Basile Carlo, Manobianca Giovanni, Bruno Andrea, Tamma Filippo
G Ital Nefrol. 2013 Jan-Feb;30(1).
Pseudohyperkalaemia that occurs in conditions with raised platelet counts is caused by an in vitro rise of the serum potassium concentration during whole blood coagulation together with lysis of platelets and other cellular components, in the presence of normal renal function and plasma potassium levels. Here, we report the case of a 66-year-old man presenting a myeloproliferative disorder with thrombocythaemia. His serum potassium level was 6.4 mmol/L in the presence of normal renal function (creatinine clearance 78 mL/min) and a normal acid-base balance. Pseudohyperkalaemia in thrombocythaemia was suspected. Our suspicion was confirmed over the following three days by measuring potassium level in both a lithium heparin specimen tube (plasma sample) and in the serum. A clear-cut difference between serum potassium levels (mean 6.27 mmol/L) and plasma potassium levels (mean 4.10 mmol/L) was found. In conclusion, the aim of the present case report is to increase the awareness of the existence of pseudohyperkalaemia occurring in diseases that cause increased platelet counts in order to reduce the risk of potentially harmful treatment.
血小板计数升高情况下出现的假性高钾血症，是在肾功能和血浆钾水平正常的情况下，全血凝固过程中血清钾浓度在体外升高，同时伴有血小板和其他细胞成分溶解所致。在此，我们报告一例66岁男性，患有伴有血小板增多的骨髓增殖性疾病。在其肾功能正常（肌酐清除率78 mL/分钟）且酸碱平衡正常的情况下，血清钾水平为6.4 mmol/L。怀疑为血小板增多症所致的假性高钾血症。在接下来的三天里，通过测量锂肝素标本管（血浆样本）和血清中的钾水平，证实了我们的怀疑。发现血清钾水平（平均6.27 mmol/L）与血浆钾水平（平均4.10 mmol/L）之间存在明显差异。总之，本病例报告的目的是提高对导致血小板计数增加的疾病中存在假性高钾血症的认识，以降低潜在有害治疗的风险。
