Red blood cell indices are measurements that describe the size and oxygen-carrying protein (hemoglobin) content of red blood cells. The indices are used to help in the differential diagnosis of anemia. They are also called red cell absolute values or erythrocyte indices.
Anemia includes a variety of conditions with the same outcome: a person's blood cannot carry as much oxygen as it should. A healthy person has an adequate number of correctly sized red blood cells that contain enough hemoglobin to carry sufficient oxygen to all the body's tissues. An anemic person has red blood cells that are either too small or too few in number. As a result, the heart and lungs must work harder to make up for the lack of oxygen delivered to the tissues by the blood.
Anemia is caused by many different diseases or disorders. The first step in finding the cause is to determine what type of anemia the person has. Red blood cell indices help to classify the anemias.
Anemia has several general causes: blood loss; a drop in production of red blood cells; or a rise in the number of red blood cells destroyed. Blood loss can result from severe hemorrhage or a chronic slow bleed, such as the result of an accident or an ulcer. Lack of iron, vitamin B12, or folic acid in the diet, as well as certain chronic diseases, lower the number of red blood cells produced by the bone marrow. Inherited disorders affecting hemoglobin, severe reactions to blood transfusions, prescription medications, or poisons can cause red blood cells to burst (hemolyze) well before the end of their usual 120-day lifespan.
Anemia of any type affects the results of one or more of the common blood tests. These tests are the hematocrit, hemoglobin, and red blood cell count. The hematocrit is a measure of red blood cell mass, or how much space in the blood is occupied by red blood cells. The hemoglobin test is a measure of how much hemoglobin protein is in the blood. The red blood cell count (RBC) measures the number of red blood cells present in the blood. Red blood cell indices are additional measurements of red blood cells based on the relationship of these three test results.
The relationships between the hematocrit, the hemoglobin level, and the RBC are converted to red blood cell indices through mathematical formulas. These formulas were worked out and first applied to the classification of anemias by Maxwell Wintrobe in 1934.
The indices include these measurements: mean corpuscular volume (MCV); mean corpuscular hemoglobin (MCH); mean corpuscular hemoglobin concentration (MCHC); and red cell distribution width (RDW). They are usually calculated by an automated instrument as part of a complete blood count (CBC). Indices are covered by insurance when medically necessary. Results are available the same day that the blood is drawn or the following day.
Nancy J. Nordenson, The Gale Group Inc., Gale, Detroit,