Pseudohyperkalemia Due to Release of Potassium from White Blood Cells during Clotting

Use of intraosseous blood for repeated hematologic and biochemical analyses in healthy pigs

“…It has been shown that potassium is contained within WBC, and if the WBC count is high, hyperkalemia may develop. 35 Although potassium concentrations measured in this study did not indicate hyperkalemia, it is possible that the increased WBC count in IO samples, compared with venous samples, was a factor in the increased potassium concentration. Additionally, potassium is released from RBC upon hemolysis.…”

Spontaneous splenic rupture and pseudo-hyperkalaemia in chronic lymphatic leukaemia

“…The same phenomenon has been observed in myeloproliferative disorders with thrombocytosis (Myerson and Frumin, 1960). In three cases of chronic myeloid leukaemia, pseudo-hyperkalaemia has been shown to be due to release of potassium from the white blood cells during clotting (Bronson et al, 1966), but in these latter cases, the hyperkalaemia was prevented by heparin. Increased white blood cell fragility and potassium release in the absence of coagulation have been demonstrated and implicated in pseudo-hyperkalaemia (Wills and Fraser, 1964).…”

Postsplenectomy thrombocytosis with pseudohyperkalaemia

“…Causes of pseudohyperkalemia include an autosomal dominant familial syndrome in which red blood cells exhibit an abnormal potassium leak,9 10 hereditary spherocytosis,11 leucocytosis of chronic inflammation such as in rheumatoid arthritis and infectious mononucleosis,12 13 chronic myeloid or lymphocytic leucaemia,14 15 essential thrombocythaemia16 17 and reactive postoperative thrombocytosis 18…”

“…Furthermore, pseudohyperkalaemia has been shown to occur only at platelet and leucocyte counts of more than 600×10 9 /L and 70×10 9 /L, respectively 14 18 19 27. Furthermore, the reason why pseudohyperkalaemia only occurs in certain cases of asplenia remains to be elucidated.…”