What is the role of the RBC index in the evaluation of hemolytic anemia?

Updated: May 27, 2021
  • Author: Srikanth Nagalla, MD, MS, FACP; Chief Editor: Emmanuel C Besa, MD  more...
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These studies are performed when a CBC count is requested. A low mean corpuscular volume (MCV) and mean corpuscular hemoglobin (MCH) are consistent with a microcytic hypochromic anemia due to iron deficiency that may occur in chronic intravascular hemolysis.

A high MCV is consistent with a macrocytic anemia. Folate consumed during chronic hemolysis may lead to megaloblastosis and a high MCV. However, the MCV also may be elevated in patients with high reticulocyte counts since these cells are larger than mature RBCs. A high MCH and mean corpuscular hemoglobin concentration (MCHC) would suggest spherocytosis.

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