most common cause of anemia and women are more likely to be affected.
She can rarely Thalassemia, a disease that affects the hemoglobin molecule, cause anemia with decreased MCH and MCV.
Also Inflammation and Tumors can lead to microcytic anemia (MCH and MCV decreased), but more often these are associated with normal MCH and MCV.

But even if MCH and MCV are in the normal range, this can be seen as an indication. There are forms of anemia in which neither of the two values ​​is noticeable, one then speaks of one normocytic anemiaanemia in which the cells look normal.
Such a form of anemia can, for example, be caused by the kidney induced anemia (renal anemia) occurrence.

A hormone (EPO), which is responsible for the post-production of red blood cells in the Bone marrow stimulates.
If the kidney is restricted in its function, too little of this hormone (EPO) and normocytic anemia occurs.

Normocytic anemia can also occur if the red blood cells are eliminated prematurely (hemolytic anemia) or if red blood cells occur during bleeding (internally or externally) get lost.

MCHC

MCHC describes the Share of hemoglobin in the total volume of a red blood cell.
It is calculated from Hemoglobin / hematocrit or MCH / MCV.

The normal range is between 30-36 g / dl.

The MCHC is increased or decreased significantly less often than MCV or MCH and is therefore of little importance in the diagnosis of anemia.

RDW

RDW describes the Red blood cell size distribution in blood.

In healthy patients, the size distribution is in the form of a normal distribution (Prince Jones curve) between 6 and 9 microns, most red blood cells are in size 7.5 microns.

The RDW indicates the percentage of red blood cells that deviate from this normal size.

The RDW is normally < 15%.

The RDW is of little importance in everyday clinical practice.
Decreased values ​​are irrelevant; increased values ​​indicate the presence of anemia.
MCH and MCV are then used for a more precise classification of the anemia.