Spurious serum hyperkalemia in essential thrombocytemia

Factitious Biochemical Measurements Resulting From Hematologic Conditions

“…Factitious biochemical results that can be seen in patients with increased numbers of WBCs, RBCs, or platelets include pseudohyperkalemia, 3,8,36,[41][42][43][44][45][46][47][48][49][50] pseudohypokalemia, 51 pseudohypoglycemia, 3,52,60 pseudohypoxemia, 3,[53][54][55][56][57][58][59]86 and falsely increased serum cobalamin levels. 3 These artifacts are due to release of cellular constituents during clotting or storage, eg, potassium, or to the metabolic activity of the cells consuming nutrients and oxygen from plasma before the sample is analyzed.…”

“…Pseudohyperkalemia is a common laboratory artifact 3,8,36,[41][42][43][44][45][46][47][48][49][50] and may lead to unnecessary treatment 8 or emergency referral and hospital admission. 46 The artifact is due to leaching of potassium from the cytosol during clotting or prolonged storage of the sample.…”

“…Pseudohyperkalemia is seen in patients with acute leukemia; chronic myeloproliferative disorders such as chronic myeloid leukemia, polycythemia vera, 41,48 and essential thrombocythemia 44,48,50 ; chronic lymphocytic leukemia 45 ; and in some patients with reactive thrombocytosis. 36,43,48 In 1 review of the data for 435 patients with a reactive or neoplastic increase in blood cell counts, thrombocytosis was associated with higher levels of pseudohyperkalemia, erythrocytosis was associated with a mild increase in potassium levels, but no pseudohyperkalemia was seen with isolated leukocytosis.…”