Ifudu O, Markell M S, Friedman E A
Department of Medicine, SUNY Health Science Center, Brooklyn 11203.
Am J Nephrol. 1992;12(1-2):102-4. doi: 10.1159/000168425.
Pseudohyperkalemia, defined as serum to plasma potassium difference of more than 0.4 mmol/l, occurs when platelets, leukocytes or erythrocytes release intracellular potassium in vitro, leading to falsely elevated serum values. Pseudohyperkalemia has been observed in myeloproliferative disorders [1], including leukemia [2] and infectious mononucleosis [3] as well as in rheumatoid arthritis [4]. We present 2 patients with renal disease and thrombocytosis in whom pseudohyperkalemia was recognized only after common therapeutic measures and/or dialysis failed to effect a decrease in serum potassium. In patients with renal disease and thrombocytosis, plasma as well as serum potassium should be routinely measured prior to instituting aggressive therapy or altering dialysis prescription in order to avoid potentially dangerous overtreatment with resulting hypokalemia.
假性高钾血症定义为血清钾与血浆钾差值超过0.4 mmol/L，当血小板、白细胞或红细胞在体外释放细胞内钾时发生，导致血清值假性升高。假性高钾血症已在骨髓增殖性疾病[1]中观察到，包括白血病[2]和传染性单核细胞增多症[3]以及类风湿性关节炎[4]。我们报告2例患有肾病和血小板增多症的患者，在常规治疗措施和/或透析未能使血清钾降低后才识别出假性高钾血症。在患有肾病和血小板增多症的患者中，在采取积极治疗或改变透析处方之前，应常规测量血浆和血清钾，以避免因低钾血症导致潜在危险的过度治疗。
