Elevated MCHC in Blood Test: Causes and Algorithm

What to do if MCHC is elevated above 375 g/L in CBC: causes of false elevation, cold agglutination, sample warming, and blood smear evaluation.

Editorial team 1 min January 9, 2023

🩸Why is MCHC level >375 g/L elevated in CBC? To understand the reason, it is recommended to:

Place the blood tube in a thermostat for 40-120 minutes, and also prepare a smear for erythrocyte morphology beforehand. During this time, erythrocytes will settle, and it will be possible to check for hemolysis, icterus, or chyle in the plasma.
Then re-examine the blood (i.e., place it on a hematology analyzer after warming).
If MCHC normalized after warming or if erythrocyte pathology/erythrocyte agglutination was found in the blood smear, this information must be indicated on the test report (for example: “cold agglutination of erythrocytes, test performed after .. min. warming at 37 C”). ❓And who knows the causes of false MCV elevation? (Point 5 of MCHC elevation in the photo). Photo source: report: Lugovskaya S. A. Clinical significance of modern hemogram parameters in the diagnosis of anemias, 2019.