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.
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http://dx.doi.org/10.5811/cpcem.2020.3.46481 | DOI Listing |
PLoS One
December 2024
LADR Laboratory Group Dr. Kramer & Kollegen, Geesthacht, Germany.
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 PDFCureus
September 2024
Acute and General Internal Medicine, University Hospitals Bristol and Weston, Weston-super-Mare, GBR.
Int J Hematol
November 2024
Department of Surgery, China Medical University Hospital, No. 2, Yude Rd., North Dist., Taichung City, 404327, Taiwan.
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 PDFPediatr Hematol Oncol
October 2024
Division of Nephrology, Department of Pediatrics, Taichung Veterans General Hospital, Taichung, Taiwan.
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.
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