Journal Article

Relationship Between Serum Glycolate and Falsely Elevated Lactate in Severe Ethylene Glycol Poisoning

Alex F. Manini, Robert S. Hoffman, Kenneth E. McMartin and Lewis S. Nelson

in Journal of Analytical Toxicology

Volume 33, issue 3, pages 174-176
Published in print April 2009 | ISSN: 0146-4760
Published online April 2009 | e-ISSN: 1945-2403 | DOI: http://dx.doi.org/10.1093/jat/33.3.174
Relationship Between Serum Glycolate and Falsely Elevated Lactate in Severe Ethylene Glycol Poisoning

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In the setting of ethylene glycol (EG) poisoning, a falsely elevated serum lactate concentration is suggested to be an assay cross-reaction with glycolate, but a concentration-dependent relationship has never been identified. We correlate serum lactate and glycolate concentrations in a case of severe EG poisoning. Serial EG [by gas chromatography (GC)], glycolate (derivatized to methyl glycolate, analysis by GC), and lactate (both enzymatic spectrophotometry and GC) concentrations were correlated at five time points. False-positive lactate was confirmed by absence of lactate on GC analysis. The correlation coefficient (Pearson's r) between lactate (by enzymatic spectrophotometry) and glycolate was 0.984 and was statistically significant (p < 0.01). The mean lactate/glycolate conversion factor was 2.58 ± 0.95. We demonstrate the linear correlation between falsely elevated serum lactate and glycolate concentrations in a case of severe EG poisoning. Our data provide further support to the belief that the lactate assay may cross-react with glycolate in EG poisoning.

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Subjects: Medical Toxicology ; Toxicology (Non-medical)

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