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Background
The MCV test is used to assess the mean size of the red blood cells. It is used for the indications of some diseases. Anemia a condition which has blood problem which prevents the body from supplying oxygen to tissue and organ.
As the part of all complete blood count (CBC), the MCV test is conducted on a regular basis. It is performed by an automated machine. The MCV test is a component of CBC. It primarily focuses on the information related to RBC. It is known as RBC indices. The RBC indices have the indicators like: MCV, mean corpuscular hemoglobin concentration (MCHC), mean corpuscular hemoglobin (MCH), and red cell distribution width (RDW).
MCV is increased or decreased based on the mean size of RBCs. A reduced level of MCV lead to microcytic. An increased level of MCV lead to macrocytic.
Indications/Applications
The MCV test is performed if you have symptoms like:
Weakness or low energy
Fatigue
Headache
Rapid heartbeat
Yellow skin or pale skin
Chest pain
Shortness of breath
The MCV test is performed if patient has anemia due to deficiency of vitamin B-12 and has symptoms like:
Nausea
Vomiting
Mental diseases like confusion, depression
Gas and bloating
Tingling in hands or feet
The MCV test is performed if patient has anemia due to deficiency of folate and has symptoms like:
Irritability
A sensitive or smooth tongue
Loss in appetite
Diarrhea
Clinical Significance
As discussed earlier, this test is used to diagnose anemia. Small size of RBC is the indicator of microcytic anemia. This is observed in the conditions like thalassemia, sideroblastic anemia, chronic iron deficient anemia. Large size of RBC is the indicator of macrocytic anemia. This is occurred due to synthesis of DNA or other factors. Severe drinking, liver dysfunction and other genetic diseases lead to condition called non-megaloblastic anemia.
Normocytic anemia can lead to low levels of hematocrit and hemoglobin. It may occur either extra vascularly or intra vascularly. It is classified as non hemolytic and hemolytic. Certain types of anemia like early chronic anemia, aplastic anemia, early iron deficiency anemia, microangiopathic hemolytic anemia and infection die to plasmodium are non hemolytic normocytic anemia.
When two RBC populations or heterogeneous RBC size, also known as anisocytosis and a peripheral blood smear are the indicators of increased RDW. The reason behind he increased level of MCV is yet to discover in about one third of cases. MCV level is increased in the conditions where RBC swells and lead to agglutination known as paraproteinemia or severe hyperglycemia.
Assessment of MCV:
It is directly measured by using an automated hemotology analyser. It is indireactly measured by using the RBC and hematocrit (Hct). One can use the below equation to calculate the MCV.
MCV (fl) = (Hct [in L/L]/RBC [in x1012/L]) × 1000
Reaction of bone marrow to anemia is determined by the reticulocyte count. By which it is classified into two types: hemolytic anemia in which RBC level is high and hyperproliferative anemia in which breakdown of RBC is high.
Reference Range
The normal level of MCV in the newborn is 96 to 108 fL. In children, adult and elder, the normal level of MCV is 80 to 95 fL.
Interpretation
The conditions which lead to hypochromic anemia and microcytic anemia in which MCH and MCV level is low:
Sideroblastic anemia
Anemia due to iron deficiency
Thalassemia
Anemia of chronic disease
The conditions which lead to macrocytic anemia in which MCV level is high:
Aplastic anemia
Severe drinking
Anemia due to folate deficiency
Hemolytic anemia
Hypothyroidism
Liver disease
Myelodysplastic disease
Anemia due to vitamin B-12 deficiency
The conditions which lead to normochromic anemia and normocytic anemia in which MCV level is normal or average:
Anemia of renal disease
Anemia of chronic disease
Aplastic anemia
Hemolytic anemia like hereditary spherocytosis, autoimmune hemolytic anemia, no spherocytic congenital hemolytic anemia due to G6PD deficiency
Severe blood loss
Collection And Panels
Collection:
Sample type: Whole blood
Sample collection method: Blood is drawn by venipuncture
Container: Lavender top tube or EDTA tube with an anticoagulant known as EDTA potassium salt
Panel:
Hematology Panel: Complete blood count (CBC)
Modifying factor:
Antimicrobial, anticonvulsants, and chemotherapy drugs can lead to increased size of the RBC. This will affect the MCV test result.
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