Pseudo-Hyperkalemia and Thrombocytosis: Case Report

Abstract

Our case is to describe clinical and laboratory diagnosis of pseudohyperkalemia associated with thrombocytosis. A 78-year-old male, with prior hypertension, who previously suffered a femoral neck fracture, was presented to the orthopedic service to perform hip arthroplasty. In further evaluation, we found one hyperkalemia and serum thrombocytosis without clinical worsening and without correlated changes in the electrocardiogram (ECG). The possibility of pseudohyperkalemia was considered, and technical mechanical failures or problems in transportation were investigated, because it is a condition induced by hemolysis and excessive potassium leakage from the cells during or after blood collection. Using heparinized test tubes, two blood samples were collected within a 6-hour period, to which K + levels were obtained in the normal range. In conclusion, a high number of platelets in the blood can release potassium ions to the plasma environment, causing pseudo-hyperkalemia, leading to the decision for hospitalization and inappropriate treatments.