Overview
Derived RBC parameters describing average size, hemoglobin content, and size heterogeneity.
Classification
| Pattern | Typical indices | Smear clues | Association examples (not exclusive) |
|---|---|---|---|
| Microcytic hypochromic | Low MCV, MCH, MCHC | Microcytes, hypochromia | Iron deficiency, thalassemia, ACD |
| Macrocytic | High MCV | Macro-ovalocytes or round macrocytes | B₁₂/folate deficiency, MDS, reticulocytosis |
| Normocytic | MCV within interval | Variable morphology | Mixed mechanisms, early disease, hemolysis |
| Elevated RDW | High RDW-CV/SD | Anisocytosis | Iron deficiency, dual deficiency, transfusion |
Morphologic Features
Indices average populations, smear identifies subpopulations indices may mask.
Laboratory Characteristics
- Verify calculation on flagged results per SOP
Reference Intervals
Use patient report intervals, age, sex, method, and lab specific.
Clinical and Laboratory Significance
First branch in anemia workup, see laboratory-approach-to-anemia.
Differential Considerations
Multiple etiologies per index pattern.
Comparison Tables
Classification Frameworks
Laboratory Notes
- Module 3 rbc-indices: calculation and analyzer derivation depth.
References
Authoritative textbooks, guidelines, and reviews supporting this reference entry. Verify reference intervals, critical limits, and reflex criteria against institutional protocols and current guideline editions.
Textbooks
- McPherson RA, Pincus MR. Henry's Clinical Diagnosis and Management by Laboratory Methods. 24th ed. Elsevier; 2021.
- Rodak BF, Carr JH. Rodak's Hematology: Clinical Principles and Applications. 6th ed. Elsevier; 2020.
- McKenzie SB, Williams JL. Clinical Laboratory Hematology. 4th ed. Pearson; 2022.
- Bain BJ. Blood Cells: A Practical Guide. 5th ed. Wiley-Blackwell; 2015.
CLSI and Professional Guidelines
- Clinical and Laboratory Standards Institute. Reference and Selected Performance Standards for the Automated Complete Blood Cell Count (CBC). CLSI document H26-A2. CLSI; 2010.
- Clinical and Laboratory Standards Institute. Defining, Establishing, and Verifying Reference Intervals in the Clinical Laboratory; Approved Standard. CLSI document EP28-A3c. CLSI; 2010.
- Clinical and Laboratory Standards Institute. Management of Critical- and Significant-Risk Results. CLSI guideline GP47-Ed1. CLSI; 2015.
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