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Postsplenectomy thrombocytosis with pseudohyperkalaemia.

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A patient experienced falsely high potassium levels (pseudohyperkalaemia) after surgery. This condition, linked to increased platelets (thrombocytosis) post-splenectomy, requires careful diagnosis to avoid incorrect treatment.

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Area of Science:

  • Clinical Medicine
  • Pathophysiology
  • Laboratory Diagnostics

Background:

  • Postoperative hyperkalaemia can be a serious complication.
  • Standard diagnostic workups may not always identify the underlying cause.

Observation:

  • A 52-year old male presented with hyperkalaemia 11 days after extensive retroperitoneal liposarcoma resection and splenectomy.
  • Initial investigations failed to reveal an aetiology, and empirical treatment was ineffective.

Findings:

  • Thrombocytosis was noted concurrently with hyperkalaemia.
  • Serum potassium was elevated, but plasma potassium levels were normal, confirming pseudohyperkalaemia.
  • Discontinuation of hyperkalaemia treatment prevented iatrogenic hypokalaemia.

Implications:

  • This case underscores pseudohyperkalaemia as a critical differential diagnosis for elevated serum potassium.
  • Thrombocytosis following splenectomy is a potential risk factor for artefactual hyperkalaemia.
  • Accurate differentiation between true and pseudohyperkalaemia is vital for appropriate patient management and avoiding therapeutic complications.