Pseudohyperkalemia and Pseudohyponatremia in Two Children with T-Cell Acute Lymphoblastic Leukemia

Area of Science:

• Hematology
• Clinical Chemistry
• Pediatric Oncology

Background:

• Pseudohyperkalemia and pseudohyponatremia are laboratory artifacts.
• These can occur in patients with hematologic disorders characterized by high cell counts.
• Factitious electrolyte measurements may lead to inappropriate clinical interventions.

Observation:

• Two pediatric patients with leukemia presented with both pseudohyperkalemia and pseudohyponatremia.
• These electrolyte disturbances were linked to the high cell counts associated with their leukemia.

Findings:

• The study highlights the critical importance of validating electrolyte measurements.
• Correlation between plasma and whole blood electrolyte values is essential for accurate diagnosis.
• Failure to correlate results can lead to misdiagnosis and improper treatment.

Implications:

• Accurate electrolyte measurement is vital for appropriate patient management in hematologic malignancies.
• Clinicians should be aware of potential electrolyte measurement interferences in leukemia.
• Implementing comparative testing (plasma vs. whole blood) can prevent treatment errors.