Table 1 Published case reports on rPPK and relevant patient characteristics
Year | Author | Diagnosis | Age (year) | Causes of rPHK | Plasma K mEq/L | Serum K mEq/L | K in blood gas (whole blood) | WBC × 109/L | Platelet × 109/L | Creatinine mg/dL | TLS | ECG | |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
1 | 1997 | Singh [1] | CLL | 70 | NA | 7 | 3.6 | 524 | 1.4–1.7 | ||||
2 | 2008 | Boban [14] | CLL | 49 female | heparin-mediated cell membrane damage during processing and centrifugation | 10.7–11.2 | 2.7 | 2.6 | 369 | 100 | No AKI | No | No abnormality |
3 | 2011 | Garwicz[23] | T cell ALL | 2 year and 10 m | 1-mechanical forces during sampling 2- heparin-induced membrane damage | 5.6–11.6 | NA | 3.7 | 391 | 86 | NA | NA | Normal |
4 | 2011 | Meng[15] | CLL | 86 female | 1-Heparin-induced cell membrane damage 2- higher consumption of metabolic fuels that lead to impaired Na/K ATPase pump activity resulting in release of potassium | 7.5(lithium heparin plasma 76 units HEPARIN) | 4.7 | 9.7 Lithium–heparin venous Whole blood (tube) 4.3 Venous whole blood (balanced lithium–heparin syringe) | 374 | 158 | 84 | LDH 382 U/L | Prolonged QT |
5 | 2012 | Garwicz [9] | CLL | 76 male | Mechanical forces acting on the membranes of fragile leukemic cells during pneumatic tube transport of lithium heparin plasma samples Leukemic cells undergo lysis in vitro, releasing potassium and ATP to the plasma | 7.3 | 4.8 | NA | 421 | Normal | Normal | None | NA |
6 | 2014 | Avelar [16] | CLL | 78 male | Sensitivity to heparin-mediated cell membrane damage during processing and centrifugation | 8.4 | 4.4 | NA | 206 | 158 | 1.4 | Uric acid, 10.6 mg/dL calcium, 8.4 mg/dL phosphorus, 4.7 mg/dL | Normal |
7 | 2015 | Mansoor [17] | CLL | 49 male | 1-Fragility of malignant cells that Makes them prone to lysis 2-High consumption of metabolic fuels by leukemic cells that lead to impaired Na + /K + ATPase pump activity, resulting in potassium release | 9.4 (pneumatic transport) 4.2 manual transport | 3.7 (manual transport) | 3.7 | 545 | 47 | 1.48 | Uric acid of 6.4 mg/dL lactate dehydrogenase of 1746 units/L | Normal |
8 | 2016 | Huang[13] | CLL | 83 male | Mechanical stress on chronic lymphocytic leukemia cells | 7.4 (pneumatic transport) 3.1( hand-carried) | NA | 3.4 (ABG syringe hand- carried to lab) | 300 | NA | NA | LDH 328 No evidence of TLS | Normal |
9 | 2017 | Li-Ting Juan [18] | ALL | 61 male | Sensitivity of fragile leukemic cell membrane to heparin Potassium and LDH levels in plasma were both higher than those measured in serum | 6.7–12.2 | 1.9–2.2 | NA | 480 | 45 | Normal | Plasma LDH 840 U/L serum LDH 653 U/L | No hyperkalemia changes |
10 | 2020 | Moreno [24] | B-cell NHL | 65 male | Heparin induced lysis of WBCs leading to release of ATP that promotes active transport of potassium Out of lymphocytes and influx of Na intracellularly | > 10 plasma Na 123 | 4.9 serum Na 139 | NA | 263 | 55 | Normal | None | NA |
11 | 2020 | Fresa A [19] | Atypical CLL | 81 male | Pathological cells could have undergone death due to the exhaustion of the substrates necessary for survival, due in turn to the extreme hyperleukocytosis of the patient | 7.5 3(Dx 81 mg/dl) 8.6 (Dx10mg/dl) | NA | Low ( NA) | 423.7 | 82 | NA | LDH 2239 U/L | Normal |
12 | 2020 | Shamy [20] | Non sever leukocytosis cases 11 HM 34 NHM | (0–94 years) male and female 7 cases < 1 years | 1-heparin-induced WBC membrane damage 2-leukocyte-induced consumption of metabolic fuels with resultant inhibition of the sodium pump (Nafl/Kfl-ATPase) and subsequent potassium release | 5.5–6.6 | 4.0–5.2 | NA | 6.5–19.7 | 128–302 | 0.7–2.8 | NA | All normal except one with peaked T wave |
13 | 2020 | Ahmed[21] | NA ? CLL | 60 male | 1-Fragile leukemic cells during the clotting process 2-Severe leukocytosis leads to consumption of metabolic fuels that an impair Na–K ATPase activity, leading to release of potassium from a large number of white blood cells 3-Damage to the membrane of the millions of fragile malignant cells by the heparin in the tubes | 6.2 | 3.5 | 440 | NA | 0.7 | No | Normal | |
14 | 2020 | Jafar [22] | CLL | 67 woman | 1-Fragile leukocyte especially with pneumatic transport 2-high metabolic fuel demand by malignant cells, causing depletion of ATP, which leads to dysfunction of the Na–K ATPase pump that normally helps keep potassium intracellular 3-Heparin induce membrane damage | 5.6 | 4 | 4.3 | 161 | NA | 0.9 | Creatine kinase 43 U/L, LDH 177 U/L, phosphorus level of 4.5 mg/dL uric acid 6.4 mg/dL, | Normal |