hyperkalemia; case report; electrolytes; pseudohyperkalemia

Hyperkalemia is a potentially lethal condition. Pseudohyperkalemia should be always excluded before implementing treatment to prevent inappropriatecause of hypokalemia ? equally a potentially lethal condition. Here we present a case report of a 62 year female with chronic myeloproliferativedisorder, i.e. essential thrombocythemia. The laboratory test results for potassium concentration were 6.3 mmol/L, for platelet count 1305 x109/Land for leukocyte count 39.8 x109/L. This was due to a temporary drug withdrawal after a surgical intervention for gastric bleeding. Potassium concentrationin lithium heparin plasma collected in a vacuum tube without gel separator and in whole blood syringe were 4.6 mmol/L and 3.4 mmol/L,respectively. It means that mechanical stress such as centrifugation can contribute to spurious hyperkalemia.Prior to reporting unexpected hyperkalemia result, pseudohyperkalemia should always be considered by the laboratory. Such potassium resultsrequire investigation in case it is pseudohyperkalemia, which may be due to thrombocytosis and leukocytosis. In cases where thrombocytosis orleukocytosis exists, an interpretative comment indicating these conditions inserted with the results of the potassium concentration can increaseawareness for more accurate patient care decisions.