1例血小板增多致假性高钾血症分析及报告流程改进
Pseudohyperkalemia Caused by Thrombocytosis:a Case Report and Related Reporting Process Improvement
尚鲁俊 1夏良裕 2王鸥 3侯立安 2张颖 2刘荔 2苏玉君 2刘欣 2王健 2梁小悦 2王亚静 2徐二木 2刘茜2
作者信息
- 1. 中国医学科学院 北京协和医学院 北京协和医院检验科,北京 100730;贵州省人民医院检验科,贵州 贵阳 550002
- 2. 中国医学科学院 北京协和医学院 北京协和医院检验科,北京 100730
- 3. 中国医学科学院 北京协和医学院 北京协和医院内分泌科,北京 100730
- 折叠
摘要
严重的高钾血症是一项必须立即进行临床干预的紧急医疗事件,而假性高钾血症会干扰高钾血症的诊断,实验室应及时识别和处理以避免误诊误治.本文报道一则案例,患者因高血压随诊发现血清钾增高,随后因血钾结果异常多次于急诊和门诊就诊,经历了高钾-降钾-低钾-补钾的过程,最终确诊为血小板增多症导致的假性高钾血症.我们通过优化实验室信息系统自动识别血小板增高导致的假性高钾血症,同时改进此类样本检测结果的报告方式,以避免血小板升高引起假性高钾血症导致临床误诊误治的风险.
Abstract
Severe hyperkalemia is an urgent medical condition that requires immediate clinical intervention. Pseudohyperkalemia interferes with the diagnosis of hyperkalemia.To prevent mis-diagnosis and mis-treatment,it is imperative for the clinical laboratory to accurately identify cases of pseudohyperkalemia before reporting results.We report a case where a patient was identified to have elevated serum potassium during hypertension follow-up period.Subsequently,this patient visited the Emergency Department and Outpatient Department multiple times and underwent a treatment process with high potassium,potassium lowering,low potassium,and potassium supplementation.Ultimately,the patient was diagnosed with pseudohyperkalemia caused by thrombocytosis.Based on this case report,we aim to optimize the laboratory information system to automatically identify pseudohyperkalemia caused by thrombocytosis and to improve the reporting process to avoid the risk of mis-diagnosis and unnecessary treatment for the future clinical practice.
关键词
高钾血症/假性高钾血症/血小板增多症Key words
Hyperkalemia/Pseudohyperkalemia/Thrombocytosis引用本文复制引用
基金项目
中央高水平医院临床科研专项(2022-PUMCH-B-073)
出版年
2024
NETL
NSTL
万方数据