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conferenceseries.com
Volume 3 Diagnostic Pathology: Open Access
ISSN: 2476-2024 Laboratory Medicine 2018
June 25-26, 2018
June 25-26, 2018 | Berlin, Germany
13th International Conference on
Laboratory Medicine & Pathology
Overcoming spurious hyperkalemia due to platelets
Suhanyah Mahathevan1, Siriwardene S C1 and Hewamana S2
1Lanka Hospitals Diagnostics, Sri Lanka
2Lanka Hospital, Sri Lanka
Background: The occurrence of spuriously high serum potassium levels have been associated with high platelet counts. It is
due to the degranulation of platelets during clotting in vitro, releasing potassium into the serum.
Case Presentation: A 69-year-old man was admitted following a fall. On admission the white cell count was 12,920/µL,
hemoglobin 83 g/L and the platelet count 1,550,000/µL (150,000-450,000). Serum sodium, potassium and chloride were
respectively 141, 5.8 (3.5-5.1) and 113 mmol/L respectively. Plasma sodium, potassium and chloride (on a sample collected
into lithium heparin at the same time) were 141, 4.3 and 112 mmol/L, respectively. Serum creatinine was 1.5 mg/dL (0.8-
1.3). The blood picture showed macrocytes and spherocytes with normal leucocytes, together with severe thrombocytosis.
Bone marrow was normocellular and had increased megakaryocytes with some dysplastic forms. Platelet lakes/clumps were
prominent. The myeloid series was normal and the erythroid series had reduced precursors. The trephine biopsy showed
increased megakaryocytes with clustering, without significant fibrosis. JAK2 V617F mutation was detected. The patient was
diagnosed to have essential thrombocythemia.
Discussion: This case illustrates the occurrence of spurious hyperkalemia associated with marked thrombocytosis. The
collection of a sample into lithium heparin at the same time, allowed the laboratory to issue the true potassium level. Essential
thrombocythemia is identified by an increased platelet count due to abnormal pluripotent stem cell proliferation resulting in
excessive megakaryocyte division. The above investigations supports this diagnosis as against a secondary thrombocythemia.
The clinical complications involve the sequela of abnormal platelet function, namely haemorrhage or thrombosis. Potassium
measurement should be performed in a plasma sample (and not in serum) in the presence of marked thrombocytosis.
Biography
I am Suhanyah Mahathevan. I work as a Biomedical Scientist in Lanka Hospital Diagnostics, Sri education qualifications: BSC (Chemistry,Graduate
Chemist),MSC (Biomedical Science,University of East London,UK),MBA(University of Kelaniya),International Specialist in Chemistry from American Society of
Clinical Pathology (SC- ASCP),Srilanka Medical Council Registered Medical Technologist ( Reg No:2178).
Suhanyah Mahathevan et al., Diagn Pathol Open 2018, Volume 3
DOI: 10.4172/2476-2024-C1-003