Department of Haematology, University Medical Center Utrecht, Postbus 85.500, 3508 GA Utrecht, The Netherlands.
Ann Clin Biochem. 2010 Mar;47(Pt 2):179-81. doi: 10.1258/acb.2010.009170. Epub 2010 Feb 9.
Serious hyperleukocytosis can strongly affect laboratory results of potassium, phosphate and arterial oxygen tension. A 40-year-old woman is presented with an acute myeloid leukaemia and a strongly elevated leukocyte count (310 x 10(9)/L). Apart from this hyperleukocytosis, initial blood tests showed hypokalaemia, hypophosphataemia and serious hypoxaemia without any corresponding complaints. Blood sampled and transported on ice or directly analysed showed no electrolyte abnormalities and hypoxaemia. The observed discrepancy in laboratory results is probably due to the metabolic activity of the leukocytes in vitro. Spurious laboratory results can be a reason for incorrect decisions concerning additional diagnostics and treatment. In conclusion, hyperleukocytosis can cause pseudohypokalaemia, pseudohypophosphataemia and pseudohypoxaemia, which can be prevented by correct sampling and immediate analysis.
严重的高白细胞血症可强烈影响钾、磷酸盐和动脉血氧分压的实验室结果。一位 40 岁的女性因急性髓系白血病和白细胞计数显著升高（310×10^9/L）就诊。除了这种高白细胞血症，初始血液检查显示低钾血症、低磷酸盐血症和严重低氧血症，但没有任何相应的主诉。在冰上采样和运输或直接分析的血液均未显示电解质异常和低氧血症。观察到的实验室结果差异可能是由于白细胞在体外的代谢活性所致。虚假的实验室结果可能是导致额外诊断和治疗决策错误的原因。总之，高白细胞血症可导致假性低钾血症、假性低磷酸盐血症和假性低氧血症，通过正确的采样和即时分析可预防这些情况的发生。
