Monday, August 1, 2011


A 40 year old smoker,nonalcoholic male presented with an episode of generalized tonic clonic convulsions followed by unconsciousness(first episode). he regained consciousness after 2-3 hours and had no significant complaints.His CT SCAN brain showed a ring enhancing lesion with surrounding cerebral oedema in left parietal region which was suggestive  of neurocysticercocis.he had no significant past history and was not on any medications.his TLC was 19800,N82%,urea 25,cr0.8,na+135,and most suprisingly k+8.7. His ECG was normal and his urine output was adequate.We panicked and immediately sent a repeat k+ and gave the patient a10%calcium gluconate 10ml i.v. slowly over 3minutes. The repeat k+ was 4.09.
                   So this is a case of spurious hyperkalemia and we must all be very cautious about it.Before jumping into any conclusions and be very aggressive in management we must always do a repeat test.
                   The causes of spurious hyperkalemia are:     
               1.hemolysis during venipuncture
                     2.release of k+ from muscle during the seizure attack.
                     3.release of k+ from muscle distal to the tourniquet.
                      4.release of k+ from clotted blood during severe leucocytosis(>50,000) or thrombocytosis