Unrecognized pseudohyperkalaemia in essential thrombocythaemia

Mannu, Gurdeep; Bhalerao, Angeline

doi:10.1258/shorts.2011.011095

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2015

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“…Causes of pseudohyperkalemia include an autosomal dominant familial syndrome in which red blood cells exhibit an abnormal potassium leak,9 10 hereditary spherocytosis,11 leucocytosis of chronic inflammation such as in rheumatoid arthritis and infectious mononucleosis,12 13 chronic myeloid or lymphocytic leucaemia,14 15 essential thrombocythaemia16 17 and reactive postoperative thrombocytosis 18…”

Section: Discussionmentioning

confidence: 99%

Postsplenectomy thrombocytosis with pseudohyperkalaemia

Alizadeh

Hadjinicolaou²,

Hadjittofi

et al. 2015

BMJ Case Reports

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SUMMARYA 52-year old man developed hyperkalaemia on the 11th postoperative day following an extensive open retroperitoneal liposarcoma resection that included splenectomy. Despite thorough investigations, no aetiology for the hyperkalaemia was identified and standard empirical treatment was ineffective. On reconsideration, in view of the patient's concurrent thrombocytosis, a pseudofactual or artefactual hyperkalaemia was suspected. This was confirmed by contemporaneous testing of serum and plasma potassium levels, with the latter value lying within the normal range. Treatment for hyperkalaemia was discontinued, thus averting an iatrogenic and potentially dangerous hypokalaemia. This case highlights pseudohyperkalaemia as an often-neglected cause of elevated serum potassium levels and discusses its association with thrombocytosis following splenectomy. BACKGROUND

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