A patient with markedly high platelets and white blood cells; what effect could this have on potassium measurements?

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Multiple Choice

A patient with markedly high platelets and white blood cells; what effect could this have on potassium measurements?

Potassium levels in a blood sample can be higher than the patient’s true in vivo level because cells release potassium during the handling and processing of the specimen. When there are many platelets and white blood cells, as in marked thrombocytosis or leukocytosis, these cells can release potassium during clotting or during drawing and processing, causing the serum measurement to rise falsely. This is known as pseudohyperkalemia—a false high potassium reading that does not reflect the patient’s actual potassium status. To distinguish from real hyperkalemia, clinicians often compare plasma potassium from a rapid, properly handled sample or use a technique that minimizes cellular release, and avoid relying on a serum value if such cell counts are extremely high.

Potassium levels in a blood sample can be higher than the patient’s true in vivo level because cells release potassium during the handling and processing of the specimen. When there are many platelets and white blood cells, as in marked thrombocytosis or leukocytosis, these cells can release potassium during clotting or during drawing and processing, causing the serum measurement to rise falsely. This is known as pseudohyperkalemia—a false high potassium reading that does not reflect the patient’s actual potassium status. To distinguish from real hyperkalemia, clinicians often compare plasma potassium from a rapid, properly handled sample or use a technique that minimizes cellular release, and avoid relying on a serum value if such cell counts are extremely high.

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