Opening problem: a sustained count pattern

An outpatient EDTA specimen collected at 09:10 and analyzed at 10:02 has hemoglobin 17.4 g/dL, hematocrit 52.1%, leukocytes 13.2 × 10^9/L, and platelets 612 × 10^9/L. The local adult female intervals are 12.0-15.5 g/dL, 36.0-46.0%, 4.0-11.0 × 10^9/L, and 150-450 × 10^9/L, respectively. The question is whether this is persistent true multilineage elevation and what integrated workup it supports.

A CBC 10 weeks earlier had hemoglobin 17.0 g/dL and platelets 588 × 10^9/L. The current smear confirms erythrocytosis, mild neutrophilia, and increased platelets without clumps, nucleated red cells, teardrops, or left shift. Persistence and smear review make a spurious platelet count less likely but do not assign an MPN diagnosis.

Repeat counts and prior results separate a durable pattern from a single event. Review reactive and secondary explanations before assuming clonality. Release the verified result with the observed pattern and follow the local escalation pathway rather than naming a disease.