Pseudohyperkalemia - Potassium released from cells due to clotting and centrifugation - a case report

Biochemia Medica
Tomáš Šálek

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 concent...Continue Reading

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Citations

Dec 6, 2018·The Journal of Bone and Joint Surgery. American Volume·Jack W Crosland
Feb 26, 2019·Biochemia Medica·Gian Luca SalvagnoGiuseppe Lippi
Feb 28, 2019·Diagnosis·Mads NyboKjell Grankvist
Aug 28, 2020·European Journal of Emergency Medicine : Official Journal of the European Society for Emergency Medicine·Gregor LindnerAdam J Singer
Jul 30, 2019·Clinica Chimica Acta; International Journal of Clinical Chemistry·Wei-Zheng Zhang, David J Price
Jan 26, 2021·The Journal of Pediatrics·Zelda GhersinPhoebe Yager

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blood collection

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