Subject(s)
Acute Kidney Injury/epidemiology , COVID-19/epidemiology , Academic Medical Centers , Acute Kidney Injury/diagnosis , Acute Kidney Injury/mortality , Acute Kidney Injury/therapy , Aged , COVID-19/diagnosis , COVID-19/mortality , COVID-19/therapy , Female , Hospital Mortality , Hospitalization , Hospitals, Urban , Humans , Incidence , Kidney Function Tests , Male , Middle Aged , New York City/epidemiology , Recovery of Function , Retrospective Studies , Risk Factors , Time Factors , Treatment OutcomeSubject(s)
Acute Kidney Injury/therapy , Anticoagulants/therapeutic use , COVID-19/complications , Continuous Renal Replacement Therapy/instrumentation , Equipment Failure/statistics & numerical data , Acute Kidney Injury/virology , Aged , Arginine/analogs & derivatives , Arginine/therapeutic use , Citric Acid/therapeutic use , Disposable Equipment , Female , Heparin, Low-Molecular-Weight/therapeutic use , Humans , Male , Middle Aged , Pipecolic Acids/therapeutic use , SARS-CoV-2 , Sulfonamides/therapeutic use , Time FactorsABSTRACT
INTRODUCTION: Hyperkalemia is a commonly encountered clinical problem. Pseudohyperkalemia is believed to be an in vitro phenomenon that does not reflect in vivo serum potassium and therefore should not be treated. Here, we present a case who unfortunately underwent unnecessary treatment because of failure to detect the common lab abnormality of pseudohyperkalemia. CASE PRESENTATION: A 91-year-old female with a history of chronic lymphocytic leukemia presented to the emergency with nausea and vomiting 24 hours after her first chemotherapy with chlorambucil. Physical examination was overall unremarkable. She had a leukocytosis of 210 × 103/µL with 96% lymphocytes along with chronic anemia with hemoglobin of 8.1 g/dL. Her initial sodium and potassium levels were normal. During the clinical course, her potassium progressively worsened and failed to improve despite standard medical treatment. Patient ultimately underwent dialysis. CONCLUSIONS: Differentiating true hyperkalemia from pseudohyperkalemia is very important in selected group of patients to avoid unnecessary medications, higher level of care, and unnecessary procedure including dialysis. We want to emphasize the importance of simple yet profound knowledge of technique of blood draws and basic metabolic panel processing for every clinician in day-to-day practice.
ABSTRACT
Vancomycin causes different types of hypersensitivity reactions, ranging from localized skin reactions to generalized cardiovascular collapse. However, cases of vancomycin-induced leukocytoclastic vasculitis are rare. In this article, we present a case where the patient developed palpable purpura on his bilateral lower limbs following treatment with vancomycin. He was diagnosed with vancomycin-induced leukocytoclastic vasculitis that resolved without sequelae after withdrawal of vancomycin.