Overview
Red blood cell indices summarize erythrocyte size and hemoglobin content derived from RBC line measurements.
Classification
Index formulas (educational, verify analyzer software)
| Index | Typical formula (verify platform) | Interpretive use |
|---|---|---|
| MCV | (Hct / RBC) × factor → fL | Microcytic vs macrocytic pattern |
| MCH | (Hb / RBC) × factor → pg | Hypochromia pattern with MCHC |
| MCHC | (Hb / Hct) × 100 | Hypochromia / spherocyte clue |
| RDW | CV of RBC volume → % | Anisocytosis, variability |
Morphologic Features
Indices correlate with smear, microcytes, macrocytes, anisocytosis.
Laboratory Characteristics
- Calculated on every automated CBC
- Extreme MCV, cold agglutinin, reticulocytosis may distort
- Reference intervals verified locally, not listed here
Reference Intervals
No universal numeric ranges, verify institutional intervals by age and sex.
Clinical and Laboratory Significance
- Low MCV + high RDW, microcytic anisocytosis pattern
- High MCV, macrocytic pattern; correlate reticulocytes and smear
- Normal MCV + high RDW, early mixed deficiency or retic release, further testing
Differential Considerations
Indices suggest patterns, etiology requires reflex testing beyond CBC.
Comparison Tables
Pattern-based next steps, not diagnoses
| Pattern | Index clue | Next step (per protocol) |
|---|---|---|
| Microcytic | Low MCV, low MCH/MCHC | Iron studies, smear |
| Macrocytic | High MCV | Retic, B12/folate, smear |
| Normocytic + high RDW | Normal MCV, high RDW | Retic, smear, clinical context |
Classification Frameworks
Not applicable.
Laboratory Notes
- Formula constants vary slightly by manufacturer, confirm in operator manual.
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.
Professional Monographs
- Barnes PW, McFadden SL, Machin SJ, Doig K. Laboratory Hematology Practice. Wiley-Blackwell; 2012.
CLSI and Professional Guidelines
- Clinical and Laboratory Standards Institute. Reference Leukocyte (WBC) Differential Count (Proportional) and Evaluation of Instrumental Methods; Approved Standard. CLSI document H20-A2. CLSI; 2007.
- 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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