Perhaps the patient has hereditary spherocytosis due to an annexin or caton transporter defect. The K results are typical.
See the following review; Rev Clin Exp Hematol. 2003;7(1):22-56.
Red blood cell membrane defects.Iolascon A, Perrotta S, Stewart GW.
Best wishes,
John Land
Dr John M. Land
Clinical Lead Biochemical Medicine
UCLH NHS Foundation Trust
Neurometabolic Unit Box 105
National Hospital
Queen Square
London WC1N 3BG
44-(0)20-7829-8768
-----Original Message-----
From: Clinical biochemistry discussion list [mailto:[log in to unmask]] On Behalf Of Peadar McGing
Sent: 11 January 2008 13:26
To: [log in to unmask]
Subject: query spurious high potassium
Dear colleagues,
I know this is a topic aired many times and I've written about it myself but I am currently dealing with a case that doesn't quite fit the bill and I wonder if anyone can offer some advice.
The case is of a woman in her 50s who had blood taken by her GP and sent via the normal courier system to the lab. Patient was asymptomatic. Sample was sent in on the 8th and repeated on the 9th. Because of the high K which was phoned by the lab, the GP sent her in to AE which she attended the next day (10th).
Date Na K Cl TCO2 Urea Creat A.G.
8-1-08 (GP) 151 5.1 107 28 4.2 74 21
9-1-08 (GP) 150 6.6 109 34 3.7 79 14
10-1-08(AE) 138 3.8 102 27 3.3 61 13
ref ranges: Na (133-145), K(3.5-5.0).
Units mmol/L except creat (µmol/L)
GP said patient is on a lot of medications, including anti-depressants, but the most notable 'medication' was that she was described as 'taking food with her rather salt than taking salt with her food'. We can't rule out refrigeration but we believe it unlikely as a cause in this case. We have some idea but things don't add up fully and I'd appreciate your thoughts, especially if you've seen this scenario before.
best wishes.
Peadar
Dr Peadar McGing, MRCPath EurClinChem,
Principal Biochemist,
Biochemistry Dept., Mater Misericordiae University Hospital, Eccles Street, Dublin 7, Ireland.
Tel: (+353 1)8032080; Fax: (+353 1)8034781.
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