Spurious electrolyte disorders: A diagnostic challenge for clinicians

American Journal of Nephrology

Volumn 38, Issue 1, 2013, Pages 50-57

  Liamis, George ^a   Liberopoulos, Evangelos ^a   Barkas, Fotis ^a   Elisaf, Moses ^a  

^a UNIVERSITY OF IOANNINA   (Greece)

Author keywords

Ion selective electrodes; Pseudohyperkalemia; Pseudohyperphosphatemia; Pseudohypocalcemia; Pseudohypomagnesemia; Pseudohyponatremia

Indexed keywords

BLOOD LEVEL; CALCIUM BLOOD LEVEL; CLINICAL PRACTICE; ELECTROLYTE BLOOD LEVEL; ELECTROLYTE DISTURBANCE; HUMAN; HYPERCALCEMIA; HYPERKALEMIA; HYPERPHOSPHATEMIA; HYPOCALCEMIA; HYPOKALEMIA; HYPOMAGNESEMIA; HYPONATREMIA; HYPOPHOSPHATEMIA; HYPOPROTEINEMIA; KIDNEY FUNCTION; PRIORITY JOURNAL; REVIEW; SERUM OSMOLALITY;

EID: 84879467846     PISSN: 02508095     EISSN: 14219670     Source Type: Journal    
DOI: 10.1159/000351804     Document Type: Review

References (67)

1. Liamis G, Rodenburg EM, Hofman A, Zietse R, Stricker BH, Hoorn EJ: Electrolyte disorders in community subjects: prevalence and risk factors. Am J Med 2013; 126: 256-263.
2. Elisaf MS, Milionis HJ, Siamopoulos KC: Electrolyte abnormalities in elderly patients admitted to a general medical ward. Geriatr Nephrol Urol 1997; 7: 73-79.
3. Milionis HJ, Liamis GL, Elisaf MS: The hyponatremic patient: a systematic approach to laboratory diagnosis. CMAJ 2002; 166: 1056-1062.
4. Weisberg LS: Pseudohyponatremia: a reappraisal. Am J Med 1989; 86: 315-318.
5. Turchin A, Seifter JL, Seely EW: Clinical problem-solving. Mind the gap. N Engl J Med 2003; 349: 1465-1469.
6. Nguyen MK, Ornekian V, Butch AW, Kurtz I: A new method for determining plasma water content: application in pseudohyponatremia. Am J Physiol Renal Physiol 2007; 292:F1652-F1656.
7. Maas AH, Siggaard-Andersen O, Weisberg HF, Zijlstra WG: Ion-selective electrodes for sodium and potassium: a new problem of what is measured and what should be reported. Clin Chem 1985; 31: 482-485.
8. Garibaldi BT, Cameron SJ, Choi M: Pseudohyponatremia in a patient with HIV and hepatitis C coinfection. J Gen Intern Med 2008; 23: 202-205.
9. Steinberger BA, Ford SM, Coleman TA: Intravenous immunoglobulin therapy results in post-infusional hyperproteinemia, increased serum viscosity, and pseudohyponatremia. Am J Hematol 2003; 73: 97-100.
10. Nanji AA, Blank DW: Pseudohyponatremia and hyperviscosity. J Clin Pathol 1983; 36: 834-835.
11. Steinberger B, Coleman TA: Multiple complications of IVIG therapy in a patient with Guillain-Barre syndrome. Am J Hematol 2001; 67: 59.
12. Story DA, Morimatsu H, Egi M, Bellomo R: The effect of albumin concentration on plasma sodium and chloride measurements in critically ill patients. Anesth Analg 2007; 104: 893-897.
13. Dimeski G, Barnett RJ: Effects of total plasma protein concentration on plasma sodium, potassium and chloride measurements by an indirect ion selective electrode measuring system. Crit Care Resusc 2005; 7: 12-15.
14. Lang T, Prinsloo P, Broughton AF, Lawson N, Marenah CB: Effect of low protein concentration on serum sodium measurement: pseudohypernatraemia and pseudonormonatraemia! Ann Clin Biochem 2002; 39: 66-67.
15. Dimeski G, Morgan TJ, Presneill JJ, Venkatesh B: Disagreement between ion selective electrode direct and indirect sodium measurements: estimation of the problem in a tertiary referral hospital. J Crit Care 2012; 27: 326. e9-e16.
16. Naparstek Y, Gutman A: Case report: spurious hypokalemia in myeloproliferative disorders. Am J Med Sci 1984; 288: 175-177.
17. Adams PC, Woodhouse KW, Adela M, Parnham A: Exaggerated hypokalaemia in acute myeloid leukaemia. BMJ 1981; 282: 1034-1035.
18. Kone BC: Hypokalemia; in DuBose TD, Hamm LL: Acid-Base and Electrolyte Disorders: A Companion to Brenner & Rector's The Kidney. Philadelphia, Saunders, 2002, pp 384.
19. Masters PW, Lawson N, Marenah CB, Maile LJ: High ambient temperature: a spurious cause of hypokalaemia. BMJ 1996; 312: 1652-1653.
20. Sodi R, Davison AS, Holmes E, Hine TJ, Roberts NB: The phenomenon of seasonal pseudohypokalemia: effects of ambient temperature, plasma glucose and role for sodium-potassium-exchanging-ATPase. Clin Biochem 2009; 42: 813-818.
21. Dharmarajan TS, Nguyen T, Russell RO: Lifethreatening, preventable hyperkalemia in a nursing home resident: case report and literature review. J Am Med Dir Assoc 2005; 6: 400-405.
22. Smellie WS: Spurious hyperkalaemia. BMJ 2007; 334: 693-695.
23. Mandal AK: Hypokalemia and hyperkalemia. Med Clin North Am 1997; 81: 611-639.
24. Graber M, Subramani K, Corish D, Schwab A: Thrombocytosis elevates serum potassium. Am J Kidney Dis 1988; 12: 116-120.
25. Colussi G, Cipriani D: Pseudohyperkalemia in extreme leukocytosis. Am J Nephrol 1995; 15: 450-452.
26. Abraham B, Fakhar I, Tikaria A, Hocutt L, Marshall J, Swaminathan S, et al: Reverse pseudohyperkalemia in a leukemic patient. Clin Chem 2008; 54: 449-451.
27. Meng QH, Krahn J: Reverse pseudohyperkalemia in heparin plasma samples from a patient with chronic lymphocytic leukemia. Clin Biochem 2011; 44: 728-730.
28. Wulkan RW, Michiels JJ: Pseudohyperkalaemia in thrombocythaemia. J Clin Chem Clin Biochem 1990; 28: 489-491.
29. Ong YL, Deore R, El-Agnaf M: Pseudohyperkalaemia is a common finding in myeloproliferative disorders that may lead to inappropriate management of patients. Int J Lab Hematol 2010; 32:e151-e157.
30. Ahmed R, Isaac AM: Postsplenectomy thrombocytosis and pseudohyperkalemia in trauma: a case report and review of literature. J Trauma 2009; 67:E17-E19.
31. Ralston SH, Lough M, Sturrock RD: Rheumatoid arthritis: an unrecognised cause of pseudohyperkalaemia. BMJ 1988; 297: 523-524.
32. Don BR, Sebastian A, Cheitlin M, Christiansen M, Schambelan M: Pseudohyperkalemia caused by fist clenching during phlebotomy. N Engl J Med 1990; 322: 1290-1292.
33. Ismail A, Shingler W, Seneviratne J, Burrows G: In vitro and in vivo haemolysis and potassium measurement. BMJ 2005; 330: 949.
34. Meenaghan M, Follett GF, Brophy PJ: Temperature sensitivity of potassium flux into red blood cells in the familial pseudohyperkalaemia syndrome. Biochim Biophys Acta 1985; 821: 72-78.
35. Alani FS, Dyer T, Hindle E, Newsome DA, Ormerod LP, Mahoney MP: Pseudohyperkalaemia associated with hereditary spherocytosis in four members of a family. Postgrad Med J 1994; 70: 749-751.
36. Garwicz D, Karlman M: Early recognition of reverse pseudohyperkalemia in heparin plasma samples during leukemic hyperleukocytosis can prevent iatrogenic hypokalemia. Clin Biochem 2012; 45: 1700-1702.
37. Singh PJ, Zawada ET, Santella RN: A case of 'reverse' pseudohyperkalemia. Miner Electrolyte Metab 1997; 23: 58-61.
38. Dickinson H, Webb NJ, Chaloner C, Wynn RF, Bonney DK: Pseudohyperkalaemia associated with leukaemic cell lysis during pneumatic tube transport of blood samples. Pediatr Nephrol 2012; 27: 1029-1031.
39. Rifkin SI: Pseudohyperkalemia in patients with chronic lymphocytic leukemia. Int J Nephrol 2011; 2011: 759749.
40. Ruddy KJ, Wu D, Brown JR: Pseudohyperkalemia in chronic lymphocytic leukemia. J Clin Oncol 2008; 26: 2781-2782.
41. Boden SD, Kaplan FS: Calcium homeostasis. Orthop Clin North Am 1990; 21: 31-42.
42. Dickerson RN, Alexander KH, Minard G, Croce MA, Brown RO: Accuracy of methods to estimate ionized and 'corrected' serum calcium concentrations in critically ill multiple trauma patients receiving specialized nutrition support. J Parenter Enteral Nutr 2004; 28: 133-141.
43. Byrnes MC, Huynh K, Helmer SD, Stevens C, Dort JM, Smith RS: A comparison of corrected serum calcium levels to ionized calcium levels among critically ill surgical patients. Am J Surg 2005; 189: 310-314.
44. Williams SF, Meek SE, Moraghan TJ: Spurious hypocalcemia after gadodiamide administration. Mayo Clin Proc 2005; 80: 1655-1657.
45. Moore CD, Newman RC, Caridi JG: Spurious hypocalcemia after gadodiamide-enhanced magnetic resonance imaging: a case report and review of the literature. Rev Urol 2006; 8: 165-168.
46. Prince MR, Erel HE, Lent RW, Blumenfeld J, Kent KC, Bush HL, et al: Gadodiamide administration causes spurious hypocalcemia. Radiology 2003; 227: 639-646.
47. Kang HP, Scott MG, Joe BN, Narra V, Heiken J, Parvin CA: Model for predicting the impact of gadolinium on plasma calcium measured by the o-cresolphthalein method. Clin Chem 2004; 50: 741-746.
48. Jacobs TP, Bilezikian JP: Clinical review: rare causes of hypercalcemia. J Clin Endocrinol Metab 2005; 90: 6316-6322.
49. Ladenson JH, Lewis JW, McDonald JM, Slatopolsky E, Boyd JC: Relationship of free and total calcium in hypercalcemic conditions. J Clin Endocrinol Metab 1979; 48: 393-397.
50. Howard MR, Ashwell S, Bond LR, Holbrook I: Artefactual serum hyperkalaemia and hypercalcaemia in essential thrombocythaemia. J Clin Pathol 2000; 53: 105-109.
51. Side L, Fahie-Wilson MN, Mills MJ: Hypercalcaemia due to calcium binding IgM paraprotein in Waldenstrom's macroglobulinaemia. J Clin Pathol 1995; 48: 961-962.
52. Jaffe JP, Mosher DF: Calcium binding by a myeloma protein. Am J Med 1979; 67: 343-346.
53. Annesley TM, Burritt MF, Kyle RA: Artifactual hypercalcemia in multiple myeloma. Mayo Clin Proc 1982; 57: 572-575.
54. Merlini G, Fitzpatrick LA, Siris ES, Bilezikian JP, Birken S, Beychok S, et al: A human myeloma immunoglobulin G binding four moles of calcium associated with asymptomatic hypercalcemia. J Clin Immunol 1984; 4: 185-196.
55. Donhowe JM, Freier EF, Wong ET, Steffes MW: Factitious hypophosphatemia related to mannitol therapy. Clin Chem 1981; 27: 1765-1769.
56. Eisenbrey AB, Mathew R, Kiechle FL: Mannitol interference in an automated serum phosphate assay. Clin Chem 1987; 33: 2308-2309.
57. Polderman KH, Bloemers FW, Peerdeman SM, Girbes AR: Hypomagnesemia and hypophosphatemia at admission in patients with severe head injury. Crit Care Med 2000; 28: 2022-2025.
58. Larner AJ: Pseudohyperphosphatemia. Clin Biochem 1995; 28: 391-393.
59. Barutcuoglu B, Parildar Z, Mutaf I, Habif S, Bayindir O: Spuriously elevated inorganic phosphate level in a multiple myeloma patient. Clin Lab Haematol 2003; 25: 271-274.
60. Jamil MG, Abdel-Raheem MM, Potti A, Levitt R: Pseudohyperphosphatemia associated with Waldenstrom's macroglobulinemia. Am J Hematol 2000; 65: 329.
61. Randall AG, Garcia-Webb P, Beilby JP: Interference by haemolysis, icterus and lipaemia in assays on the Beckman Synchron CX5 and methods for correction. Ann Clin Biochem 1990; 27: 345-352.
62. Adler SG, Laidlaw SA, Lubran MM, Kopple JD: Hyperglobulinemia may spuriously elevate measured serum inorganic phosphate levels. Am J Kidney Dis 1988; 11: 260-263.
63. Izzedine H, Camous L, Bourry E, Azar N, Leblond V, Deray G: Make your diagnosis. Multiple myeloma-associated with spurious hyperphosphatemia. Kidney Int 2007; 72: 1035-1036.
64. Bailey HL, Chan EM: Liposomal amphotericin B interferes with the phosphorus assay on the Synchron LX 20 analyzer. Clin Chem 2007; 53: 795-796.
65. Lane JW, Rehak NN, Hortin GL, Zaoutis T, Krause PR, Walsh TJ: Pseudohyperphosphatemia associated with high-dose liposomal amphotericin B therapy. Clin Chim Acta 2008; 387: 145-149.
66. Schiller B, Virk B, Blair M, Wong A, Moran J: Spurious hyperphosphatemia in patients on hemodialysis with catheters. Am J Kidney Dis 2008; 52: 617-620.
67. Kroll MH, Elin RJ: Relationships between magnesium and protein concentrations in serum. Clin Chem 1985; 31: 244-246.