Shrestha Biraj, Rijal Swarup Sharma, Pokhrel Arpan, Paudel Anish, Baral Krantikiran, Poudel Bidhya, Basnet Sijan, Donato Anthony
Internal Medicine, Reading Tower Health, Reading, USA.
Internal Medicine, St. Francis Hospital, Illinois, USA.
Cureus. 2022 Apr 9;14(4):e23978. doi: 10.7759/cureus.23978. eCollection 2022 Apr.
Elevated potassium levels can be a life-threatening emergency. We describe a case of falsely elevated serum potassium level in a patient with leukemia, which was suspected to be falsely elevated because the patient was asymptomatic with a normal electrocardiogram (EKG). Common reasons behind such a discrepancy in leukemia patients are the use of a tourniquet before collection, use of vacuum/pneumatic tubes for transportation, prolonged periods of incubation, use of heparin for sample collection, and processing of samples via centrifugation. Since the process is related to the method of collection and processing, we recommend using rapid point of care testing in such cases to differentiate between false and true potassium elevation, as it is a well-validated tool. Moreover, there is a good correlation between potassium measured with the blood gas, point of care, and central laboratory analyzers when the concentration of potassium is above 3 mEq/L.
血钾水平升高可能是危及生命的紧急情况。我们描述了一例白血病患者血清钾水平假性升高的病例,怀疑其为假性升高是因为患者无症状且心电图(EKG)正常。白血病患者出现这种差异的常见原因包括采集前使用止血带、使用真空/气动管运输、长时间孵育、使用肝素采集样本以及通过离心处理样本。由于该过程与采集和处理方法有关,我们建议在此类病例中使用即时检验来区分假性和真性钾升高,因为它是一种经过充分验证的工具。此外,当血钾浓度高于3 mEq/L时,血气分析、即时检验和中心实验室分析仪所测血钾之间具有良好的相关性。