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Intoxication with ethylene glycol and falsely increased plasma lactate concentration


Authors: J. Racek 1;  V. Petříková 1;  D. Rajdl 1;  I. Novák 2
Authors place of work: Ústav klinické biochemie a hematologie 1;  I. interní klinika Lékařské fakulty UK a Fakultní nemocnice v Plzni 2
Published in the journal: Klin. Biochem. Metab., 25, 2017, No. 1, p. 32-35

Summary

Objective:
To describe a patient intoxicated with ethylene glycol and to show possible problems of delayed diagnosis due to interference of ethylene glycol oxidative products in lactate determination.

Design:
Case report and evaluation of laboratory results.

Settings:
Department of Clinical Biochemistry and Hematology and Ist Department of Internal Medicine, Faculty of Medicine, Charles University and Faculty Hospital, Alej Svobody 80, 304 60 Pilsen (Czech Republic).

Material and Methods:
Case report.

Results:
The paper describes a patient intoxicated with ethylene glycol including diagnostic consideration, worsened by falsely increased concentration of lactate, measured amperometrically using blood-gas analyzers.

Conclusion:
Products of ethylene glycol oxidation (glycolic and glyoxylic acids) are the cause of falsely increased concentration of lactate when measured by a lactate enzymatic electrode with lactate oxidase and amperometric detection.

Keywords:
ethylene glycol, glyoxylate, lactate, interference.


Zdroje

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3. Duncan, R. J. S., Tipton, K. F.: The oxidation and reduction of glyoxylate by lactic dehydrogenase. European J. Biochem., 1969, (11), p. 58 – 61

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10. Morgan, T. J., Clark, C., Clague, A.: Artifactual elevation of measured plasma L-lactate cencentration in the presence of glycolate. Critical Care Med., 1999, 27(10), p. 2177 – 2179

11. Porter, W. H., Crellin, M., Rutter, P. W., Oeltgen, P.: Interference of glycolic acid in the Beckman Synchron method for lactate: An useful clue for unsuspected ethy-lene glycol intoxication. Clin. Chem., 2000, 46(6), p. 674 – 675

12. Manini, A. F., Hoffman, R. S., McMartin, K. E., Nelson, L. S.: Relationship between serum glycolate and falsely elevated lactate in severe ethylene glycol poisoning. J. Anal. Toxicol., 2009, 33, p. 174 – 176

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14. Verelst, S., Vermeersch, P., Desmet, K.: Ethylene glycol poisoning presenting with a falsely elevated lactate level. Clin. Toxicol. (Phila), 2009, 47(3), p. 236 – 238

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16. Reference manual for ABL800 FLEX (Radiometer), kap. 5, s. 5-95

17. Operator´s Manual for GEM® Premier 2500 (Instrumentation Laboratory), kap. 11, s. 11.6 – 11.8

Štítky
Clinical biochemistry Nuclear medicine Nutritive therapist
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