Benefit of point of care testing in patient with major hyperleukocytosis

Interpretation of Folate Results in Hemolytic Plasma Samples: A Practical Approach

“…All data are presented as the median and interquartile range (IQR), because they were considered to be non-normally distributed. The potential influence of sample transportation, centrifugation, and cellular constitution (notably WBCs, which may alter the plasma fluid fraction [8] and may Since hemolysis was previously reported to be associated with an increase in plasma folate concentration [11], the critical difference in the laboratory-specific plasma folate concentration (CDfolate) was calculated with the formula [12]: CDfolate =1.65 ×√2 ×CVfolate. Changes greater than the CDfolate were interpreted as interference due to the hemolysate.…”

Leucocytosis‐induced plasma hyperkalaemia in samples conveyed by a pneumatic transport system: tips and tricks

“…In previous articles, including the recent case report published by Racek et al (), spurious hyperkalaemia has been documented in uncentrifuged plasma samples conveyed to laboratory by means of a pneumatic transport system (PTS). We also recently described the case of a child with high leucocytosis (i.e., 800 × 10 9 /l), whose uncentrifuged plasma samples were transported to the laboratory by PTS and then revealed a spurious increase of plasma potassium and an unexpected artefactual decrease of sodium in plasma (Grzych et al , ). Given that these electrolyte abnormalities are most likely to be attributable to the use of PTS, it was suggested that PTS should be avoided for convening blood samples with leucocytosis (Racek et al , ).…”

“…Given that these electrolyte abnormalities are most likely to be attributable to the use of PTS, it was suggested that PTS should be avoided for convening blood samples with leucocytosis (Racek et al, 2019). Nevertheless, avoidance of sample transportation with PTS did not apparently solved the problem in our previously published case (Grzych et al, 2019). On the other hand, although potassium measurement with a point of care (POC) device was found to considerably limit such interference -thus enabling a more reliable measurementthe use of POC testing is sometimes challenged by lack of resources or equipment.…”

Alternating and Concurrent True Hyperkalemia and Pseudohyperkalemia in Adult Sickle Cell Disease

“…9 We would advocate for caution in the use of these potent potassium binders and to always give consideration to the presence of pseudohyperkalemia under appropriate clinical scenarios. [6][7][8]10 We posit that providers managing adult patients with sickle cell disease must be aware of such a phenomenon to avoid the dangers of overtreatment of episodes of pseudohyperkalemia in such patients. 10 In conclusion, we suggest that the diagnoses of both true hyperkalemia and pseudohyperkalemia concurrently present in a patient at one point in time must be considered as indeed possible as demonstrated by our patient during the latter part of the first admission.…”

“…6 This is often associated with moderate to severe thrombocytosis or leukocytosis. 7,8 Clearly, true hyperkalemia is a potentially lethal condition. At the same time, the institution of inappropriate intensive treatment of pseudohyperkalemia leading to severe hypokalemia is also potentially lethal.…”