Falsely elevated lactate in severe ethylene glycol intoxication.
نویسندگان
چکیده
A 29-year-old male presented at the emergency department of our hospital in a confused state. He had a history of psychoses and substance abuse. Physical examination revealed hyperventilation and abdominal tenderness. Blood gas analysis in the emergency department using an ABL 725 Radiometer analyser showed a severe metabolic acidosis with massive lactate elevation. Lactate acidosis due to mesenteric ischaemia was suspected. However, toxicology screening demonstrated ethylene glycol intoxication. Treatment with ethanol infusion and acute haemodialysis was started. Repeated laboratory measurements using a clinical chemistry analyser showed minimal plasma lactate elevation. Falsely elevated lactate measurement is a little known phenomenon that can occur in ethylene glycol intoxication and can cause serious delay in diagnosis. Therefore, elevated lactate concentrations measured on intensive care unit and emergency department blood gas analysers should be confirmed by a clinical chemistry analyser in the main laboratory in case of suspected ethylene glycol intoxication.
منابع مشابه
Ethylene glycol poisoning and lactate concentrations.
We were interested to read the article by Manini et al. (1), which confirmed previous observations that a severe ethylene glycol poisoning may lead to falsely elevated lactate levels (2). High lactate levels were indeed measured by enzymatic spectrophotometry (Integra analyzer) but excluded by a specific GC analysis. A linear correlation was nicely demonstrated between the serially determined b...
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BACKGROUND Intoxication with ethylene glycol happen all around the world and without rapid recognition and early treatment, mortality from this is high. METHODS In our study, we retrospectively analysed six cases of ethylene glycol intoxication in our department. We measured ethylene glycol or glycolate levels, lactate levels and calculated the osmolal and anion gap. RESULTS Data from six p...
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BACKGROUND A patient presented with severe acidosis and a point-of-care lactate measurement of 42 mmol/L. Mesenteric ischemia was suspected, with a potential need for laparotomy; however, plasma lactate measurements were below 4 mmol/L. Ethylene glycol ingestion was subsequently diagnosed. We therefore wished to determine why discrepancies in lactate measurements occur and whether this "lactate...
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1. Morgan TJ, Clark C, Clague A. Artifactual elevation of measured plasma L-lactate concentration in the presence of glycolate (Clinical Investigations). Crit Care Med 1999; 27(10): 2177–2179. 2. Brindley PG, Butler MS, Cembrowski G, Brindley DN. Falsely elevated point-of-care lactate measurement after ingestion of ethylene glycol. Can Med Assoc J 2007; 176: 1097–1099. 3. Lactate Gen.2, 2003-12...
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BACKGROUND Ethylene glycol intoxication causes severe metabolic acidosis and acute kidney injury. Fomepizole has become available as its antidote. Nevertheless, a prompt diagnosis is not easy because patients are often unconscious. Here we present a case of ethylene glycol intoxication who successfully recovered with prompt hemodialysis. CASE PRESENTATION A 52-year-old Japanese male was admit...
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ورودعنوان ژورنال:
- The Netherlands journal of medicine
دوره 68 1 شماره
صفحات -
تاریخ انتشار 2010