Reverse Pseudohyperkalemia in a Patient with Acute Lymphoblastic Leukemia: A Case Report

一位急性淋巴性白血病人的反向假性高血鉀現象

阮莉婷(Li-Ting Juan) ； 潘憲棠(Shien-Tung Pan) ； 邵寶釵(Bio-Chia Show) ； 歐明哲(Ming-Che Ou) ； 王秋惠(Chiou-Huey Wang)

《童綜合醫學雜誌》 13卷1期 (2019/06) Pp. 37-42

https://doi.org/10.3966/207135922019061301008

摘要

Reverse pseudohyperkalemia is a rare condition, typically observed in patients with acute or chronic leukemia/ lymphoma. Inappropriate potassium-lowering therapies in patients with reverse pseudohyperkalemia may result in hypokalemia and its associated deleterious effects. Here we describe a 61-year-old man who presented with severe hyperkalemia after the diagnosis of acute leukemia of ambiguous lineages, B/myeloid. Our case demonstrates that early recognition of reverse pseudohyperkalemia is challenging for clinicians and laboratory personnel and is a crucial aspect for treating such patients. With a high index of suspicion for this phenomenon, measuring potassium levels using a heparin-free collecting tube that is manually transported to the laboratory and immediately analyzing them can facilitate an early diagnosis and avoid mismanagement of such patients.

關鍵字

Hyperkalemia ； Pseudohyperkalemia ； Reverse pseudohyperkalemia ； Acute leukemia/lymphoma ； Acute leukemia of ambiguous lineages ； B/myeloid

並列摘要

反向假性高血鉀是一種少見的現象，通常發生於急性或慢性白血病／淋巴瘤之患者。臨床上對高血鉀症的治療可能導致具有反向假性高血鉀現象的患者轉變為低鉀血症及造成傷害。我們報導一名61歲診斷為acute leukemia of ambiguous lineages, B/myeloid的男性出現反向假性高血鉀之案例，本案例顯示臨床醫師和醫檢師儘早識別出反向假性高血鉀現象對患者的治療是非常重要的，當高度懷疑病患出現反向假性高血鉀現象時，以不含肝素的採血管採集血液，以人工運送方式送至檢驗室並立即檢測血鉀濃度，可有助於早期診斷及避免錯誤醫療處置。

並列關鍵字

高血鉀 ； 假性高血鉀 ； 反向假性高血鉀 ； 急性白血病