Biochemia Medica, Vol. 28 No. 1, 2018.
Other
https://doi.org/10.11613/BM.2018.011002
Pseudohyperkalemia - Potassium released from cells due to clotting and centrifugation - a case report
Tomáš Šálek
orcid.org/0000-0002-8392-5003
; Department of biomedical sciences, Medical Faculty of the University of Ostrava, Ostrava – Zábřeh, Czech Republic; Department of Clinical biochemistry and pharmacology, Tomas Bata hospital in Zlín, Zlín, Czech Republic
Abstract
Hyperkalemia is a potentially lethal condition. Pseudohyperkalemia should be always excluded before implementing treatment to prevent inappropriate
cause of hypokalemia – equally a potentially lethal condition. Here we present a case report of a 62 year female with chronic myeloproliferative
disorder, i.e. essential thrombocythemia. The laboratory test results for potassium concentration were 6.3 mmol/L, for platelet count 1305 x109/L
and for leukocyte count 39.8 x109/L. This was due to a temporary drug withdrawal after a surgical intervention for gastric bleeding. Potassium concentration
in lithium heparin plasma collected in a vacuum tube without gel separator and in whole blood syringe were 4.6 mmol/L and 3.4 mmol/L,
respectively. It means that mechanical stress such as centrifugation can contribute to spurious hyperkalemia.
Prior to reporting unexpected hyperkalemia result, pseudohyperkalemia should always be considered by the laboratory. Such potassium results
require investigation in case it is pseudohyperkalemia, which may be due to thrombocytosis and leukocytosis. In cases where thrombocytosis or
leukocytosis exists, an interpretative comment indicating these conditions inserted with the results of the potassium concentration can increase
awareness for more accurate patient care decisions.
Keywords
hyperkalemia; case report; electrolytes; pseudohyperkalemia
Hrčak ID:
192393
URI
Publication date:
15.2.2018.
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