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Lecture 7

Erythrocyte Indices
Important in assessing border-line of

anemia
Should be interpreted only in the light of
otherfindings i.e. appearance or RBCs on
fixed smears
Computed using: RBC count, Hemoglobin
(Hgb), and haematocrit (Hct)

Types of RBC Indices


1. Mean Corpuscular Volume (MCV)

2. Mean Corpuscular Hemoglobin (MCH)


3. Mean Corpuscular Hemoglobin Concentration
4.
5.

6.
7.

8.

(MCHC)
Color Index (CI)
Volume Index (VI)
Saturation Index (SI)
Mean corpuscular Diameter (MCD)
Mean Corpuscular Thickness (MCAT)

1. MCV (Mean corpuscular volume)


average volume of individual blood cell
Volume % Hct
= ---------------------- X10 = cubic micra or femtoliter
RBC in million
= NV = 82 -92 cubic micra (u3)
Interpretation:
95 160 u3 = macrocytic anemia
72 79 u3 = microcytic anemia
50 71 u3 = microcytic, hypochromic

Example:

Given:
Hct = 46 vol%;
RBC count = 5,000,000 / mm3
46
MCV = --------- X 10 = 92 mm3
5
NV = 82 -92 cubic micra (u3)
Normocytic

2. MCH (Mean Corpuscular Hemoglobin)


=ratio of hgb to red cell count
=average weight or amount of Hgb in an individual RBC

Gm Hgb
= ------------- X 10 = micromicrogram (uug) or*picogram
RBC in Million
*pictogram = millionth part of microgram
or gram x 10 -12
Normal Value: 27 33 uug or pg
Interpretation:
>33 uug = macrocyte
<27 uug = microcyte
<22 uug = microcytic hypochromic

2. MCH (Mean Corpuscular Hemoglobin)


Example:
Given: Hgb = 16 gm/100 ml;
RBC count = 5,500,000/mm3
Gm Hgb
MCH = ------------- X 10
RBC in Million
16
MCH = --------- x 10 = 29 uug
5.5
Normochromic

Normal Value:
27 33 uug or pg

3. Mean Corpuscular hemoglobin Concentration


(MCHC)
=mean concentration of Hgb in the average RBC
Gm Hgb
MCHC
= ------------- X 100 = %
Vol % Hct
Normal Value = 32 38%

Example:
Given: Hgb = 16gm/100 ml; Hct = 46 vol%

16
MCHC = ------- X 100 = 34.7%
46

** MCH measures the weight of Hgb in the


average red cell and is reported in uug or
pictogram;
Whereas, MCHC indicates concentration of
Hgb in the average red cell reported in %.

Use of Erythrocyte Indices:


The MCV, MCH, MCHC are called red
cell indices, gives accurate picture of RBC
morphology in fixed smears

Example1:
Given: RBC = 4.5 mil/mm3,
Hgb = 13.5 gm/100ml;
Hct = 40 vol%
40
MCV = ------- X 10 = 89 cubic micra
4.5
13.5
MCH = ----- X 10 = 30 uug
4.5
13.5

MCHC = ------ X 100 = 33.8%


40

Normal Value:
MCV= 82 -92 cubic micra (u3)
MCH= 27 33 uug or pg
MCHC = 32 38%

Therefore, the RBCs


are normal in size
(normocytic); the hgb
concentration is
normal
(normochromic)

Example 2:

Describe the cell size, hemoglobin weight and


hemoglobin concentration.
Given:
MCV = 89 cubic micra, MCH = 25.5 uug; MCHC =
28.8 %

Normal Value:
MCV= 82 -92 cubic micra (u3)
MCH= 27 33 uug or pg
MCHC = 32 38%

Describe the cell size, hemoglobin weight and hemoglobin


concentration.
Given:
MCV = 89 cubic micra, MCH = 25.5 uug; MCHC = 28.8 %

Therefore, RBCs are normal in size or Normocytic, but


contain less hgb than normal; Low MCHC shows to be
hypochromic.

Example 3:
Given:
MCV = 71 cubic micra;
MCH = 22.2 uug;
MCHC = 31.2%

Normal Value:
MCV= 82 -92 cubic micra (u3)
MCH= 27 33 uug or pg
MCHC = 32 38%

Describe the cell size, hemoglobin

weight and hemoglobin concentration.

Other Blood Indices:


1. COLOR INDEX (C.I.)
= average amount of haemoglobin in each
erythrocyte as compared with the average
amount in a normal erythrocyte
% hemoglobin
CI = ------------------------------% RBC

Example: RBC = 3, 200,000/mm3; Hgb = 9.6 gm/100 ml


So:
% hemoglobin
CI = ------------------------% RBC
Given Hgb (9.6)
% Hgb = ---------------------------- X 100 = 60%
Standard Hgb (16)

Given RBC Ct (3,200,000)


% RBC = --------------------------------Standard RBC ct. (5,000,000)
Therefore:
60
Color Index = ----------- = 0.94
64
Normal Value: 0.90 to 1.10

X 100 = 64%

COLOR INDEX (C.I.)

Note:
Increased in pernicious anemia due to
macrocytes and megalocytes
Decreased in secondary anemia and

chlorosis

2. VOLUME INDEX (V.I.)


= average size of RBC as compared with the
average size of a normal RBC
Percent Hct (% Hct)
V.I. = ------------------------------Percent RBC (%RBC)

Example: RBC count= 3,000,000/mm3; Hct = 32 vol%


So:
Percent Hct (% Hct)
V.I. = ------------------------------Percent RBC (%RBC)
Given Hct (32)
% Hct = --------------------------- X 100 = 68%
Standard Hct (47)

Given RBC c t. (3,000,000)


%RBC = ------------------------------------- X 100 =
60%
Standard RBC (5,000,000)
Therefore:
68
Volume Index = ------- = 1.13
60

Normal Value: 0.90 1.10

2. VOLUME INDEX (V.I.)


Note:
Increased in infants during the first few
weeks of life,
Decreased in older children,
usually lower than adult

3. SATURATION INDEX (S.I.)


= average amount of haemoglobin per unit
volume of cell in relation to the normal
Color index
%Hgb
S.I. = --------------------- or ------------Volume Index
% Hct

Example: RBC ct. = 3,500,000/ mm3 (3.5/5) = 70%


Hgb = 12gm/100ml (12/16)= 75%
Hct = 31vol% (31/47) = 66%

Color index
S.I. = --------------------Volume Index

%Hgb
or
------------% Hct

75
Color Index = ------- = 1.07
70
66
Volume Index = ------ = 0.94
70

3. SATURATION INDEX (S.I.)


Therefore:
1.07
Saturation Index = --------- = 1.14
0.94
Or:

75
Saturation Index = ------- = 1.14
66

Normal value: 0.80 to 1.20

4. MEAN CORPUSCULAR DIAMETER (MCD)


= mean or average diameter of the rbc in terms of
micron

5. MEAN CORPUSCULAR AVERAGE THICKNESS


(MCAT)
= mean or average thickness of rbc
MCV
MCAT in micron = -----------(MCD)2
_________

2
**The thickness is obtained by dividing the MCAT by the
normal MCAT

Thank You