[Pseudo-hyperkalemia and hyperleukocytosis]

Area of Science:

• Hematology
• Clinical Chemistry

Background:

• Hyperleukocytosis, a hallmark of certain leukemias, can present with laboratory abnormalities.
• Elevated white blood cell counts can interfere with standard laboratory tests, leading to spurious results.

Observation:

• A case of pseudo-hyperkalemia was observed in a patient with acute myeloid leukemia.
• This phenomenon is attributed to the fragility of white blood cells and mechanical stress during blood sample collection.

Findings:

• Pseudo-hyperkalemia is a laboratory artifact, not a true elevation of serum potassium.
• The condition arises from the release of intracellular potassium from damaged leukocytes during sample processing.

Implications:

• Accurate differentiation between true and pseudo-hyperkalemia is essential for appropriate patient management.
• Avoiding unnecessary interventions for pseudo-hyperkalemia prevents iatrogenic hypokalemia and associated complications.
• This case highlights the importance of considering pre-analytical variables in interpreting laboratory results, especially in hematological malignancies.