Pseudohyperkalemia: To Treat or not to Treat

Chronic lymphocytic leukemia (CLL) is characterized by excessive production of abnormal lymphocytes in the bone marrow. It usually presents as hepatosplenomegaly and lymphadenopathy along with constitutional symptoms of fever, tiredness, and weight loss. Pseudohyperkalemia may occur in patients with extreme leukocytosis. High serum and plasma potassium levels have been seen in pseudohyperkalemia. Whole blood potassium determination will usually help lead to a correct diagnosis. It is important to diagnose this condition early so that the patients are not inappropriately treated. We aim to highlight that hyperkalemia in CLL patients should only be treated if the patient is symptomatic or if the patient shows cardiac effects of hyperkalemia on electrocardiogram.