What is the interpretation of these lab results and the recommended course of action?

Interpretation of Complete Blood Count Results

The CBC results show a normal blood profile with only a mildly elevated hematocrit of 49.2% (normal range 34.0-46.6%), which may indicate mild hemoconcentration but is not clinically significant and requires no specific intervention.

Analysis of CBC Parameters

Red Blood Cell Parameters

• Hemoglobin (15.6 g/dL) and RBC count (5.07 x10^6/uL) are within normal limits 1
• Hematocrit is mildly elevated at 49.2% (normal range 34.0-46.6%) 1
• Red cell indices (MCV, MCH, MCHC) are all within normal ranges, indicating normocytic, normochromic red cells 1
• RDW is normal at 13.6%, suggesting uniform red cell size distribution 1

White Blood Cell Parameters

• Total WBC count is normal at 6.2 x10^3/uL 1
• Differential counts show normal distribution of neutrophils, lymphocytes, monocytes, eosinophils, and basophils 1
• All absolute counts of white cell subtypes are within normal ranges 1

Platelet Parameters

• Platelet count is normal at 212 x10^3/uL 1

Clinical Significance and Recommendations

Elevated Hematocrit

• The isolated elevation in hematocrit without corresponding elevation in hemoglobin or RBC count suggests mild hemoconcentration rather than a true polycythemia 1, 2
• Potential causes include:
  • Dehydration (most common cause of isolated hematocrit elevation) 1
  • Recent physical exertion 3
  • High altitude exposure 3
  • Laboratory variation or pre-analytical factors 4

Recommended Course of Action

• No immediate intervention is required as this is a mild, isolated finding 1
• Consider checking hydration status of the patient 1
• If clinically indicated, repeat CBC in 2-4 weeks to confirm normalization 1
• If the patient has symptoms of dehydration, recommend increased fluid intake 1

When to Consider Further Evaluation

• Further evaluation would be warranted only if:
  • Hematocrit continues to rise on repeat testing 1
  • Patient develops symptoms such as headache, visual disturbances, or thrombotic events 2
  • Hemoglobin and RBC count also become elevated (suggesting true polycythemia) 1, 2

Common Pitfalls to Avoid

• Overinterpreting isolated mild hematocrit elevation without clinical correlation 1
• Failing to consider pre-analytical variables that can affect hematocrit values:
  • Prolonged tourniquet application during blood draw 4
  • Sample handling issues 4
  • Position of patient during blood collection (standing vs. recumbent) 3
• Missing true polycythemia vera which would typically show elevation in all three red cell parameters (RBC count, hemoglobin, and hematocrit) 1, 2