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Hematologist, oncohematologist

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Causes of increased and decreased mean red blood cell volume

Alexey Kryvenko, medical expert
Last reviewed: 04.07.2025

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The clinical significance of MCV is similar to the significance of unidirectional changes in the color index and hemoglobin content in the erythrocyte (MCH), since macrocytic anemias are usually simultaneously hyperchromic (or normochromic), and microcytic anemias are hypochromic. Changes in MCV can provide useful information about water-electrolyte imbalance. An increase in MCV indicates a hypotonic nature of water-electrolyte imbalance, while a decrease indicates a hypertonic nature.

Diseases and conditions associated with changes in MCV

MCV less than 80 fl

MCV in the range of 80-100

MCV over 100 fl

Microcytic anemias:

iron deficiency
thalassemia
sideroblastic

Anemias that may be accompanied by microcytosis:

hemoglobinopathies
synthesis disorder
porphyrins

Lead poisoning

Normocytic anemias:

aplastic
hemolytic
hemoglobinopathies
after bleeding

Anemias that may be accompanied by normocytosis:

regenerative phase
iron deficiency anemia

Macrocytic and megaloblastic anemias:

vitamin B ₁₂ deficiency;
folate deficiency

Anemias that may be accompanied by macrocytosis:

myelodysplastic syndromes
hemolytic anemia;
liver diseases