A Case of Hyperkalemia Versus Pseudohyperkalemia in Chronic Lymphocytic Leukemia.

Clin Pract Cases Emerg Med

Albany Medical Center Hospital, Department of Emergency Medicine and Department of Surgery, Division of Surgical Critical Care, Albany, New York.

Published: May 2020

Introduction: Both hyperkalemia and pseudohyperkalemia occur in the emergency department. True hyperkalemia necessitates emergent treatment while pseudohyperkalemia requires recognition to prevent inappropriate treatment. It is imperative that the emergency physician (EP) have an understanding of the causes and clinical presentations of both phenomena.

Case Report: We present a case of an 88-year-old male with chronic lymphocytic leukemia (CLL) and suspected blast crisis who was found to have elevated serum potassium levels without other manifestations of hyperkalemia and eventually was determined to have pseudohyperkalemia due to white cell fragility.

Discussion: Differentiation of hyperkalemia and pseudohyperkalemia is a critical skill for the EP. We discuss multiple causes of hyperkalemia and pseudohyperkalemia in an effort to broaden the knowledge base.

Conclusion: We present a case of CLL as an unusual cause of pseudohyperkalemia and review common causes of pseudohyperkalemia.

Download full-text PDF

Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7220025PMC
http://dx.doi.org/10.5811/cpcem.2020.3.46481DOI Listing

Publication Analysis

Top Keywords

hyperkalemia pseudohyperkalemia
12
pseudohyperkalemia
8
chronic lymphocytic
8
lymphocytic leukemia
8
hyperkalemia
5
case hyperkalemia
4
hyperkalemia versus
4
versus pseudohyperkalemia
4
pseudohyperkalemia chronic
4
leukemia introduction
4

Similar Publications

Objectives: In most countries the majority of patients are in outpatient care. In difference to hospitalized patients, their blood samples often take hours after collection to centrifugation. The study investigates the release of potassium and the development of pseudohyperkalemia in lithium heparin (Li-Hep) and serum blood collection tubes over time.

View Article and Find Full Text PDF
Article Synopsis
  • Hyperkalaemia is a serious medical emergency that requires immediate treatment, but there is uncertainty about the exact level at which treatment should start due to different clinical situations.
  • The case report focuses on an 89-year-old man with frequent falls and unstable potassium levels, who did not exhibit symptoms of hyperkalaemia and lacked a significant drug history.
  • Further examination identified a myeloproliferative neoplasm causing thrombocytosis, leading to a diagnosis of pseudohyperkalaemia, which emphasizes the importance of distinguishing between true hyperkalaemia and pseudohyperkalaemia in patients with blood disorders.
View Article and Find Full Text PDF
Article Synopsis
  • Pseudohyperkalemia, a condition characterized by falsely high potassium levels, can be confused with true hyperkalemia, leading to unnecessary treatments; it is important to differentiate between the two.
  • A study analyzed 1188 blood samples and found that pneumatic tube transportation was associated with a higher occurrence of pseudohyperkalemia, particularly when white blood cell (WBC) counts were elevated (≥ 100 × 10/μL).
  • The results indicate that for every increase of 100 × 10/μL in WBC count, the likelihood of pseudohyperkalemia increased significantly (multiplied by 3.75), suggesting that careful sample handling is crucial for accurate potassium level assessment
View Article and Find Full Text PDF

Hyperkalemia presentation at a clinic during the cold season.

CEN Case Rep

June 2024

Division of Nephrology and Hypertension, Department of Internal Medicine, St. Marianna University School of Medicine, 2-16-1 Sugao, Miyamae-Ku, Kawasaki, Kanagawa, 216-8511, Japan.

Familial pseudohyperkalemia (FP) is an underrecognized cause of pseudohyperkalemia, caused by the leaking of potassium from red blood cells. This extracellular shift of potassium is temperature-dependent and occurs when blood samples are stored below room temperature or for a long time, manifesting as apparent hyperkalemia. We report a suspicious case of FP, which demonstrated an apparent seasonal trajectory of serum-potassium levels at the local clinic.

View Article and Find Full Text PDF

Patients with newly diagnosed hematological malignancies often present with a considerable cellular burden, leading to complications including hyperkalemia. However, pseudohyperkalemia, arising from cell lysis, can pose challenges in clinical practice. Although pseudohyperkalemia is frequently reported in adult hematological malignancies, its occurrence in pediatric patients is underreported, and its incidence in this demographic remains unclear.

View Article and Find Full Text PDF

Want AI Summaries of new PubMed Abstracts delivered to your In-box?

Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!