Required section · Section 1 of 6
A high MCV is a starting point
An outpatient EDTA CBC has hemoglobin 8.7 g/dL, MCV 114 fL, RDW 19.2%, white blood cells 3.4 × 10^3/microliter, platelets 118 × 10^3/microliter, and reticulocytes 0.6%. Bicytopenia means low values in two cell lines; all three cell lines are low here, so this is pancytopenia: anemia, leukopenia, and thrombocytopenia. The analyzer flags the result for smear review under the local procedure. The question is whether the pattern fits impaired DNA synthesis, reticulocytosis, liver or alcohol effects, medication, or marrow disease.
Mean corpuscular volume is an average of the red-cell volume distribution. It can miss a smaller macrocytic population and can be falsely increased by hyperglycemia, marked leukocytosis, cold agglutinins, delayed room-temperature storage, and aperture problems. Investigate an implausible MCV against specimen condition, analyzer flags, count, hematocrit, and smear before release.
Anemia is not defined by MCV. Use the local CBC reference interval and reportable-range procedures for the result itself.
| Analyte | Result | Interval | Flag |
|---|---|---|---|
| Hemoglobin | 8.7 g/dL | 12.0-16.0 g/dL | low |
| MCV | 114 fL | 80-100 fL | high |
| RDW | 19.2% | 11.5-14.5% | high |
| WBC | 3.4 × 10^3/microliter | 4.0-11.0 × 10^3/microliter | low |
| Platelets | 118 × 10^3/microliter | 150-400 × 10^3/microliter | low |
| Reticulocytes | 0.6% | 0.5-2.0% | not increased |
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