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Pseudohyperkalemia Caused by Fist Clenching during Phlebotomy
Abstract
CLINICIANS are occasionally confronted with the finding of an elevated serum or plasma potassium level in an otherwise healthy person. Such an abnormality may herald the presence of occult mineralocorticoid deficiency or a defect in renal tubular transport.1 Alternatively, it may represent so-called pseudohyperkalemia, caused by the release of potassium from formed elements in the blood in patients with leukocytosis or thrombocytosis.2 , 3 We report here on a patient in whom pseudohyperkalemia resulted from the common practice of repeatedly clenching and unclenching a fist during venipuncture. This maneuver, which has been passed on from generation to generation of house staff, medical . . .
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Fist clenching and pumping may cause pseudohyperkalemia and alterations of some other biochemistry and hematology parameters.
“Fist clenching and pumping may case pseudohyperkalemia and alterations of some other biochemistry and hematology parameters [57], [58], [59], [60], [61], [62].”
From Joint EFLM-COLABIOCLI Recommendation for venous blood sampling (2018) · cites this paper as [57]
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Research works printed but not linked: 17
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Cited by
Sorted by citations
Joint EFLM-COLABIOCLI Recommendation for venous blood sampling
Simundic, A.-M., Bölenius, K., Cadamuro, J., Church, S., Cornes, M. P., van Dongen-Lases, E. C., Eker, P., Erdeljanovic, T., Grankvist, K., Guimaraes, J. T., et al. (2018) · Clinical Chemistry and Laboratory Medicine (CCLM) · doi:10.1515/cclm-2018-0602 · Cited by 240
Lima-Oliveira, G., Volanski, W., Lippi, G., Picheth, G., & Guidi, G. C. (2017) · Scandinavian Journal of Clinical and Laboratory Investigation · doi:10.1080/00365513.2017.1295317 · Cited by 117
Seimiya, M., Yoshida, T., Sawabe, Y., Sogawa, K., Umemura, H., Matsushita, K., & Nomura, F. (2010) · American Journal of Kidney Diseases · doi:10.1053/j.ajkd.2010.06.014 · Cited by 28
A case of severe pseudohyperkalaemia due to muscle contraction
Van Elslande, J., Dominicus, T., Toelen, J., Frans, G., & Vermeersch, P. (2020) · Biochemia medica · doi:10.11613/bm.2020.021004 · Cited by 7
Metadata
- Authors
- Don, B. R., Sebastian, A., Cheitlin, M., Christiansen, M., & Schambelan, M.
- Affiliations
- San Francisco General Hospital (US)
- Venue
- New England Journal of Medicine
- Publisher
- Massachusetts Medical Society
- Published
- 1990-05-03
- Volume
- 322
- Issue
- 18
- Pages
- 1290-1292
- ISSN
- 0028-4793 (ISSN-L)
- 1533-4406
- OpenAlex
- W2316437649
- Cited by
- 132
- References
- 0
- Citations by year
- 2026: 5 · 2025: 1 · 2024: 2 · 2023: 8 · 2022: 7 · 2021: 4 · 2020: 5 · 2019: 5 · 2018: 6 · 2017: 5 · 2016: 9 · 2015: 3 · 2014: 7 · 2013: 3 · 2012: 4
- FWCI
- 1.52
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- New England Journal of Medicine (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institutes of Health (5r01hl011046-27, 5p01dk039964-04)
- National Heart, Lung, and Blood Institute (HL11046)
- National Institute of Diabetes and Digestive and Kidney Diseases (DK 39964)
- National Center for Research Resources (RR-79)
- Topics
- Health Sciences › Medicine › Nephrology › Potassium and Related Disorders
- Health Sciences › Health Professions › Medical Laboratory Technology › Clinical Laboratory Practices and Quality Control
- Health Sciences › Medicine › Nephrology › Parathyroid Disorders and Treatments
- Keywords
- pseudohyperkalemia, phlebotomy, venipuncture, serum potassium, leukocytosis, thrombocytosis
- MeSH terms
- Bloodletting, Diagnosis, Differential, Hand, Humans, Hydrogen-Ion Concentration, Hyperkalemia, Lactates, Male, Middle Aged, Potassium, Tourniquets
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