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Clinical Chemistry 54: 449-451, 2008; 10.1373/clinchem.2007.095216
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(Clinical Chemistry. 2008;54:449-451.)
© 2008 American Association for Clinical Chemistry, Inc.

Letters to the Editor

Reverse Pseudohyperkalemia in a Leukemic Patient

Boban Abraham1, Ijaz Fakhar2, Anurag Tikaria1, LaDonna Hocutt3, Jim Marshall3, Sundararaman Swaminathan2 and Joshua A. Bornhorst4,a

1 Department of Internal Medicine
2 Department of Nephrology
3 Clinical Laboratory
4 Department of Pathology, University of Arkansas for, Medical Sciences, Little Rock, Arkansas 72205

aAddress correspondence to this author at: University of Arkansas for Medical Sciences, College of Medicine, Department of Pathology, 4301 W Markham St, Little Rock, AR 72205, Fax 501-526-4621, e-mail jabornhorst@UAMS.edu

The first 20% of the full text of this article appears below.


To the Editor:

Hyperkalemia is a potentially fatal electrolyte abnormality that must be differentiated from pseudohyperkalemia, which can occur when potassium is released from ruptured platelets or blood cells during the clotting process in serum specimens (1)(2). We describe a case of "reverse" pseudohyperkalemia in a patient with chronic lymphocytic leukemia (CLL) in whom potassium concentrations in plasma specimens exceeded concentrations observed in serum by more than 1.3 mmol/L (3).

A 49-year-old woman with stage IV CLL was admitted for chemotherapy. Her white cell count (WBC) was 364 x 109 cells/L (96% lymphocytes) and 100 x 109 platelets/L. The patient was treated with rituximab, cyclophosphamide, and fludarabine and received bicarbonate and allopurinol. After therapy, the potassium concentration obtained from a lithium-heparin specimen with separator gel was 10.7 mmol/L on a Beckman LX-20 chemistry analyzer (Beckman Coulter). A second lithium-heparin plasma specimen yielded a potassium concentration of 11.2 mmol/L. . . . [Full Text of this Article]




eLetters:

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Possible artefactual hyperkalemia
Christian P PERIER
Clinical Chemistry Online, 25 Feb 2008 [Full text]

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