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Most studies on circulatory megakaryocytes have implicated myelodysplastic syndromes and myeloproliferative disorders because of disruption of the bone marrow barrier and extramedullary hematopoiesis that is commonly seen in the spleen. As myeloproliferative disorders progress, particularly in the absence of the spleen, it is very likely that considerable numbers of megakaryocytes are present in the circulation. Myeloproliferation is associated with essential thrombocytosis or leukocytosis and is the leading cause of pseudo-hyperkalemia followed by reactive thrombocytosis due to splenectomy, rheumatoid arthritis, and renal cancer. The simultaneous measurement of plasma potassium is required when the platelet count exceeds 500\u2009\u00d7\u200910<jats:sup>9<\/jats:sup>\/L and the level of serum potassium is \u2009&gt;\u20095.4\u00a0mmol\/L.<\/jats:p>","DOI":"10.1186\/s40001-022-00787-9","type":"journal-article","created":{"date-parts":[[2022,8,23]],"date-time":"2022-08-23T13:03:14Z","timestamp":1661259794000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Markedly increased small-sized megakaryocytes and platelets count in the circulation with pseudo-hyperkalemia following splenectomy"],"prefix":"10.1186","volume":"27","author":[{"given":"Guiying","family":"Li","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bin","family":"Wang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dongyan","family":"Li","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rong","family":"Zhu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xueyan","family":"Chen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2022,8,23]]},"reference":[{"issue":"1","key":"787_CR1","doi-asserted-by":"publisher","first-page":"128","DOI":"10.1007\/s12185-020-02862-5","volume":"112","author":"J Zhu","year":"2020","unstructured":"Zhu J, Guo W, Wang B. Megakaryocytes in peripheral blood smears of non-hematological diseases. Int J Hematol. 2020;112(1):128\u201330.","journal-title":"Int J Hematol"},{"issue":"5","key":"787_CR2","doi-asserted-by":"publisher","first-page":"617","DOI":"10.1002\/ajh.25377","volume":"94","author":"S Sale","year":"2019","unstructured":"Sale S, Rocco V, Pancione Y, Carri DD, Fumi M, Bain BJ. A confusing \u201cwhite cell count\u201d: circulating micromegakaryocytes in post-thrombocythemia myelofibrosis. Am J Hematol. 2019;94(5):617\u20138.","journal-title":"Am J Hematol"},{"issue":"3","key":"787_CR3","first-page":"83","volume":"102","author":"E Sabattini","year":"2010","unstructured":"Sabattini E, Bacci F, Sagramoso C, Pileri SA. WHO classification of tumours of haematopoietic and lymphoid tissues in 2008: an overview. 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Establishing a practical blood platelet threshold to avoid reporting spurious potassium results due to thrombocytosis. Ann Clin Biochem. 2005;42(Pt 3):196\u20139.","journal-title":"Ann Clin Biochem"}],"container-title":["European Journal of Medical Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s40001-022-00787-9.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s40001-022-00787-9\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s40001-022-00787-9.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,9,2]],"date-time":"2022-09-02T11:23:15Z","timestamp":1662117795000},"score":1,"resource":{"primary":{"URL":"https:\/\/eurjmedres.biomedcentral.com\/articles\/10.1186\/s40001-022-00787-9"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,8,23]]},"references-count":8,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2022,12]]}},"alternative-id":["787"],"URL":"https:\/\/doi.org\/10.1186\/s40001-022-00787-9","relation":{},"ISSN":["2047-783X"],"issn-type":[{"value":"2047-783X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,8,23]]},"assertion":[{"value":"8 December 2021","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"7 August 2022","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"23 August 2022","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Written informed consent was obtained from patient\u2019s wife, because the patient died prior to the decision to write the manuscript. This article does not contain any studies with human participants or animals performed by any of the authors.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}},{"value":"Because the patient died prior to the decision to write the manuscript, written informed consent was obtained from this patient\u2019s wife.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Informed consent"}}],"article-number":"155"}}