Postsplenectomy thrombocytosis with pseudohyperkalaemia.
A 52-year old man developed hyperkalaemia on the 11th postoperative day following an extensive open retroperitoneal liposarcoma resection that included splenectomy. Despite thorough investigations, no aetiology for the hyperkalaemia was identified and standard empirical treatment was ineffective. On reconsideration, in view of the patient's concurrent thrombocytosis, a pseudofactual or artefactual hyperkalaemia was suspected. This was confirmed by contemporaneous testing of serum and plasma potassium levels, with the latter value lying within the normal range. Treatment for hyperkalaemia was discontinued, thus averting an iatrogenic and potentially dangerous hypokalaemia. This case highlights pseudohyperkalaemia as an often-neglected cause of elevated serum potassium levels and discusses its association with thrombocytosis following splenectomy.
HPB & Liver Transplant Surgery Department, Royal Free London NHS Foundation Trust, London, UK.
Katrin
K
Alizadeh
Radcliffe Department of Medicine, University of Oxford, Oxford, UK.
Andreas V
AV
Hadjinicolaou
HPB & Liver Transplant Surgery Department, Royal Free London NHS Foundation Trust, London, UK.
Christopher
C
Hadjittofi
London Sarcoma Service & NCL HPB Unit, University College Hospital, London, UK.
Arjun
A
Shankar
D006801:Humans; D006947:Hyperkalemia / Q000175:diagnosis*; D007008:Hypokalemia / Q000209:etiology; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000097:blood*; D011188:Potassium / Q000009:adverse effects / Q000097:blood*; D012016:Reference Values; D013156:Splenectomy / Q000009:adverse effects*; D013922:Thrombocytosis / Q000209:etiology*
D011188:Potassium