Department of Haematology, Ulster Hospital Dundonald, Belfast, Northern Ireland.
Int J Lab Hematol. 2010 Feb;32(1 Pt 1):e151-7. doi: 10.1111/j.1751-553X.2008.01114.x. Epub 2008 Nov 2.
Pseudohyperkalaemia in conditions with increased platelet counts is caused by an in vitro rise of the serum potassium concentration during whole blood coagulation and the lysis of the platelets and other cellular components, in the presence of normal renal function and normal plasma potassium levels. The association between pseudohyperkalaemia and aetiology of thrombocytosis was studied in a 6-year retrospective audit on 90 patients with thrombocytosis referred to the Haematology Department in Ulster Hospital Dundonald, a large district general hospital. Over two-thirds of this study population had myeloproliferative disorders, and the most common diagnosis was primary thrombocythaemia (41%, n = 37). Reactive thrombocytosis was observed in approximately one-third of the cases (32%, n = 29). Pseudohyperkalaemia with apparent potassium level above the upper limit of the normal range (reference range K 3.5-5.1 mmol/l) was observed in the majority of patients with thrombocytosis from any aetiology (60%, n = 54). The likelihood of finding pseudohyperkalaemia was highest among patients with primary thrombocythaemia (75.7%, n = 28/37) and polythaemia rubra vera (75%, n = 12/16), followed by myelofibrosis (50%, 4/8) and reactive thrombocytosis (34.5%, n = 10/29). A highly significant positive correlation was observed between the platelet counts and the serum potassium level (Spearman's correlation coefficient, R = 0.998, P = 0.01). Awareness of pseudohyperkalemia in disease conditions with increased platelet counts will lead to the withholding of potentially harmful treatment.
假性高钾血症在血小板计数增加的情况下是由于全血凝固过程中血清钾浓度升高，以及血小板和其他细胞成分的溶解，而肾功能正常和血浆钾水平正常。在对 Ulster Hospital Dundonald 血液科就诊的 90 例血小板增多症患者进行的为期 6 年的回顾性审计中，研究了假性高钾血症与血小板增多症病因之间的关系。该研究人群中超过三分之二患有骨髓增殖性疾病，最常见的诊断是原发性血小板增多症（41%，n=37）。大约三分之一的病例观察到反应性血小板增多症（32%，n=29）。从任何病因引起的血小板增多症患者中，大多数患者（60%，n=54）出现了假性高钾血症，表现为钾水平明显高于正常范围上限（参考范围 K 3.5-5.1mmol/l）。在原发性血小板增多症（75.7%，n=28/37）和真性红细胞增多症（75%，n=12/16）患者中，发现假性高钾血症的可能性最高，其次是骨髓纤维化（50%，n=4/8）和反应性血小板增多症（34.5%，n=10/29）。血小板计数与血清钾水平之间存在高度显著的正相关关系（Spearman 相关系数，R=0.998，P=0.01）。在血小板计数增加的疾病情况下，认识到假性高钾血症将导致避免潜在有害的治疗。
