Postsplenectomy thrombocytosis with pseudohyperkalaemia

Alizadeh, Katrin; Hadjinicolaou, Andreas V.; Hadjittofi, Christopher; Shankar, Arjun

doi:10.1136/bcr-2015-211720

Cited by 4 publications

(7 citation statements)

References 24 publications

(27 reference statements)

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“…The immunological, hematological and anatomical consequences of splenectomy have long been a source of interest and controversy among researchers and doctors alike [6,9]. Thus, the literature review offers a long array of studies on the complications following the procedure [10,11,12,13,14,15,16]. While attempts to investigate the predictive factors that lead to these complications have been made, we feel confident that enlarging the area of research with a more thorough statistical analysis could greatly benefit patient care [16,17,18,19,20].…”

Section: Introductionmentioning

confidence: 99%

Predictive Factors for Platelet Count Variation After Splenectomy in Non-Traumatic Diseases

Dragomir

Hogea

Moga

et al. 2019

JCM

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Background: The spleen plays a central role in a range of diseases. As such, great emphasis has been placed on the procedure of spleen removal, the benefits and the numerous associated complications. Given the immediate risk of the thrombotic complications, the aim of this study was to evaluate clinical and laboratory patient characteristics in non-traumatic diseases of the spleen, and to investigate possible predictive factors for platelet count variation following the procedure. Methods: A total of 72 patients who underwent splenectomy were included in this retrospective study. Correlation coefficients as well as multiple linear regressions were used to assess the relationship between post-splenectomy platelet count and various preoperative clinical and laboratory patient characteristics. Results: Following multiple linear regression analysis, we determined that 54.93% of post-splenectomy platelet count variation was explained by admission platelet count (p = 0.00), lymphocyte count (p = 0.04), WBC count (p = 0.00), LOS (p = 0.00), patient gender (p = 0.00), spleen accessibility on admission (p = 0.02) and PT (p = 0.00). Conclusions: Platelet count variation following splenectomy for non-traumatic diseases can be predicted by assessing preoperative patient characteristics. The implications of this study suggest that by means of a prediction model, patient care could benefit from assessing and addressing various preoperative factors that lead to these complications.

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Section: Introductionmentioning

confidence: 99%

Predictive Factors for Platelet Count Variation After Splenectomy in Non-Traumatic Diseases

Dragomir

Hogea

Moga

et al. 2019

JCM

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“…Thus, due to the lack of anticoagulants, the platelets are degranulated, and the intracellular potassium is released. 11 …”

Section: Discussionmentioning

confidence: 99%

Pseudohyperkalemia associated with essential thrombocytosis; a hint for better clinical practice

Yaghoubi

Dalil

2023

Clinical Case Reports

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A 75-year-old Iranian man admitted to the emergency ward of Shariati Hospital, Tehran, Iran, with symptoms of weakness, lethargy, nausea, and vomiting. His past medical history was remarkable for diabetes mellitus, hypertension, and hyperlipidemia. The patient was on metformin 500 mg daily and losartan 25 daily but admitted to not always being compliant.On examination, the patient was alert and oriented. Her temperature, O 2 saturation, respiratory rate, and pulse rate were normal. But his systolic blood pressure was 147 over 73 mmHg. Initial blood tests revealed a

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“…( 7 ) Pseudohyperkalaemia is also characterised by the absence of ECG changes and symptoms of hyperkalaemia together with a lack of response to the classical treatment of hyperkalaemia. Furthermore, it has been demonstrated that patients with pseudohyperkalaemia secondary to thrombocytosis occur at platelet concentrations above 600 × 10 9 /L ( 8 ). Figure 1 shows that hyperkalaemia occurred when measuring potassium in platelet concentrations >600 × 10 9 /L, even in our limited data set in this single patient.…”

Section: Discussionmentioning

confidence: 99%

“…Platelet aggregates degranulate in these blood samples and release intracellular potassium. ( 8 ) In thrombocytosis, there are more platelets that release more intracellular potassium. Plasma electrolytes are taken in a specialised lithium heparinised bottle where tube inversions ensure mixing of anticoagulant (heparin) with blood to prevent clotting.…”

Section: Discussionmentioning

confidence: 99%

Pseudohyperkalaemia in essential thrombocytosis: an important clinical reminder

Mizzi

Rizzo

Fava

2021

Endocrinology, Diabetes &Amp; Metabolism Case Reports

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Summary An 82-year-old female was admitted to a general hospital due to progressive bilateral lower limb weakness. A T8–T9 extramedullary meningioma was diagnosed by MRI, and the patient was referred for excision of the tumour. During the patient’s admission, she was noted to have persistent hyperkalaemia which was refractory to treatment. Following a review by an endocrinology team, a diagnosis of pseudohyperkalaemia secondary to thrombocytosis was made. This case demonstrates the importance of promptly identifying patients who are susceptible to pseudohyperkalaemia, in order to prevent its potentially serious consequences. Learning points Pseudohyperkalaemia should be considered in patients with unexplained or asymptomatic hyperkalaemia. It should also be considered in those patients who are resistant to the classical treatment of hyperkalaemia. A diagnosis of pseudohyperkalaemia is considered when there is a difference of >0.4 mmol/L of potassium between serum and plasma potassium in the absence of symptoms and ECG changes. In patients who are presenting with consistently elevated serum potassium levels, it may be beneficial to take venous blood gas and/ or plasma potassium levels to rule out pseudohyperkalaemia. Pseudohyperkalaemia may subject patients to iatrogenic hypokalaemia which can be potentially fatal. Pseudohyperkalaemia can occur secondary to thrombocytosis, red cell haemolysis due to improper blood letting techniques, leukaemia and lymphoma.

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Postsplenectomy thrombocytosis with pseudohyperkalaemia

Cited by 4 publications

References 24 publications

Predictive Factors for Platelet Count Variation After Splenectomy in Non-Traumatic Diseases

Predictive Factors for Platelet Count Variation After Splenectomy in Non-Traumatic Diseases

Pseudohyperkalemia associated with essential thrombocytosis; a hint for better clinical practice

Pseudohyperkalaemia in essential thrombocytosis: an important clinical reminder

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