Graber M, Subramani K, Corish D, Schwab A
VA Medical Center, Northport, NY.
Am J Kidney Dis. 1988 Aug;12(2):116-20. doi: 10.1016/s0272-6386(88)80005-2.
Spurious elevation of the serum potassium can be seen if the platelet count exceeds 1,000 x 10(9)/L in patients with myeloproliferative disease. To see if serum potassium is increased at more modest elevations of the platelet count we studied these parameters in 283 controls and 161 patients with reactive thrombocytosis. The incidence of hyperkalemia was 34% in patients with over 500 x 10(9) platelets/L compared with 9% if the platelet count was below 250 x 10(9)/L. Over this range there was a significant correlation of potassium increasing with the platelet count. The higher potassium values could not be explained on the basis of leukocytosis, renal insufficiency, or acidosis, suggesting that the elevated serum levels were often spurious. In support of this conclusion, the serum potassium exceeded plasma potassium by a larger amount in patients with thrombocytosis. We conclude that serum potassium rises in direct proportion to the platelet count in normal patients and in those with thrombocytosis, and that this increment is an artifact.
在骨髓增殖性疾病患者中，如果血小板计数超过1000×10⁹/L，可出现血清钾假性升高。为了观察在血小板计数轻度升高时血清钾是否升高，我们对283名对照者和161名反应性血小板增多症患者的这些参数进行了研究。血小板计数超过500×10⁹/L的患者中高钾血症的发生率为34%，而血小板计数低于250×10⁹/L时为9%。在此范围内，钾升高与血小板计数显著相关。较高的钾值不能用白细胞增多、肾功能不全或酸中毒来解释，这表明血清水平升高往往是假性的。支持这一结论的是，血小板增多症患者血清钾超过血浆钾的量更大。我们得出结论，正常患者和血小板增多症患者的血清钾与血小板计数成正比升高，且这种升高是一种假象。
