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Mean Corpuscular Volume (MCV) 

  • Author: Choladda Vejabhuti Curry, MD; Chief Editor: Eric B Staros, MD  more...
 
Updated: Jan 13, 2015
 

Reference Range

Mean corpuscular volume (MCV) is the average volume of red cells in a specimen. MCV is elevated or decreased in accordance with average red cell size; ie, low MCV indicates microcytic (small average RBC size), normal MCV indicates normocytic (normal average RBC size), and high MCV indicates macrocytic (large average RBC size).

The reference range for MCV is 80-96 fL/red cell in adult.[1] Reference ranges may vary depending on the individual laboratory and patient's age.

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Interpretation

Mean corpuscular volume (MCV) is the average volume of red cells. It can be directly measured by automated hematology analyzer,[2] or it can be calculated from hematocrit (Hct) and the red blood cell count (RBC) as follows:[1]

  • MCV in fl = (Hct [in L/L]/RBC [in x10 12/L]) x 1000

MCV, along with mean corpuscular hemoglobin (MCH), and mean corpuscular hemoglobin concentration (MCHC), is a part of RBC indices (erythrocyte indices), which are measurements and/or calculations for determining the size, content, and hemoglobin concentration.

More recently, red cell distribution width (RDW) has also been included as a part of RBC indices. The indices are useful in the morphologic characterization of anemia. Among these parameters, MCV is the most useful value used to classify the type of anemia based on red cell morphology.[2] Of note, type of anemia can also be categorized based on bone marrow responses to anemia using reticulocyte count into hypoproliferative anemia (decreased red blood cell production) and hemolytic anemia (increased red blood cell destruction).

Main types of anemia classified based on red cell morphology and their common causes

The common causes of microcytic and hypochromic anemia (decreased MCV and MCH) are as follows:[3, 4, 5]

The common causes of macrocytic anemia (increased MCV) are as follows:[3]

The common causes of normocytic and normochromic anemia (normal MCV) are as follows:[3]

Of note, when considering the causes of anemia, the guidelines above are helpful but have limitations. For example, hemolytic anemia and aplastic anemia can manifest as normochromic and normocytic anemia or macrocytic anemia; anemia of chronic disease can be normochromic and normocytic anemia or microcytic anemia; sideroblastic anemia can be microcytic anemia, macrocytic anemia, or normochromic and normocytic anemia (due to the presence of dimorphic population of microcytes and macrocytes).

In addition, once the causes of anemia are considered, correlation with clinical findings, including history and physical examination, is important, as is, when necessary, performing more definitive tests to arrive with a definitive diagnosis.

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Collection and Panels

Collection and panel details are as follows:

  • Specimen: Whole blood, usually collected by venipuncture
  • Collection: EDTA tube (purple/lavender top) containing EDTA potassium salt additive as an anticoagulant (see image below)
    EDTA tubes, purple top. EDTA tubes, purple top.
  • Panels: Complete blood count (CBC)
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Background

Description

Mean corpuscular volume (MCV) is the average volume of red cells in a specimen. MCV is elevated or decreased in accordance with average red cell size; ie, low MCV indicates microcytic (small average RBC size), normal MCV indicates normocytic (normal average RBC size), and high MCV indicates macrocytic (large average RBC size).

Indications/Applications

Mean corpuscular volume (MCV) laboratory test, as part of a standard complete blood count (CBC), is used along with other RBC indices (MCH and MCHC) to help classify the cause of anemia based on red cell morphology. See also the Interpretation section above.

Considerations

MCV, as well as MCH and MCHC, reflect average values and may not adequately reflect RBC changes where mixed RBC populations are present, such as dimorphic RBC populations in sideroblastic anemia or combined iron deficiency anemia (decreased MCV and MCH) and megaloblastic anemia (increased MCV).

Elevated red cell distribution width (RDW) provides a clue for heterogenous red cell size (anisocytosis) and/or the presence of 2 red cell populations, and peripheral blood smear review can help confirm the above findings.[6, 3]

Of note, a third of older patients may have an elevated MCV without an identifiable cause.[2]

MCV can be falsely elevated in the presence of red blood cell agglutination (as in cold agglutinin disease or paraproteinemia) or severe hyperglycemia (glucose > 600mg/dL) as red blood cells become swollen.[6]

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Contributor Information and Disclosures
Author

Choladda Vejabhuti Curry, MD Assistant Professor of Pathology and Immunology, Baylor College of Medicine; Hematopathologist and Cytopathologist, Section of Hematopathology, Texas Children's Hospital

Choladda Vejabhuti Curry, MD is a member of the following medical societies: American Society for Clinical Pathology, American Society of Cytopathology, American Society of Hematology, College of American Pathologists, United States and Canadian Academy of Pathology, Society for Hematopathology, European Association for Haematopathology, International Clinical Cytometry Society

Disclosure: Nothing to disclose.

Chief Editor

Eric B Staros, MD Associate Professor of Pathology, St Louis University School of Medicine; Director of Clinical Laboratories, Director of Cytopathology, Department of Pathology, St Louis University Hospital

Eric B Staros, MD is a member of the following medical societies: American Medical Association, American Society for Clinical Pathology, College of American Pathologists, Association for Molecular Pathology

Disclosure: Nothing to disclose.

References
  1. Vajpayee N, Graham SS, Bem S. Basic Examination of Blood and Bone Marrow. McPherson RA, Pincus MR. Henry's Clinical Diagnosis and Management by Laboratory Methods. 22nd. Elsevier/Saunders: Philadelphia, PA; 2011. 30.

  2. Ryan DH. Examination of blood cells. Lichtman MA, Kipps TJ, Seligsohn U, et al, eds. Williams Hematology. 8th ed. New York, NY: The McGraw-Hill Companies, Inc.; 2010. Chapter 2.

  3. Elghetany MT, Banki K. Erythrocytic Disorders. McPherson RA, Pincus MR. Henry's Clinical Diagnosis and Management by laboratory Methods. 22nd. Elsevier/Saunders: Philadelphia, PA; 2011. 32.

  4. Bach V, Schruckmayer G, Sam I, Kemmler G, Stauder R. Prevalence and possible causes of anemia in the elderly: a cross-sectional analysis of a large European university hospital cohort. Clin Interv Aging. 2014. 9:1187-96. [Medline]. [Full Text].

  5. Pornprasert S, Panya A, Punyamung M, Yanola J, Kongpan C. Red cell indices and formulas used in differentiation of ß-thalassemia trait from iron deficiency in Thai school children. Hemoglobin. 2014. 38(4):258-61. [Medline].

  6. Perkins SL. Examination of the Blood and Bone Marrow. Greer JP, Foester J, Rodgers GM, et al, eds. Wintrobe’s Clinical Hematology. 12th ed. Philadelphia, PA: Lippincott Williams & Wilkins; 2009. Chapter 1:1-20.

  7. Briggs C, Bain BJ. Basic Haematological Techniques. Bain BJ, Bates I, Laffan M, Lewis SM. Dacie and Lewis Practical Haematology. 11th ed. Philadelphia, PA: Churchill Livingstone/Elsevier; 2012. chap 3.

  8. Jung HA, Kim HJ, Maeng CH, Park SH, Lee J, Park JO, et al. Changes in the Mean Corpuscular Volume after Capecitabine Treatment Are Associated with Clinical Response and Survival in Patients with Advanced Gastric Cancer. Cancer Res Treat. 2014 Aug 21. [Medline].

  9. Jung HA, Kim HJ, Maeng CH, Park SH, Lee J, Park JO, et al. Changes in the Mean Corpuscular Volume after Capecitabine Treatment Are Associated with Clinical Response and Survival in Patients with Advanced Gastric Cancer. Cancer Res Treat. 2014 Aug 21. [Medline].

  10. Kim AH, Jang W, Kim Y, Park YJ, Han K, Oh EJ. Mean corpuscular volume (MCV) values reflect therapeutic effectiveness in zidovudine-receiving HIV patients. J Clin Lab Anal. 2013 Sep. 27(5):373-8. [Medline].

  11. Marks PW, Glader B. Approach to Anemia in the Adult and Child. Hoffman F, Benz EJ, Shattil SJ, eds. Hematology Basic Principles and Practice. 5th. Philadelphia, PA: Churchill Livingstone/Elsevier; 2009. 34.

 
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EDTA tubes, purple top.
 
 
 
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