RBC INDICES OR

WINTROBE INDICES

Prepared by: Francis Gerald Scott T. Gonzales, RMT

 RBC INDICES
• Use to classify anemia according to red cell
indices

MCV or MEAN CELL VOLUME

MCH or MEAN CELL HEMOGLOBIN
MCHC or MEAN CELL HEMOGLOBIN
CONCENTRATION
 MEAN CELL VOLUME (MCV)
• Normal value: 80-100 fL (femtoliters)
• Formula:

MCV= Hct (%) x 10

RBC (x 1012 L)
 MEAN CELL VOLUME (MCV)
• If MCV is increased = MACROCYTIC CELLS
o Megaloblastic anemia, nonmegaloblastic anemia
(liver disease, hypothyroidism)

• If MCV is decreased = MICROCYTIC CELLS

o IDA, defective iron utilization (chronic disease) &
thalassemia
Sample problem
 MEAN CELL HEMOGLOBIN (MCH)
• Normal value: 27-31 pg (pictograms)
• MCH is rarely used, MCV and MCHC are more
commonly used
• Formula:

MCH= Hgb (g/dL) x 10

RBC (x 1012 L)
 MEAN CELL HEMOGLOBIN (MCH)
• If MCH is increased in
o Found in macrocytic anemias because RBCs are
larger and carry more Hb

• If MCH is decreased in
o Found in hypochromic anemias and microcytic
anemias unless RBCs are also spherocytic
Sample problem
 MEAN CELL HEMOGLOBIN
CONCENTRATION (MCHC)
• Normal value: 31-36%
• Formula:

MCHC= Hgb (g/dL) x 100

Hct (%)
 MEAN CELL HEMOGLOBIN
CONCENTRATION (MCHC)
• If MCHC is increased = HYPERCHROMIC CELLS
o spherocytes

• If MCHC is decreased = HYPOCHROMIC CELLS

o IDA, defective iron utilization (chronic disease) &
thalassemia
 MEAN CELL HEMOGLOBIN
CONCENTRATION (MCHC)
• MCHC above 38% does not occur
– Incorrect calculation
– Presence of COLD AGGLUTININS (dec. Hct)
• MCHC will not fall below 22%
– Lipemia
– Presence of Hb S, Hb C
Sample problem
 HYPOCHROMIA GRADING
1+ = area of central pallor is one-half of cell
diameter
2+ = area of pallor is two-thirds of cell diameter
3+ = area of pallor is three-quarters
4+ = thin rim of hemoglobin