[Pseudohyperkalemia and thrombocytosis]

Area of Science:

• Clinical Medicine
• Hematology
• Nephrology

Background:

• Hyperkalemia is a common medical condition requiring prompt management.
• Potential causes include renal failure, adrenal insufficiency, cell lysis, and iatrogenic factors.
• Pseudo-hyperkalemia, arising from laboratory artifacts, must also be considered.

Purpose of the Study:

• To report cases of pseudo-hyperkalemia associated with thrombocytosis.
• To highlight the importance of differentiating pseudo-hyperkalemia from true hyperkalemia.

Main Methods:

• Case series involving three patients with thrombocytosis and non-symptomatic hyperkalemia.
• Comparison of kalemia levels in standard collection tubes versus heparinized tubes.

Main Results:

• Patients presented with thrombocytosis (1306–2404 G/L) and elevated serum potassium (6.1–7.7 mmol/L).
• Kalemia levels were normal (4.4–4.6 mmol/L) when blood was collected in heparin tubes, indicating pseudo-hyperkalemia.
• No specific treatment for hyperkalemia was required.

Conclusions:

• The concurrent presence of thrombocytosis and asymptomatic hyperkalemia suggests pseudo-hyperkalemia.
• Measuring kalemia in heparinized blood tubes is recommended for confirmation.
• Accurate diagnosis prevents unnecessary and potentially harmful treatments for hyperkalemia.