C Martinez1, H Lubbos, L I Rose, C Swartz, F Kayne. 1. Division of Endocrinology and Metabolism, Division of Nephrology, Department of Medicine, Allegheny University Hospitals (Hahnemann, Division), Philadelphia, Pennsylvania, USA.
Abstract
OBJECTIVE: To describe two patients with diabetic ketoacidosis and positive ethylene glycol levels and to call attention to the possibility of a false-positive ethylene glycol determination in patients with ketoacidosis. METHODS: Clinical manifestations and laboratory tests in the two patients were summarized. Serum specimens for both patients were analyzed for ethylene glycol, serum ketones, glucose, osmolality, pH, and electrolytes. RESULTS: Respective laboratory findings in our two patients were as follows: serum glucose levels, 56.4 and 45.7 mmol/L; serum acetone, positive in 1:80 and 1:128 dilution; serum osmolality, 366 and 377 mmol/kg; pH, 6.9 and 7.2; and ethylene glycol, 3.46 and 2.45 mmol/L. CONCLUSION: Neither of these two elderly women had ingested ethylene glycol; nevertheless, both had positive results for ethylene glycol on a blood toxicology screen. Review of the literature demonstrates that false-positive ethylene glycol levels can be detected in patients with ketoacidosis. This information is documented in this report and should alert practicing physicians to such a possibility.
OBJECTIVE: To describe two patients with diabetic ketoacidosis and positive ethylene glycol levels and to call attention to the possibility of a false-positive ethylene glycol determination in patients with ketoacidosis. METHODS: Clinical manifestations and laboratory tests in the two patients were summarized. Serum specimens for both patients were analyzed for ethylene glycol, serum ketones, glucose, osmolality, pH, and electrolytes. RESULTS: Respective laboratory findings in our two patients were as follows: serum glucose levels, 56.4 and 45.7 mmol/L; serum acetone, positive in 1:80 and 1:128 dilution; serum osmolality, 366 and 377 mmol/kg; pH, 6.9 and 7.2; and ethylene glycol, 3.46 and 2.45 mmol/L. CONCLUSION: Neither of these two elderly women had ingested ethylene glycol; nevertheless, both had positive results for ethylene glycol on a blood toxicology screen. Review of the literature demonstrates that false-positive ethylene glycol levels can be detected in patients with ketoacidosis. This information is documented in this report and should alert practicing physicians to such a possibility.
Authors: Riaz V Bavakunji; Jake D Turner; Sagar Jujjavarapu; Maarten W Taal; Richard J Fluck; Janson C Leung; Nitin V Kolhe; Nicholas M Selby Journal: NDT Plus Date: 2011-03-07