Mean corpuscular volume
- Stanley L Schrier, MD
Stanley L Schrier, MD
- Editor-in-Chief — Hematology
- Section Editor — Myeloproliferative Disorders; Red Cell Disorders
- Professor of Medicine
- Stanford University School of Medicine
The mean corpuscular volume (MCV) is one of the standard red blood cell (RBC) "indices" (table 1). It is the volume of the "average" RBC, stated in femtoliters (fL, 10-15 L). Measurement of the MCV and its importance in the differential diagnosis of anemia will be discussed here . Control of RBC hydration, which directly influences the MCV, is discussed separately. (See "Control of red blood cell hydration".)
A general approach to the patient with anemia is presented separately. (See "Approach to the adult patient with anemia".)
METHODOLOGY AND NORMAL VALUES
The mean corpuscular volume (MCV) can be measured or calculated in a number of different ways (see "Automated hematology instrumentation"):
●Use of volume-sensitive automated blood cell counters, such as the Coulter counter. In this type of apparatus, the red cells pass one-by-one through a small aperture and generate a signal directly proportional to their volume.
●Other automated counters measure red blood cell (RBC) volume by means of techniques that measure refracted, diffracted, or scattered light.
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- METHODOLOGY AND NORMAL VALUES
- MICROCYTOSIS AND MACROCYTOSIS
- ESTIMATION OF MCV FROM THE PERIPHERAL SMEAR
- RED BLOOD CELL DISTRIBUTION WIDTH
- Significance of a normal RDW
- Significance of an increased RDW
- - Hematologic implications
- - Cardiovascular and cerebrovascular disease
- - Chronic kidney disease
- - Other clinical settings
- - All cause mortality
- SOURCES OF ERROR
- CAUSES OF NORMOCYTIC ANEMIA
- CAUSES OF MACROCYTOSIS
- Age-specific changes in red cell size
- Disorders of nucleic acid metabolism
- Abnormal RBC maturation
- Other causes
- CAUSES OF MICROCYTOSIS
- Iron deficiency anemia
- Anemia of chronic inflammation
- SUMMARY AND RECOMMENDATIONS