Pseudohyperkalemia: Hyperkalemia Cocktail or Alternative Diagnosis

Case Reports in Medicine
Sanjay Prakash NeupaneMahesh Mani Dangal

Abstract

Hyperkalemia is a commonly encountered clinical problem. Pseudohyperkalemia is believed to be an in vitro phenomenon that does not reflect in vivo serum potassium and therefore should not be treated. Here, we present a case who unfortunately underwent unnecessary treatment because of failure to detect the common lab abnormality of pseudohyperkalemia. A 91-year-old female with a history of chronic lymphocytic leukemia presented to the emergency with nausea and vomiting 24 hours after her first chemotherapy with chlorambucil. Physical examination was overall unremarkable. She had a leukocytosis of 210 × 103/µL with 96% lymphocytes along with chronic anemia with hemoglobin of 8.1 g/dL. Her initial sodium and potassium levels were normal. During the clinical course, her potassium progressively worsened and failed to improve despite standard medical treatment. Patient ultimately underwent dialysis. Differentiating true hyperkalemia from pseudohyperkalemia is very important in selected group of patients to avoid unnecessary medications, higher level of care, and unnecessary procedure including dialysis. We want to emphasize the importance of simple yet profound knowledge of technique of blood draws and basic metabolic panel processin...Continue Reading

References

Oct 10, 1991·The New England Journal of Medicine·M W NijstenA S Dofferhoff
May 3, 1990·The New England Journal of Medicine·B R DonM Schambelan
Jan 1, 1995·American Journal of Nephrology·G Colussi, D Cipriani
Sep 27, 2005·American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation·Paul S Kellerman, James M Thornbery
Jan 25, 2006·American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation·Giacomo Colussi
May 30, 2008·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Kathryn J RuddyJennifer R Brown
Jul 18, 2009·American Journal of Hematology·Neha R ChawlaRonald L Sham
May 24, 2011·International Journal of Nephrology·Stephen I Rifkin
Jun 1, 2013·North American Journal of Medical Sciences·Jaya R AsirvathamLoring Bjornson

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Methods Mentioned

BETA
blood draws

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