Thrombocytosis Elevates Serum Potassium

Graber, Mark L.; Subramani, Krishnaiyer; Corish, Denise; Schwab, Albrecht

doi:10.1016/s0272-6386(88)80005-2

Cited by 59 publications

(28 citation statements)

References 8 publications

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“…Potassium also moves out of white blood cells and platelets after clotting has occurred; thus, the potassium concentration of serum is normally 0.1-0.5 mEq/l greater than that measured in a plasma sample. Severe hyperkalemia as high as 9 mEq/l has been reported to be found in patients with marked leukocytosis or thrombocytosis (3,4). The present patient showed no abnormalities on hematological examination; thus the release of potassium during clotting was excluded.…”

Section: Discussionsupporting

confidence: 41%

Familial Pseudohyperkalemia: A Rare Cause of Hyperkalemia

et al. 2005

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A previously healthy 19-year-old girl was admitted to our hospital because of hyperkalemia. Pseudohyperkalemia was diagnosed because there was a marked difference between levels of serum and plasma potassium. Her plasma potassium level was markedly increased after 6-hour in vitro incubation of blood at room temperature, suggesting excessive potassium release from red blood cells without coagulation. The plasma potassium levels of the patient and her father were markedly elevated in blood specimens incubated in vitro at 4°C, but not at 37°C. These data indicated pseudohyperkalemia syndrome caused by abnormal leakage of potassium from red blood cells at the lower temperatures.

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Section: Discussionsupporting

confidence: 41%

Familial Pseudohyperkalemia: A Rare Cause of Hyperkalemia

et al. 2005

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“…It is known that the serum K + concentration normally exceeds the true value in the plasma by 0.1 to as much as 0.5 mEq/l due to K + release from white cells and platelets during the clotting process [24]. Although this difference in normal subjects is clinically unimportant, the measured serum K + concentration may be falsely high (up to 9 mEq/l) in patients with marked leukocytosis (white cell count >70,000/mm 3 ) or thrombocytosis (platelet count >500,000/mm 3 ) [24,25,26,27,28].…”

Section: Pseudohyperkalemiamentioning

confidence: 99%

Spurious Electrolyte Disorders: A Diagnostic Challenge for Clinicians

et al. 2013

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Spurious electrolyte disorders refer to an artifactually elevated or decreased serum electrolyte values that do not correspond to their actual systemic levels. When a clinician is confronted with a case of electrolyte disturbance, the first question should be whether it is an artifact. Spurious electrolyte disorders (pseudohyponatremia, pseudohypernatremia, pseudohypokalemia, pseudohyperkalemia, pseudohypomagnesemia, pseudohypophosphatemia, pseudohyperphosphatemia, pseudohypocalcemia and pseudohypercalcemia) are not infrequently observed in clinical practice. The recognition that an electrolyte disturbance may be an artifact may prevent inappropriate therapeutic interventions that could potentially have unfavorable outcomes. Clinicians must be alert to the possibility of spurious laboratory abnormalities when faced with conflicting laboratory values or measurements that are discordant with the clinical presentation. Moreover, in the presence of conditions that predispose to spurious electrolyte disorders, the normal measured electrolyte levels should raise the suspicion that true electrolyte disorders may be present.

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“…Other factors that may interfere in serum potassium concentration are: type of sample, between whole blood or serum that underwent hemolysis (potassium released from ruptured platelets in the clotting process); muscular activity before venous pucture (potassium may increase from 10% to 20% if the patient opens and closes his/her hands before blood collection (17); extreme thrombocytosis and leukocytosis (20); and lower temperature of whole blood sample before separation, increasing potassium concentration in the serum (17,21,22).…”

Section: Discussionmentioning

confidence: 99%

Diabetic ketoacidosis: difference between potassium determined by blood gas analysis versus plasma measurement

Robles

Neto

Dias

et al. 2011

Arq Bras Endocrinol Metab

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OBJECTIVE: To evaluate the accuracy of potassium concentrations measured by blood gas analysis (PBG) compared with laboratory serum potassium (LSP), in the initial care of patients with diabetic ketoacidosis (DKA). SUBJECTS AND METHODS: Fifty three patients with diabetes mellitus were evaluated in a retrospective analysis. PBG was carried out using the Radiometer ABL 700 (Radiometer Copenhagen®), and results were compared with LSP ADVIA 1650 Chemistry system (Siemens®), the gold standard method. Both methods are based on potentiometry. RESULTS: Mean PBG was 3.66 mmol/L and mean LSP was 4.79 mmol/L. Mean difference between PBG and LSP was -1.13 mmol/L (p < 0.0005, 95% CI, -1.39 to -0,86). Lin concordance correlation coefficient was rc = 0.28 (95% CIb, 0.10 to 0.45), demonstrating low concordance between the methods. CONCLUSION: Although PBG measurement is faster and easier, it should not be used as a surrogate for LSP in the clinical treatment of DKA.

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Thrombocytosis Elevates Serum Potassium

Cited by 59 publications

References 8 publications

Familial Pseudohyperkalemia: A Rare Cause of Hyperkalemia

Familial Pseudohyperkalemia: A Rare Cause of Hyperkalemia

Spurious Electrolyte Disorders: A Diagnostic Challenge for Clinicians

Diabetic ketoacidosis: difference between potassium determined by blood gas analysis versus plasma measurement

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