Artifactual elevation of lactate in ethylene glycol poisoning

The diagnosis of ethylene glycol poisoning is based on nonspecific clinical symptoms and signs and indirect and direct laboratory measurement. Few institutions have timely access to direct measurement of ethylene glycol. As a result, diagnosis sometimes can be delayed and therapy initiated late. We...

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Bibliographic Details
Published inThe Journal of emergency medicine Vol. 25; no. 3; pp. 289 - 293
Main Authors Woo, Michael Y, Greenway, Donald C, Nadler, Steven P, Cardinal, Pierre
Format Journal Article
LanguageEnglish
Published New York, NY Elsevier Inc 01.10.2003
Elsevier
Subjects
Adult
Biological and medical sciences
Chemical and industrial products toxicology. Toxic occupational diseases
Emergency Medical Services
ethylene glycol
Ethylene Glycols - poisoning
False Positive Reactions
Humans
lactate
Lactic Acid - blood
Male
Medical sciences
Middle Aged
Solvents
Toxicology
lactate
ethylene glycol
Human
Ethylene glycol
False positive
Hyperlactacidemia
Biological marker
Male
Differential diagnostic
Case study
Metabolic disorder
Glycolic acid
Adult
Poisoning
Lactic acid
Elderly
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Summary:The diagnosis of ethylene glycol poisoning is based on nonspecific clinical symptoms and signs and indirect and direct laboratory measurement. Few institutions have timely access to direct measurement of ethylene glycol. As a result, diagnosis sometimes can be delayed and therapy initiated late. We present two cases of ethylene glycol poisoning. These cases demonstrate the need to recognize the false elevation of lactate in some chemistry analyzers due to the interference of glycolic acid, a metabolite of ethylene glycol. Using the “lactate gap” in comparing the measurement of lactate with two commonly used chemical analyzers aids in differentiating ethylene glycol poisoning from lactic acidosis.
Bibliography:ObjectType-Article-2
SourceType-Scholarly Journals-1
ObjectType-Feature-1
content type line 23
ISSN:0736-4679
2352-5029
DOI:10.1016/S0736-4679(03)00203-8