Hyperkalemia in the setting of severe leukocytosis: Should you treat?
BACKGROUNDSevere hyperkalemia is a common and life-threatening problem presenting to the emergency department. Rapid correction of the electrolyte abnormality is essential but doing so can be detrimental in circumstances under which delaying treatment for confirmation is required. Our case exemplifi...
Gespeichert in:
Veröffentlicht in: | The American journal of emergency medicine 2023, Vol.66, p.174.e1-174.e2 |
---|---|
Hauptverfasser: | , |
Format: | Report |
Sprache: | eng |
Online-Zugang: | Volltext |
Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
container_end_page | 174.e2 |
---|---|
container_issue | |
container_start_page | 174.e1 |
container_title | The American journal of emergency medicine |
container_volume | 66 |
creator | Arani, Naszrin Wechsler, Adriana H |
description | BACKGROUNDSevere hyperkalemia is a common and life-threatening problem presenting to the emergency department. Rapid correction of the electrolyte abnormality is essential but doing so can be detrimental in circumstances under which delaying treatment for confirmation is required. Our case exemplifies one of those scenarios: pseudohyperkalemia in the setting of severe leukocytosis. CASEAn elderly woman with long-standing but untreated chronic lymphocytic leukemia presented with a left hip fracture. She was found to have a potassium level of 8.4 mEq/L without symptoms of hyperkalemia, renal disease, or EKG findings. Her white blood cell count was 444 K/uL. Despite a potentially life-threatening hyperkalemia, correction was deferred pending confirmation by venous whole blood, which revealed a normal potassium level. DISCUSSIONPseudohyperkalemia can occur in the setting of severe leukocytosis. It is important for emergency physicians to recognize this phenomenon and avoid iatrogenic hypokalemia. The pathophysiology behind this phenomenon and the methods for correct analysis are presented here. |
doi_str_mv | 10.1016/j.ajem.2023.01.008 |
format | Report |
fullrecord | <record><control><sourceid>proquest</sourceid><recordid>TN_cdi_proquest_miscellaneous_2768240986</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2768240986</sourcerecordid><originalsourceid>FETCH-proquest_miscellaneous_27682409863</originalsourceid><addsrcrecordid>eNqVyjsOwjAQAFELCYnvBahc0mB2nRACDQUC0UMfWbCAgxND1kbK7aHgAlTzihFigqAQMJuXypRUKQ06UYAKIO-IPi4SPctxiT0xYC4BENNF2he7Q_uk5mEcVdZIW8twJ8kUgq1v0l-_fFND0lF8-HMbPFtey-PdR3eRrY8yNGTCZiS6V-OYxr8OxXS_O20Ps2fjX5E4FJXlMzlnavKRC73Mcp3CKs-SP9YPy4xEzA</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>report</recordtype><pqid>2768240986</pqid></control><display><type>report</type><title>Hyperkalemia in the setting of severe leukocytosis: Should you treat?</title><source>Access via ScienceDirect (Elsevier)</source><source>ProQuest Central UK/Ireland</source><creator>Arani, Naszrin ; Wechsler, Adriana H</creator><creatorcontrib>Arani, Naszrin ; Wechsler, Adriana H</creatorcontrib><description>BACKGROUNDSevere hyperkalemia is a common and life-threatening problem presenting to the emergency department. Rapid correction of the electrolyte abnormality is essential but doing so can be detrimental in circumstances under which delaying treatment for confirmation is required. Our case exemplifies one of those scenarios: pseudohyperkalemia in the setting of severe leukocytosis. CASEAn elderly woman with long-standing but untreated chronic lymphocytic leukemia presented with a left hip fracture. She was found to have a potassium level of 8.4 mEq/L without symptoms of hyperkalemia, renal disease, or EKG findings. Her white blood cell count was 444 K/uL. Despite a potentially life-threatening hyperkalemia, correction was deferred pending confirmation by venous whole blood, which revealed a normal potassium level. DISCUSSIONPseudohyperkalemia can occur in the setting of severe leukocytosis. It is important for emergency physicians to recognize this phenomenon and avoid iatrogenic hypokalemia. The pathophysiology behind this phenomenon and the methods for correct analysis are presented here.</description><identifier>EISSN: 1532-8171</identifier><identifier>DOI: 10.1016/j.ajem.2023.01.008</identifier><language>eng</language><ispartof>The American journal of emergency medicine, 2023, Vol.66, p.174.e1-174.e2</ispartof><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>780,784,4490,27925,64387</link.rule.ids></links><search><creatorcontrib>Arani, Naszrin</creatorcontrib><creatorcontrib>Wechsler, Adriana H</creatorcontrib><title>Hyperkalemia in the setting of severe leukocytosis: Should you treat?</title><title>The American journal of emergency medicine</title><description>BACKGROUNDSevere hyperkalemia is a common and life-threatening problem presenting to the emergency department. Rapid correction of the electrolyte abnormality is essential but doing so can be detrimental in circumstances under which delaying treatment for confirmation is required. Our case exemplifies one of those scenarios: pseudohyperkalemia in the setting of severe leukocytosis. CASEAn elderly woman with long-standing but untreated chronic lymphocytic leukemia presented with a left hip fracture. She was found to have a potassium level of 8.4 mEq/L without symptoms of hyperkalemia, renal disease, or EKG findings. Her white blood cell count was 444 K/uL. Despite a potentially life-threatening hyperkalemia, correction was deferred pending confirmation by venous whole blood, which revealed a normal potassium level. DISCUSSIONPseudohyperkalemia can occur in the setting of severe leukocytosis. It is important for emergency physicians to recognize this phenomenon and avoid iatrogenic hypokalemia. The pathophysiology behind this phenomenon and the methods for correct analysis are presented here.</description><issn>1532-8171</issn><fulltext>true</fulltext><rsrctype>report</rsrctype><creationdate>2023</creationdate><recordtype>report</recordtype><recordid>eNqVyjsOwjAQAFELCYnvBahc0mB2nRACDQUC0UMfWbCAgxND1kbK7aHgAlTzihFigqAQMJuXypRUKQ06UYAKIO-IPi4SPctxiT0xYC4BENNF2he7Q_uk5mEcVdZIW8twJ8kUgq1v0l-_fFND0lF8-HMbPFtey-PdR3eRrY8yNGTCZiS6V-OYxr8OxXS_O20Ps2fjX5E4FJXlMzlnavKRC73Mcp3CKs-SP9YPy4xEzA</recordid><startdate>20230401</startdate><enddate>20230401</enddate><creator>Arani, Naszrin</creator><creator>Wechsler, Adriana H</creator><scope>7X8</scope></search><sort><creationdate>20230401</creationdate><title>Hyperkalemia in the setting of severe leukocytosis: Should you treat?</title><author>Arani, Naszrin ; Wechsler, Adriana H</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-proquest_miscellaneous_27682409863</frbrgroupid><rsrctype>reports</rsrctype><prefilter>reports</prefilter><language>eng</language><creationdate>2023</creationdate><toplevel>online_resources</toplevel><creatorcontrib>Arani, Naszrin</creatorcontrib><creatorcontrib>Wechsler, Adriana H</creatorcontrib><collection>MEDLINE - Academic</collection></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Arani, Naszrin</au><au>Wechsler, Adriana H</au><format>book</format><genre>unknown</genre><ristype>RPRT</ristype><atitle>Hyperkalemia in the setting of severe leukocytosis: Should you treat?</atitle><jtitle>The American journal of emergency medicine</jtitle><date>2023-04-01</date><risdate>2023</risdate><volume>66</volume><spage>174.e1</spage><epage>174.e2</epage><pages>174.e1-174.e2</pages><eissn>1532-8171</eissn><abstract>BACKGROUNDSevere hyperkalemia is a common and life-threatening problem presenting to the emergency department. Rapid correction of the electrolyte abnormality is essential but doing so can be detrimental in circumstances under which delaying treatment for confirmation is required. Our case exemplifies one of those scenarios: pseudohyperkalemia in the setting of severe leukocytosis. CASEAn elderly woman with long-standing but untreated chronic lymphocytic leukemia presented with a left hip fracture. She was found to have a potassium level of 8.4 mEq/L without symptoms of hyperkalemia, renal disease, or EKG findings. Her white blood cell count was 444 K/uL. Despite a potentially life-threatening hyperkalemia, correction was deferred pending confirmation by venous whole blood, which revealed a normal potassium level. DISCUSSIONPseudohyperkalemia can occur in the setting of severe leukocytosis. It is important for emergency physicians to recognize this phenomenon and avoid iatrogenic hypokalemia. The pathophysiology behind this phenomenon and the methods for correct analysis are presented here.</abstract><doi>10.1016/j.ajem.2023.01.008</doi></addata></record> |
fulltext | fulltext |
identifier | EISSN: 1532-8171 |
ispartof | The American journal of emergency medicine, 2023, Vol.66, p.174.e1-174.e2 |
issn | 1532-8171 |
language | eng |
recordid | cdi_proquest_miscellaneous_2768240986 |
source | Access via ScienceDirect (Elsevier); ProQuest Central UK/Ireland |
title | Hyperkalemia in the setting of severe leukocytosis: Should you treat? |
url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2024-12-24T23%3A46%3A03IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest&rft_val_fmt=info:ofi/fmt:kev:mtx:book&rft.genre=unknown&rft.atitle=Hyperkalemia%20in%20the%20setting%20of%20severe%20leukocytosis:%20Should%20you%20treat?&rft.jtitle=The%20American%20journal%20of%20emergency%20medicine&rft.au=Arani,%20Naszrin&rft.date=2023-04-01&rft.volume=66&rft.spage=174.e1&rft.epage=174.e2&rft.pages=174.e1-174.e2&rft.eissn=1532-8171&rft_id=info:doi/10.1016/j.ajem.2023.01.008&rft_dat=%3Cproquest%3E2768240986%3C/proquest%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2768240986&rft_id=info:pmid/&rfr_iscdi=true |