Abstract

BACKGROUND:

Ethylene glycol (EG) poisoning remains a rare but important presentation to acute toxicology units. Guidelines recommended that Ethylene Glycol should be available as an 'urgent' test within 4 hours but these are difficult to deliver in practice. This study assessed a semi-quantitative enzymatic spectrophotometric assay for EG compatible with automated platforms.

METHODS:

The EG method was assessed in 21 samples from patients with an increased anion gap and metabolic acidosis not due to EG ingestion, and 7 samples known to contain EG. All samples were analysed in random order in a blinded-manner to their origin on a laboratory spectrophotometer.

RESULTS:

In this study, 7 samples were known to contain EG at concentrations >100mg/L. The method correctly identified all 7 samples as containing EG. No false positives were observed. 13 samples gave clear negative results. EG was present at <20mg/L in one sample, but this sample remained within the limits of the negative control. Passing-Bablock correlation of estimates of EG concentration against results obtained when the samples had been analysed using the quantitative method on an automated analyser showed a good correlation (R=0.84) but with an apparent under-recovery.

CONCLUSIONS:

A semi-quantitative assay for EG was able to discriminate well between samples containing EG and those with other causes of acidosis. It is a practical small-scale assay for rapid identification of cases of EG-poisoning.

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 2016 Sep 28. pii: 0004563216672892. [Epub ahead of print]

PMID: 27687084