Which of the following test results suggests significant hemoglobinemia may be present in a sample?
a. Elevated mean cell volume (MCV)
b. Reticulocytosis
c. Hemoglobin less than 10 g/dL
d. Unrealistically high mean cell hemoglobin concentration (MCHC)
ANS: D
When red cells are lysed in the circulation with the resultant release of hemoglobin into plasma, the red cell count and thus hematocrit will be decreased. However, if enough hemoglobin exists in plasma, then it will be measured as hemoglobin in the hemoglobin test, thus increasing the hemoglobin concentration relative to the number of red cells (and thus hematocrit). This will lead to an elevated MCHC that can exceed the upper limit of the reference range.
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