Spurious hyperkalaemia: an insight

Area of Science:

• Clinical Medicine
• Hematology
• Laboratory Diagnostics

Background:

• Hyperkalaemia is a frequent electrolyte disturbance with severe cardiac implications.
• Spurious hyperkalaemia (pseudohyperkalaemia) is a common artifact leading to unnecessary healthcare utilization.
• Accurate differentiation between true and spurious hyperkalaemia is crucial for patient management.

Observation:

• A patient with Chronic Myelomonocytic Leukaemia (CMML) presented with markedly elevated serum potassium levels on two separate occasions.
• Initial assessments suggested severe hyperkalaemia, prompting concern for life-threatening cardiac dysrhythmias.
• Thorough investigation revealed the hyperkalaemia to be factitious, not indicative of true potassium excess.

Findings:

• The elevated potassium levels in this CMML patient were ultimately attributed to a spurious laboratory result.
• This underscores the importance of considering pseudohyperkalaemia in patients with hematological malignancies.
• The case demonstrates how spurious findings can lead to significant clinical concern and resource utilization.

Implications:

• Highlights the diagnostic challenge posed by spurious hyperkalaemia, particularly in patients with underlying conditions like CMML.
• Emphasizes the need for clinicians to be vigilant for laboratory artifacts that can mimic serious medical emergencies.
• Suggests that improved awareness and diagnostic protocols for pseudohyperkalaemia can reduce avoidable emergency department visits and hospital admissions.