Overview
- The mean corpuscular haemoglobin (MCH) and mean corpuscular haemoglobin concentration (MCHC) are red blood cell indices which confer whether a cell is normochromic, hyperchromic or hypochromic.
- Mean corpuscular haemoglobin (MCH) - the average amount of haemoglobin per red blood cell
- mean corpuscular haemoglobin concentration (MCHC) - the average concentration of haemoglobin within red blood cells
Normal Range
- MCH: 27 - 32pg
- MCHC: 300 - 350 g/L
Hypochromia
Reduced red cell haemoglobin (MCH / MCHC), or increased central pallor on blood film.
Causes of Hypochromia
Microcytic
- Iron deficiency anaemia
- Anaemia of chronic disease (infection / inflammation / malignancy)
- Thalassaemia
- Congenital sideroblastic anaemia
- Lead poisoning
- Hyperthyroidism
Macrocytic
- Reticulocytosis
Hyperchromia
Increased red cell haemoglobin (MCH / MCHC), or reduced central pallor on blood film.
Significance
- Hyperchromic cells may be spherocytes, microspherocytes, macrocytes or sickle cells.
Causes of Hyperchromia
- Spherocytosis - hereditary spherocytosis, immune haemolysis, Clostridium infection
- Microspherocytosis - microangiopathic haemolytic anaemia, severe burns
- Macrocytosis - B12/folate deficiency chronic liver disease, alcohol abuse, hypothyroidism, post splenectomy, aplastic anaemia, myelodysplastic syndrome
- Sickle cells - sickle cell disease
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