A Case of Hyperkalemia Versus Pseudohyperkalemia in Chronic Lymphocytic Leukemia

Both hyperkalemia and pseudohyperkalemia occur in the emergency department. True hyperkalemia necessitates emergent treatment while pseudohyperkalemia requires recognition to prevent inappropriate treatment. It is imperative that the emergency physician (EP) have an understanding of the causes and c...

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Bibliographic Details
Published in:Clinical practice and cases in emergency medicine 2020-05, Vol.4 (2), p.208-210
Main Authors: Le, Rachel D, Geary, Sean P
Format: Article
Language:English
Subjects:
Case Report
Clinical medicine
Edema
Electrocardiography
Electrolytes
Emergency medical care
Hospitals
Hyperkalemia
Laboratories
Leukemia
Medicine
Patients
Thrombosis
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Summary:Both hyperkalemia and pseudohyperkalemia occur in the emergency department. True hyperkalemia necessitates emergent treatment while pseudohyperkalemia requires recognition to prevent inappropriate treatment. It is imperative that the emergency physician (EP) have an understanding of the causes and clinical presentations of both phenomena. We present a case of an 88-year-old male with chronic lymphocytic leukemia (CLL) and suspected blast crisis who was found to have elevated serum potassium levels without other manifestations of hyperkalemia and eventually was determined to have pseudohyperkalemia due to white cell fragility. Differentiation of hyperkalemia and pseudohyperkalemia is a critical skill for the EP. We discuss multiple causes of hyperkalemia and pseudohyperkalemia in an effort to broaden the knowledge base. We present a case of CLL as an unusual cause of pseudohyperkalemia and review common causes of pseudohyperkalemia.
ISSN:2474-252X
2474-252X
DOI:10.5811/cpcem.2020.3.46481