MCHC (whole blood)
MCHC reflects the concentration of hemoglobin within red blood cells. Unlike MCH and MCV, MCHC changes only slightly in pregnancy.
| Units | Nonpregnant Adult | 1st Trimester | 2nd Trimester | 3rd Trimester |
|---|---|---|---|---|
| g/L | 310–370 | 325–353 | 324–352 | 319–355 |
Pregnancy physiology
- MCHC remains stable because hemoglobin concentration per RBC changes little.
- Mild hemodilution in pregnancy does not usually change MCHC.
- Used together with MCV and MCH to classify anemia type.
Causes of decreased MCHC (hypochromia)
- Iron deficiency anemia — most common worldwide
- Thalassemia trait (α or β)
- Sideroblastic anemia
- Anemia of chronic inflammation
- Chronic blood loss
Cited references:
• Kratz et al., N Engl J Med 2004;351:1548–63.
• Lockitch G — Diagnostic Biochemistry in Normal Pregnancy.
• Dunning & Fischbach — Manual of Laboratory and Diagnostic Tests.
Causes of increased MCHC
- Hereditary spherocytosis (classic cause)
- Autoimmune hemolytic anemia (RBC membrane changes)
- Cold agglutinin disease (lab artifact → falsely high)
- Severe burns
- Hyperlipidemia (artifact)
- Dehydration (mild apparent increase)
Cited references:
• Kratz et al., NEJM 2004 — Laboratory reference values.
• Gronowski AM — Laboratory Testing in Pregnancy.
• Laposata M — Clinical Hematology Fundamentals.
References
- Kratz A, Ferraro M, Sluss PM, Lewandrowski KB. Laboratory reference values. N Engl J Med. 2004;351:1548–63.
- Lockitch G. Handbook of Diagnostic Biochemistry and Hematology in Normal Pregnancy. CRC Press; 1993.
- Dunning MB, Fischbach FT. Manual of Laboratory and Diagnostic Tests. LWW; 2004.