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Pseudohyperkalemia
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Pseudohyperkalemia

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Contributors: Scott Echternacht, Benjamin L. Mazer MD, MBA, Michael W. Winter MD
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Synopsis

Pseudohyperkalemia is a laboratory artifact that can show a clinically nonsignificant hyperkalemia due to a variety of causes, including hematologic abnormalities, errors in blood sample collection, and complications of serum potassium measurement. Rarely, pseudohyperkalemia can present in a familial form.

Hematologic abnormalities are a common cause of pseudohyperkalemia and include significant leukocytosis or thrombocytosis. Pseudohyperkalemia is also often due to errors in blood sample collection, such as potassium release secondary to a tourniquet or hemolysis within the test tube. Pseudohyperkalemia can be a complication of serum potassium measurement due to excess potassium release from the clot that forms during the separation of serum. Familial pseudohyperkalemia is caused by hereditary xerocytosis. This defect causes red cell membrane abnormalities that increase cellular potassium leak within collection tubes. Plasma potassium measurement, which is becoming more common, is not often affected by these spurious elevations.

For more information on the familial form, see OMIM.

Codes

ICD10CM:
E87.5 – Hyperkalemia

SNOMEDCT:
14140009 – Hyperkalemia

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Differential Diagnosis & Pitfalls

Increased potassium release from cells:
  • Metabolic acidosis (other than organic acidosis due to lactic acidosis or ketoacidosis)
  • Insulin deficiency
  • Hyperglycemia
  • Hyperosmolality
  • Any cause of increased tissue breakdown (eg, trauma, tumor lysis syndrome, severe accidental hypothermia, rhabdomyolysis)
  • Beta blockers
  • Exercise
  • Hyperkalemic periodic paralysis
  • Digitalis overdose
  • Red blood cell transfusion
  • Administration of succinylcholine to patients with burns, extensive trauma, prolonged immobilization, chronic infection, or neuromuscular disease
  • Administration of arginine hydrochloride
  • Use of drugs that activate ATP-dependent potassium channels in cell membranes such as calcineurin inhibitors (eg, cyclosporine, tacrolimus), diazoxide, minoxidil, volatile anesthetics (eg, isoflurane)
Reduced urinary potassium excretion:

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Last Reviewed: 05/09/2019
Last Updated: 05/24/2019
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Pseudohyperkalemia
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Pseudohyperkalemia : Leukocytosis, Thrombocytosis
Copyright © 2019 VisualDx®. All rights reserved.