High MCHC: What Does It Mean?

Medically reviewed by Nancy Carteron, MD, FACR on October 25, 2017Written by Jill Seladi-Schulman, PhD on October 25, 2017

What is MCHC?

MCHC stands for mean corpuscular hemoglobin concentration. It’s a measure of the average concentration of hemoglobin inside a single red blood cell. MCHC is commonly ordered as part of a complete blood count (CBC) panel.

Why did my doctor order this test?

Usually, MCHC is ordered as part of a CBC panel. Your doctor can order this panel for any of the following reasons:

  • as part of a complete physical screen to evaluate your overall health
  • to aid in screening for or diagnosing various diseases or conditions
  • to monitor a condition once you’ve been diagnosed
  • to observe the effectiveness of a treatment

The CBC panel gives your doctor information about three types of cells in your blood: white blood cells, red blood cells, and platelets. The MCHC value is part of the red blood cell assessment.

What do the results mean?

MCHC is calculated by multiplying the hemoglobin result from the CBC panel by 100 and then dividing by the hematocrit result.

The reference range for MCHC in adults is 33.4–35.5 grams per deciliter (g/dL).

If your MCHC value is below 33.4 grams per deciliter, you have low MCHC. Low MCHC values occur if you have anemia due to iron deficiency. It can also indicate thalassemia. This is an inherited blood disorder in which you have fewer red blood cells and less hemoglobin present in your body. Learn more about low MCHC and its possible causes.

If your MCHC value is above 35.5 grams per deciliter, you have high MCHC.

What causes high MCHC?

A high MCHC value is often present in conditions where hemoglobin is more concentrated within your red blood cells. It can also occur in conditions where red blood cells are fragile or destroyed, leading to hemoglobin being present outside of the red blood cells. Conditions that can cause high MCHC calculations are:

Autoimmune hemolytic anemia

Autoimmune hemolytic anemia is a condition that occurs when your body develops antibodies that attack your red blood cells. When the condition has no determinable cause, it’s called idiopathic autoimmune hemolytic anemia.

Autoimmune hemolytic anemia can also develop along with another existing condition, such as lupus or lymphoma. Additionally, it can occur due to some medications, such as penicillin.

Your doctor can diagnose autoimmune hemolytic anemia using a blood test, such as a CBC panel. Other blood tests can also detect certain types of antibodies present in the blood or attached to red blood cells.

Symptoms of autoimmune hemolytic anemia include:

  • fatigue
  • paleness
  • weakness
  • jaundice, a yellowing of the skin and the whites of your eyes
  • chest pain
  • fever
  • fainting
  • abdominal discomfort, due to an enlarged spleen

If destruction of red blood cells is very mild, you may not experience any symptoms.

Corticosteroids such as prednisone are the first line of treatment for autoimmune hemolytic anemia. A high dose may be given initially and then gradually reduced over time. In cases where destruction of red blood cells is severe, blood transfusions or removal of the spleen (splenectomy) may be necessary.

Hereditary spherocytosis

Hereditary spherocytosis is a genetic disease affecting red blood cells. The genetic mutation affects the red blood cell membrane and makes it more fragile and prone to destruction.

In order to diagnose hereditary spherocytosis, your doctor will evaluate your family history. Typically, genetic testing isn’t needed, as the condition is inherited from a parent who has it. Your doctor will also use blood tests, such as a CBC panel, to learn more about the severity of the condition.

Hereditary spherocytosis has several forms, ranging from mild to severe. Symptoms can include:

Taking folic acid supplements or eating a diet high in folic acid can promote red blood cell production. In severe cases, blood transfusions or splenectomy may be needed. Additionally, if gallstones are a problem, all or part of the gallbladder may need to be removed.

Severe burns

People hospitalized with burns on greater than 10 percent of their body often have hemolytic anemia. A blood transfusion can help combat the condition.

The takeaway

MCHC is a measure of the average amount of hemoglobin inside of a single red blood cell, and it’s often ordered as part of a CBC panel.

You’ll have a high MCHC value if there’s an increased concentration of hemoglobin inside of your red blood cells. Additionally, conditions where hemoglobin is present outside of red blood cells due to red blood cell destruction or fragility can produce a high MCHC value.

Treatments for conditions causing high MCHC can include corticosteroids, splenectomy, and blood transfusions. Talk to your doctor about your blood test results. They’ll be able to answer your questions and describe your treatment plan.

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