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MCH is an index of the average blood cell hemoglobin mass (erythrocyte) which is determined by a test such as blood count. What is the MCH standard? What is MCH below or above the norm? What does increased or decreased MCH mean?

MCH(mean corpuscular hemoglobin, mean cell hemoglobin), or SWH, is one of the parameters determined in the blood count - it is an indicator of the average hemoglobin mass in the red blood cell (erythrocytes). MCH is one of the red cell (erythrocyte) markers.

MCH is calculated by dividing the weight of hemoglobin in a given blood volume by the number of blood cells (MCH-Hgb / RBC). Therefore, in order to calculate the MCH, it is necessary to know the results of the patient's hematocrit and hemoglobin determination.

Due to whether the cell's hemoglobin weight value is correct or not, we divide the red blood cells into:

  • normochromic - have the correct MCH value
  • hypochromic - have a reduced MCH value

MCH - norm

The correct value is in the range of 27-31 pq for both genders.

MCH - above normal. What does elevated MCH mean?

In the case ofincreasing the level of MCHwe can deal with:

  1. congenital spherocytosis - this is the most common hemolytic anemia. Genetically inherited. It consists in the mutation of the skeletal proteins that build erythrocytes, which changes the shape of the blood cell into a spherical one, the instability of its membrane, reducing the susceptibility to deformation and difficulty in passing through the capillaries, which contributes to their premature destruction in the spleen
  2. acquired haemolytic anemia - it is caused by autoantibodies directed against one's own erythrocytes. It can be idiopathic or secondary (in the course of other diseases) and is the most common acquired haemolytic anemia.

MCH - below normal. What does reduced MCH mean?

MCH below normalmay mean several diseases. The most common are:

1. Iron deficiency anemia- this is anemia in which, due to too little iron in the body, the formation of erythrocytes smaller than normal and containing less hemoglobin has occurred. It is the most common cause of anemia (80% of cases). Among the main reasonsIron deficiency is distinguished by:

  • blood loss, e.g. :
    • vaginal bleeding
    • gastrointestinal bleeding
    • urinary bleeding
    • bleeding from the respiratory tract
    • trauma
    • blood donation
  • increased blood requirement
    • premature babies
    • adolescence
    • pregnancy and lactation
    • when treating vitamin B12 deficiency
  • digestive tract malabsorptione.g. :
    • condition after gastrectomy (resection / removal of the stomach or part of it)
    • enteropathy
    • decreased gastric acidity
    • improper diet
    • Crohn's disease
  • diet deficiencies

Treatment consists in removing the cause and supplementing iron deficiency in the body in order to achieve the correct concentration of hemoglobin and ferritin in the blood with the help of iron preparations.

2. Thalassemia- this is a hereditary, genetically conditioned hemolytic anemia caused by incorrect synthesis of globin chains in the hemoglobin molecule. As a result, erythrocytes are abnormally built and have a lower amount of hemoglobin, and therefore transport little oxygen. Toxic chain intrusions render erythropoiesis (the process of multiplication and differentiation of erythrocytes in the bone marrow) ineffective. The red blood cells in the marrow or spleen are broken down.

3. Anemia of chronic diseases- anemia in which the stimulation of cellular immunity and increased production of pro-inflammatory cytokines play an important role. It is characterized by decreased red blood cell production, low levels of iron and transferrin (a protein that transports iron ions in the blood to tissues), and increased levels of ferritin (a storage protein that keeps iron harmless in the body).

Anemia often develops within months of disclosing the underlying disease. Requires differentiation from iron deficiency anemia. Treatment is mainly based on treating the underlying disease. In severe cases with symptoms such as:

  • heart failure
  • angina
  • central nervous system disorders

RBC (red blood cell concentrate) is rolled over

In the case ofabsolute iron deficiency(significantly reduced ferritin concentration), its deficiency should be compensated. In patients with evidence of anemia associated with cancer chemotherapy, treatment with medications may be consideredstimulating erythropoiesis.

Important

What are the other erythrocyte indices that are important in the diagnosis and differentiation of anemia?

  • hemoglobin concentration- normal values ​​are: men 14-18 g / dl, non-pregnant women 12-16 g / dl, pregnant women 11-14 g / dl
  • mean erythrocyte volume (MCV)- normal values ​​are 82-92 fl
  • average Hb concentration in red blood cells (MCHC)- normal values ​​32-36 g / dl. MCHC changes usually parallel to MCHchanges
  • erythrocyte volume distribution range (RDW) . It may be increased after red blood cell transfusion when there are two populations of red blood cells that differ in size
  • reticulocytes- the norm 0.5-1.5% of the number of red blood cells - these are immature, young forms of red blood cells. The percentage of reticulocytes is increased in the case of a decrease in the number of erythrocytes in order to compensate for their deficiency, which is a normal response of the body, e.g. in the case of haemorrhagic anemia, haemolytic anemia, compensation for vitamin B12 or iron deficiency. The percentage of reticulocytes decreases as the bone marrow becomes ineffective

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