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Increased electronic mean corpuscular volume induced by marked hyperglycemia
Annals of Clinical and Laboratory Science
|March 1, 1981
Summary
High blood glucose in diabetics can falsely elevate red blood cell volume (MCV) and alter other blood indices. Proper predilution corrects these erroneous electronic measurements.
Area of Science:
- Hematology
- Clinical Chemistry
Background:
- Diabetic hyperglycemia can impact red blood cell (RBC) indices.
- Accurate RBC indices are crucial for diagnosing and managing anemia and other conditions.
Observation:
- Elevated glucose levels in diabetic patients were linked to increased electronic Mean Corpuscular Volume (MCV).
- This hyperglycemia caused falsely high hematocrit and falsely low Mean Corpuscular Hemoglobin Concentration (MCHC), with normal Mean Corpuscular Hemoglobin (MCH).
- Blood smear morphology did not support the automated indices.
Findings:
- Automated RBC indices can be significantly affected by high intracellular glucose concentrations.
- The observed changes are due to glucose-induced intracellular hyperosmolarity, leading to water influx into RBCs.
- This phenomenon is glucose concentration-dependent, temperature-sensitive, and rapidly reversible.
Implications:
- Standard automated hematological analysis may require adjustments for diabetic patients with hyperglycemia.
- Predilution with isotonic medium can yield accurate RBC indices by allowing equilibration.
- Understanding this glucose-dependent RBC swelling phenomenon is vital for precise clinical interpretation.