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Manual flagging failed to identify pseudohyperkalemia in acute myeloid leukemia: case report.
Int J Emerg Med
October 2024
Division of Nephrology, Department of Internal Medicine, UCSF Fresno Center for Medical Education and Research, 155 N Fresno St, Fresno, CA, 93701, USA.
Article Synopsis
- Pseudohyperkalemia, often seen in chronic lymphocytic leukemia, is rare in acute myeloid leukemia (AML), but can pose diagnostic challenges, as shown in a case involving a 55-year-old man with severe leukocytosis and falsely elevated potassium levels.
- Despite the lab's manual flagging system meant to identify such cases, it failed to function properly, leading to reliance on clinicians' instincts for the correct diagnosis of pseudohyperkalemia.
- The incident was linked to pneumatic tube transport of blood samples, prompting the lab to consider enhancements in its flagging system and the importance of using whole blood for potassium measurements in cases of significant leukocytosis.
Pseudohyperkalemia can lead to inaccurate hyperkalemia diagnosis, inappropriate initiation of potassium-lowering therapies, and overall unnecessary treatment possibly inducing iatrogenic hypokalemia. Patients with leukocytosis and thrombocytosis should raise clinical suspicion that hyperkalemic laboratory results in the absence of other traditional signs of hyperkalemia may be indicative of pseudohyperkalemia. Here we present a case of severe leukocytosis with chronic lymphocytic leukemia (CLL) found to have critically elevated potassium levels on admission to the intensive care unit (ICU).
View Article and Find Full Text PDFErroneous potassium results: preanalytical causes, detection, and corrective actions.
Crit Rev Clin Lab Sci
September 2023
Department of Laboratory Medicine, Paracelsus Medical University, Salzburg, Austria.
Potassium is one of the most requested laboratory tests. Its level is carefully monitored and maintained in a narrow physiological range. Even slightly altered potassium values may severely impact the patient's health, which is why an accurate and reliable result is of such importance.
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