Elevated MCHC of 347: Could It Be Autoimmune Hemolytic Anemia?
A 34-year-old female, standing at 5 feet 10 inches and weighing 140 pounds, began to experience concerning symptoms, which led her to seek medical evaluation. She reported chest discomfort, muscle aches, profound fatigue, weakness, dizziness, as well as acute abdominal and kidney pain. During the examination, her physician detected a nodule on the thyroid, prompting a test for TSH levels, which returned normal results. The blood work indicated a high mean corpuscular hemoglobin concentration (MCHC) of 347. This finding has sparked anxiety over potential diagnoses. Given that she does not consume alcohol, the possibility of liver complications seems unlikely. The primary concern now appears to be autoimmune hemolytic anemia. Is autoimmune hemolytic anemia the sole explanation for her condition? Although her symptoms align with this disorder, she is apprehensive about receiving such a diagnosis. This condition appears to have life-long implications, with symptoms that could fluctuate in intensity. Would this condition pose significant health risks?
Answers (1)
7/18/2025, 8:20:36 PM
OpenHealth AI
Elevated MCHC levels can be concerning and may suggest several conditions, including autoimmune hemolytic anemia (AIHA), but it's essential to consider a broader context. Your symptoms, including chest discomfort, fatigue, and kidney pain, along with the high MCHC, certainly warrant further investigation.
Explanation
-
Mean Corpuscular Hemoglobin Concentration (MCHC): This lab value reflects the average concentration of hemoglobin in a given volume of red blood cells. A high MCHC can indicate conditions such as hereditary spherocytosis or autoimmune hemolytic anemia, where red blood cells are prematurely destroyed.
-
Symptoms: The combination of physical symptoms you reported—fatigue, weakness, dizziness—might align with a variety of conditions, including AIHA, but they are not exclusive to it. Other factors, such as thyroid disorders, autoimmune diseases like lupus, or other hematological issues, should also be explored.
-
Concerns about Diagnosis: It's completely natural to feel apprehensive about any potential diagnosis, especially one that may have long-term implications. However, AIHA varies in severity, and many individuals can manage it effectively with appropriate treatment.
Next Steps
- Monitor Your Symptoms: Keep a detailed log of your symptoms, noting any changes in severity or new developments. This information can help clarify the situation.
- Follow Up on Blood Work: Ask your healthcare provider if further tests are warranted, such as a peripheral blood smear, Coombs test, or additional autoimmune panels, to determine the underlying cause of the elevated MCHC.
- Consider Lifestyle Adjustments: Focus on maintaining a balanced diet rich in iron and vitamins, stay hydrated, and avoid any known stressors or triggers.
- Stay Informed: Educate yourself about autoimmune hemolytic anemia and related conditions. Understanding your condition can help alleviate some fears.
While your situation feels overwhelming, proactively seeking information and following through with necessary tests will help clarify your diagnosis and guide any needed treatment options. Please stay in close communication with your healthcare team for personalized care and support.
Related Questions
Seeking Answers for Ongoing Health Issues
Hi there, I’m currently feeling quite stressed about reaching out in this space. I’m a 30-year-old male, weighing approximately 60 kilograms. A decade ago, I was diagnosed with hypothyroidism. Although I received treatment, including two weeks of levothyroxine that alleviated some symptoms, I still experience ongoing issues, albeit with less severity. My symptoms are consistent with hypothyroidism: - Widespread hair loss from my scalp - Dryness of skin, especially on my face - Discomfort in both my hands and feet - Overwhelming fatigue, both mentally and physically - Difficulty with concentration and memory - Muscular soreness - Unusual tiredness in my biceps and hamstrings; activities like climbing stairs or lifting objects feel excessively draining - Easy bruising and reduced ability to clot blood Despite my persistent challenges, no physician seems to take my concerns seriously. This ongoing situation frustrates me immensely, particularly the cognitive difficulties, which hinder my daily life and diminish my sense of self due to the impact on my memory. Interestingly, my thyroid blood tests consistently return normal results. I’m reaching out for guidance—what should I communicate to my doctor to prompt them to take action, or at the very least, consider alternatives? I would greatly appreciate any advice.
Understanding the Term 'Not Identified' in Pathology Reports
My mother, aged 53, has been diagnosed with endometrial adenocarcinoma, FIGO Stage 1. Following her diagnosis, she underwent a complete hysterectomy, which included the removal of her ovaries and fallopian tubes. Upon reviewing her biopsy results, I noticed the following entries: - **Adenomyosis:** Present, unaffected by cancer - **Involvement of Uterine Serosa:** Not identified - **Involvement of Lower Uterine Segment:** Not identified - **Other Tissue or Organ Involvement:** Not identified - **Lymphatic and/or Vascular Invasion:** Not identified What exactly does the term "not identified" signify in this context? Does it imply that these areas were tested and found to be clear, or does it suggest that they were not assessed at all?
Guidance on Recovery After Lipoma Extraction
Yesterday, I underwent the removal of a 7 cm lipoma located on the side of my mid back. Initially, during the ultrasound, it was estimated to be around 3 to 4 cm and seemed to be superficial. However, during the procedure, it was discovered that the lipoma was actually connected to my latissimus dorsi muscle. The surgery lasted approximately 45 minutes. My doctor informed me that I would likely experience significant soreness and prescribed pain medication. He advised against heavy lifting and recommended that I take it easy for the next couple of weeks. Fast forward to 36 hours post-surgery, and I find myself experiencing no pain whatsoever. I haven’t needed to take any pain relievers, not even a Tylenol. There is a mild discomfort when I bend at the hip, lift something light, or if there’s direct pressure applied to the area. This leads me to my question: How should I gauge my body’s signals during recovery? If I’m feeling good, is it safe for me to return to my usual activities, aside from heavy lifting, and just exercise caution instead?
Concerned About Sleep Behavior and Its Impact on My Child
I am a 29-year-old woman, standing at 5 feet tall and weighing 160 pounds. For the past three months, I’ve been taking Zepbound at a dosage of 2.5 mg. In terms of my medical history, I have been diagnosed with "unspecified parasomnia" and inappropriate tachycardia syndrome following a COVID infection. Currently, I'm undergoing investigations for elevated antinuclear antibodies (ANA at 1:640) and thyroglobulin antibodies (332), along with experiencing erythromyalgia. For the last 16 years, I have been dealing with peculiar sleep behaviors that began abruptly when I was just 12. These nocturnal episodes can range from mildly bothersome to distressing, but I never sought answers until I became pregnant with my daughter in 2022. My previous habit of leaping out of bed became increasingly hazardous as my pregnancy progressed. After her birth, I found myself picking her up from her bassinet and running with her while she was still asleep, an act that fills me with dread to think about even three years later. Now that she’s 2.5 years old, just last night she inadvertently found herself in bed with me after a long night. I experienced an episode where I abruptly got out of bed, dashed into the kitchen, raced back, picked her up, and continued out of the room, before seemingly placing her back in bed. I was in a half-awake state yet retained enough awareness to remember this behavior. My sleep-related symptoms include: - Vivid hallucinations that arise approximately 10 to 30 minutes after I fall asleep. These can occur several times in one night or only once or twice weekly, but they never happen during my waking hours. - Sleep paralysis that primarily occurs during naps when I sleep on my back in a warm environment, although it rarely happens at night. - Confusional awakenings where I regain consciousness unable to speak or recall my identity, my husband's, or my whereabouts; I may simply feel a general sense of familiarity, requiring some time to fully recover. - Sudden episodes of running out of the room while still partially asleep, which might be triggered by a hallucination I can't recall. - Daily exhaustion regardless of whether I sleep for 5 or 9 hours. In the past, I relied heavily on coffee and naps, but my tachycardia diagnosis and having a toddler has made that impossible. The overwhelming fatigue typically strikes around 1 or 2 PM each day, and if I resist the urge to sleep, it leads to severe brain fog. - My inappropriate sinus tachycardia syndrome worsens at night, particularly due to frequent sit-ups or startling awake from a deep sleep, causing my heart rate to spike up to 200 at times. This issue has developed in the past three years, post-COVID. In terms of testing: - A sleep neurologist considered narcolepsy as a potential diagnosis. My Multiple Sleep Latency Test (MSLT) showed no early onset sleep or REM episodes, though I did sleep through all five naps. During my nighttime polysomnography (PSG), I experienced a sleep latency of just 6 minutes. In a previous PSG, the latency was also 6 minutes, and I reached REM sleep at 50 minutes, which was deemed early. After the MSLT results, the neurologist couldn't provide further direction and suggested I return if anything changes. - I consulted another neurologist who performed a 5-day ambulatory EEG, which was clear of seizures but did capture numerous nocturnal episodes that the PSG/MSLT had not detected. - An MRI of my head with and without contrast appeared normal. Any advice or insights you may offer would be immensely appreciated. I have aspirations of adding another child to my family, but I’m deeply concerned about the risks I might unwittingly pose to my children. My husband works away for three weeks each month, leaving me responsible for our daughter most nights. Additionally, managing fatigue is a challenge without my usual coffee or the opportunity to nap since my toddler has stopped napping.
Intense Lower Abdominal Pain and Missed Cycle: Seeking Advice (F/35)
Hello everyone, I hope you can excuse any grammatical errors, as English is not my first language. I am a 35-year-old woman who has undergone treatment for endometriosis (surgery done two years ago), along with a diagnosis of myomatosis and a gastric bypass in 2017. I have been using monthly Depo-Provera (Novafem) for over seven years without a break. Generally, I experience light yet consistent withdrawal bleeding every month, about every 30 to 35 days, and I am not attempting to conceive at this time. My most recent menstrual period began on May 22 and continued for a week. As of today, July 17, I am now at day 56 of my cycle without any bleeding. Lately, I have been experiencing increasingly bothersome PMS-like symptoms, especially this week, including: - Tenderness in my breasts - Heightened emotional sensitivity - An unexpected flare-up of hormonal acne - Bloating and gas in my digestive tract - Discharge that ranges from clear to milky white, which is usual for me and doesn’t have an unpleasant odor. Earlier today, I suddenly began to feel intense pain in my lower abdomen, deep in my pelvis. The discomfort was so severe that I was doubled over and unable to speak. There hasn’t been any fever, vomiting, or diarrhea, making me doubt it’s appendicitis. I took some naproxen and prednisone, which I had previously been prescribed during another flare. Thankfully, the pain subsided within 30 minutes. Additional information: - I took a pregnancy test yesterday, and it was negative. - No known issues with PCOS. - I have a history of anxiety and have been diagnosed with bipolar II, which I have managed with stable medication for over ten years. - There have been no signs of infection, such as fever, chills, or unusual vaginal discharge. - I am not experiencing pain while urinating. I am trying to understand what could be happening: - Is this related to uterine activity or a possible 'trapped period' from the Novafem? - Could my endometriosis have resurfaced even after surgery? - Or could this simply be a case of hormone dysregulation? I would greatly appreciate any insights or similar experiences anyone might want to share. I plan to arrange for an ultrasound if symptoms persist, but for now, I just want to feel less isolated and more grounded. Under what circumstances should I consider going to the emergency room? I hope it's not necessary, as I can't afford it and would prefer to seek help only in a life-threatening situation. Thank you very much for your assistance!