The Exact Manual Calculation of the Erythrocyte

Indices
by: Tom Anthony A. Tonguia, RMT
Objectives

 Explain the three erythrocyte indices.

 Write the formula and accurately calculate the erythrocyte
indices.
 Interpret the results of the erythrocyte indices values.
 Identify some sources of error in the computations.
Introduction
• Erythrocyte or Red Blood Cell Indices are quantitative
measurements of the size and hemoglobin content of the
red blood cells.
• Three erythrocyte indices:
– Mean Corpuscular Volume (MCV)
– Mean Corpuscular Hemoglobin (MCH)
– Mean Corpuscular Hemoglobin Concentration (MCHC)
• The indices determination is routinely done with the use of
automated Hematology analyzers.
The indices can be calculated from manually
determined values of the following Hematology data:
Name of Test Abbreviation Units

Hematocrit or Packed Cell Volume Hct %

PCV L/L

Hemoglobin Hgb g/dL

Red Cell Count RBC x10^12/L

Calculating the Erythrocyte Indices
• Mean Corpuscular Volume (MCV)
– The MCV is calculated using the Hct(%) and the RBC count
(x10^12/L). The MCV is the average volume of a red blood cell.
The result is reported in femtoliters. One femtoliter (fL) is equal
to 10^-15L or one cubic micrometer (um^3).

MCV= Hct x 10
RBC
Calculating the Erythrocyte Indices
• Mean Corpuscular Hemoglobin (MCH)
– The MCH is calculated using the Hgb (g/dL) and the RBC count
(x10^12/L).
– It indicates the average weight of the hemoglobin in the red
blood cell.
– Measured in picograms
– One picogram (pg)= 10^-12g=micromicrogram (uug).

MCH= Hgb x 10
RBC
Calculating the Erythrocyte Indices
• Mean Corpuscular Hemoglobin Content (MCHC)
– The MCHC is expressed as the average hemoglobin
concentration in a given volume of packed red cells.
– It is calculated from the results of the hemoglobin and the
hematocrit.
– The MCHC is expressed in percentage of g/dL since it
compared hemoglobin to hematocrit.

MCHC= Hgb x 100

Hct
Reference Ranges for Erythrocyte Indices
• MCV= 80-100fL
– indicates the size of the RBCs: small (microcytic), normal
(normocytic), large (macrocytic)
– below normal range= MICROCYTIC; within normal range=
NORMOCYTIC; above normal range= MACROCYTIC
• MCH= 27-32 pg
• MCHC= 32-37 g/dL (or %)
• Automated cell counters directly measure the MCV, and
the hematocrit is calculated from the MCV and RBC count
(Hct=MCV x RBC).
– the MCV is now considered the most reliable automated index.
– It is probably the most effective discriminating factor for the
classification of anemias.
• The MCHC was previously the most reliable index
because it is derived from the two manual measurements
that could be accurately determined: the hematocrit and
hemoglobin.
Sources of Error
• All the calculatios depend on the results obtained from the
RBC count, hematocrit and hemoglobin values.
• Any errors in those data will also cause error in the
indices.
• If done manually, the RBC count gives the least reliable
result and is the chief source of error for the MCV and
MCH.
• An MCHC result of greater than 40 g/dL could indicate
instrument malfunction or presence of cold agglutinins in
the blood specimen.