We use cookies to understand how you use our site and to improve your experience. This includes personalizing content and advertising. To learn more, click here. By continuing to use our site, you accept our use of cookies. Cookie Policy.

Features Partner Sites Information LinkXpress
Sign In
Advertise with Us
Abbott Diagnostics


Sysmex Europe designs and produces laboratory and hematology diagnostic solutions, including instruments, reagents, c... read more Featured Products: More products

Download Mobile App


ATTENTION: Due to the COVID-19 PANDEMIC, many events are being rescheduled for a later date, converted into virtual venues, or altogether cancelled. Please check with the event organizer or website prior to planning for any forthcoming event.
06 Jun 2020 - 09 Jun 2020
Virtual Venue
08 Jun 2020 - 11 Jun 2020
Virtual Venue

Increased Mean Corpuscular Hemoglobin Concentration Scrutinized for Accuracy

By LabMedica International staff writers
Posted on 21 Dec 2016
Print article
Image: The XN-10 RET automated hematology system (Photo courtesy of Sysmex).
Image: The XN-10 RET automated hematology system (Photo courtesy of Sysmex).
In daily practice in hematology laboratories, spurious increased mean corpuscular hemoglobin concentration (MCHC) induces an analytical alarm and needs prompt corrective action to ensure delivery of the right results to the clinicians.

Elevated MCHC is a rare event in routine laboratory practice, but it must be managed properly. In daily practice, the MCHC limit defined by a specific commercial analyzer is fixed at 365 g/L. Exceeding this value leads to a suspicious ‘flag’ and this ‘flag’ has to be considered in an accreditation context to assess the accuracy of reported parameters.

Hematologists at the Hôpital de la Conception (Marseille, France) measured and analyzed in parallel with blood smears from 128 unknown patients with MCHC greater than 365 g/L, all erythrocyte parameters including reticulocyte parameters, chemistry index and osmolality. Differences between optical parameters (RBC-O, HGB-O) and usual parameters (RBC, HGB) obtained by impedance and photometry were also reported.

The scientists used the Sysmex XN-10 RET automated hematology system (Sysmex Corporation, Kobe Japan) that has two different technologies for achieving a full erythrocyte analysis. Erythrocytes are counted using an impedance method with a hydrodynamic focusing system in a fixed volume at room temperature. When required, XN-10 RET can provide a second erythrocyte count (RBC-O) using fluorescence flow cytometry after stabilization and warming at 41 °C in the incubation chamber. RBC-O is a measured parameter, corresponding to total erythrocyte count, including reticulocyte counts, whereas HGB-O is a calculated parameter derived mainly from the RBC-O count and RBC hemoglobin content (RBC-He).

The team classified four groups from their observations: 22 with red blood cell (RBC) agglutination; 17 with optical interference; 18 with RBC disease and 71 others including unclassified and/or patients with hyposmolar plasma. The use of RBC-O and HGB-O permitted efficient correction of the abnormalities when RBC agglutination and/or optical interference were present in 36 of 39 patients. Reticulocyte parameters permitted to elaborate an RBC score that allowed a highly sensitive detection of RBC disease patients (17/18).

The authors concluded that in case of elevated MCHC, their study proves the capability of XN-10 RET optical parameters to provide solutions in the majority of cases, especially concerning RBC cold agglutination and optical interference. The calculated RBC score offers a highly useful tool for managing a blood smear and specifying patients with RBC disease. This original study allows optimization of the workflow in laboratories eliminating manual tasks, guiding biological interpretation in the case of elevated MCHC. The study was originally published online on August 27, 2016, in the International Journal of Laboratory Hematology.

Related Links:
Hôpital de la Conception

Print article



view channel
Image: Stenotrophomonas maltophilia colonies on sheep blood agar. Cultivation 48 hours in an aerobic atmosphere, 37 °C (Photo courtesy of microbiologyinpictures).

Global Spread of the Multi-Resistant Pathogen Stenotrophomonas Maltophilia Revealed

Stenotrophomonas maltophilia strains occur in several natural and human associated ecosystems. The bacterium was long regarded as relatively unproblematic, but is now considered to be one of the most feared... Read more
Copyright © 2000-2020 Globetech Media. All rights reserved.