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Nurse Susan
Nurse Susan, Nurse (RN)
Category: Health
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Experience:  RN, BSN, MSN-ED, Nurse Educator whose passion is helping people understand their health and wellness
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What would cause High MCV, MCH, and MPV to become elevated?

Resolved Question:

What would cause High MCV, MCH, and MPV to become elevated? b-12 and folate ruled out. Side symptoms for 1.5 years; bruising easily and fatigue.
Submitted: 3 years ago.
Category: Health
Expert:  Nurse Susan replied 3 years ago.
Hello JACustomer,

I hope I can help you here; please understand though that online I can not state anything with 100% certainty, all I can do is offer my best educated guess based on what you've written.

It may help to explain what the MCV, MCH, and MPV mean. RED BLOOD CELLS (RBC) help carry oxygen to your body's tissues; these cells are also known as corpuscles. I am presuming that your levels of red blood cells were normal. HEMOGLOBIN is the chemical which carries oxygen, and which "rides" upon those red blood cells. HEMATOCRIT helps determine the mass of the RBC, or what percentage of the blood is made up of red blood cells. You did not give values for either hematocrit or hemoglobin so I presume they were within the normal range. Defining them makes your question (and your lab values) easier to understand.

The Mean Corpuscular Volume, or MCV means on average, how BIG those red blood cells. Often when peoples levels of red blood are lower or higher than they should be, the size of the red blood cell will change. People with lower levels of red blood cells can make cells that are bigger than average, thus the MCV will be higher. The most common reasons for the MCV to be increased is a deficiency in Vitamin B and folic acid, which you state have been ruled out. Some parasites can also cause a large MCV. Celiac disease can cause a large MCV. Many gastrointestinal problems can cause a large MCV.

Mean Corpuscular Hemoglobin (MCH) means how much hemoglobin is riding on those red blood cells. Your cells were larger, thus more hemoglobin can fit on them. Thats why your MCH was a bit elevated at 37.9. This happens in macrocytic anemia (macrocytic meaning large red blood cells, anemia meaning low levels of RBC) Increases here can also happen with hyperlipedemia (high, very high cholesterol levels) and very high numbers of white blood cells.

Though you did not ask this, Mean Corpuscular Hemoglobin Concentration (MCHC) is the average concentration of hemoglobin in those cells.

Your PLATELETS (PLT) are the things that help you clot, so when you injure yourself you don't bleed to death. The Mean Platelet Volume tells us how big these platelets are; how uniform in size the platelets are. It is not a measure of the overall levels of those platelets. Abnormally high values here occur in thrombocytopenia, some leukemias, polycythemia vera (a bone marrow disease), rheumatoid arthritis, renal failure, Hodgkin's disease, pancreatitis.

Please understand that I am not and can not say that you have or do not have anything, these are just guesses. Putting this information together with your symptoms, I can not help but wonder if your doctors think you may have some form of bone marrow disease or disorder. If you had a leukemia, which is a cancer of the bone marrow, I would have expected wildly abnormal white blood cell counts. But your easy bruising and fatigue makes me wonder about how well your bone marrow is doing its job, especially given you have some swollen lymph nodes. Easy bruising may suggest that even if your levels of platelets are normal, they are not "working" properly in clotting blood.

I hope I was able to help; please rate me only when you are satisfied (as your positive rating is the only way I get paid). If you need any more information or clarification, please ask. I am here if you have further questions...

Customer: replied 3 years ago.
Thank you. White blood cell count is 5.68 steady last 2 cbc's and mchc in normal range. Mcv is 95.9 mch 33.8 and mpv 11.4 and have not fluctuated much in a year. I did have a stress fracture on the ankle that was from running (only thought) unexplained. I feel my docs are at a questioned stage. Any thoughts on what my next objective is? Direction. I do not feel healthy any longer and irratibilty/patience is becoming more so. I am on a synthetic hormone replacement for testosterone for last 10 years, did my fair share of drinking through college, I do have inflamation of stomach lining as well so I can not really pin point and they can not pin point the issue. If it is bone marrow issues or leukemia what tests can be performed. I had a chest and abdominal ct 3 months ago with barrium that was normal? I will ad I get under arm pain groin area and forearm and leg pain periodically. Just reaching out and again thank you.
Expert:  Nurse Susan replied 3 years ago.
Hi JACustomer,

Thank you for that additional information, and I am so sorry you've been unwell for so long. I do hope I can guide you and offer you some direction.

Different labs will have different values and reference ranges. My lab book (Fischbach, F. (2000) A Manual of Laboratory and Diagnostic Tests, 6th Edition; Lippencott Publishers) has as its range of normal for the MCV as 82-98, so by their standards, your MCV would be normal, if on the high side. 95 is a bit high, and you did say you have inflammation of the stomach. That can cause a higher MCV.

Likewise, their reference range for the MCH is 26-34; yours squeaks just under the line at the high side of normal.

However, the MPV of 11.4 is definitely high; my books range is 7.4-10.4. Focusing more on causes of a high MPV that make sense with your symptoms...and the arm and leg pain you mention make me wonder if you may have an autoimmune disease. Rheumatoid arthritis is an autoimmune disorder where the bodys cells mistakenly attack itself; in this case, the joints. Inflammation of the stomach could also be immune disorder related. Testing for this is a blood test, and the tests are called "Rheumatoid factor" and "ANA". Both of these tests check for abnormal proteins that often accompany autoimmune disorders; RF is more specific to rheumatoid arthritis.

Cancers of any type are a wild overgrowth of cells that do not do their job. If you had a leukemia, which is cancer of the bone marrow, the white blood cells that bone marrow makes would be wildly out of range. Your CBC was within normal limits, so I am pretty confident you do not have a leukemia.

If bone marrow problems are suspected, a bone marrow biopsy can be done. It is not the most comfortable procedure, but it takes a sample of that marrow and examines it directly for abnormalities.

I would, were I you, speak to my doctor about the possibility of an autoimmune disorder, and see if he/she agrees that its worth checking for.\

I hope I was able to help, and that you feel better soon.
Nurse Susan, Nurse (RN)
Category: Health
Satisfied Customers: 1091
Experience: RN, BSN, MSN-ED, Nurse Educator whose passion is helping people understand their health and wellness
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