Differentials

Pseudohyperkalemia

SIGNS / SYMPTOMS
INVESTIGATIONS
SIGNS / SYMPTOMS

Pseudohyperkalemia is a falsely elevated potassium concentration due to release of potassium from blood cells during in vitro coagulation. Hematologic disorders (e.g., thrombocytosis, polycythemia vera, extreme leukocytosis [as in leukemia], hereditary spherocytosis) may predispose to pseudohyperkalemia.[2]

Pseudohyperkalemia may also be caused by errors in sample collection and/or storage, such as prolonged transit time from taking the sample to laboratory analysis, poor storage conditions, and mechanical trauma during venipuncture.[1][2]

Consider pseudohyperkalemia if the patient has normal renal function, normal ECG, and/or history of a hematologic disorder.[1]

INVESTIGATIONS

Repeated measurements of serum potassium will be normal.[2]

In practice, if there was mechanical trauma during venipuncture, the serum will have a reddish tint and the laboratory will usually report the result as hemolyzed.

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