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Pseudohyperkalaemia in Kawasaki disease
T Shimizu1, Y Yamashiro, K Yabuta
1Department of Paediatrics, Juntendo University School of Medicine, Tokyo, Japan.
European Journal of Pediatrics
|July 1, 1992
Summary
Pseudohyperkalaemia, a false high potassium level, can occur in children with Kawasaki disease and very high platelet counts. This occurs due to potassium release during blood clotting, not true hyperkalemia.
Area of Science:
- Pediatrics
- Clinical Chemistry
Background:
- Kawasaki disease is associated with thrombocytosis.
- Elevated serum potassium levels can be misdiagnosed as hyperkalemia.
Purpose of the Study:
- To investigate the cause of pseudohyperkalaemia in patients with Kawasaki disease and thrombocytosis.
- To determine the relationship between platelet count and serum potassium levels.
Main Methods:
- Measured plasma and serum potassium concentrations in patients with Kawasaki disease.
- Assessed the correlation between platelet count and the difference between serum and plasma potassium levels.
Main Results:
- Three of 16 patients with Kawasaki disease and markedly increased platelet counts exhibited pseudohyperkalaemia.
- Plasma potassium was normal, while serum potassium was elevated.
- A significant correlation was found between platelet count and the serum-plasma potassium difference.
Conclusions:
- Pseudohyperkalaemia should be considered in Kawasaki disease patients with significant thrombocytosis.
- The elevated serum potassium is an artifact of in vitro coagulation due to high platelet counts.
- Distinguishing pseudohyperkalaemia from true hyperkalemia is crucial for appropriate patient management.