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Detection of ingested nitromethane and reliable creatinine assessment using multiple common analytical methods.

Identifieur interne : 000891 ( Main/Corpus ); précédent : 000890; suivant : 000892

Detection of ingested nitromethane and reliable creatinine assessment using multiple common analytical methods.

Auteurs : Christine M. Murphy ; John J. Devlin ; Michael C. Beuhler ; Paul Cheifetz ; Susan Maynard ; Michael D. Schwartz ; Sherri Kacinko

Source :

RBID : pubmed:28814126

English descriptors

Abstract

AIM

Nitromethane, found in fuels used for short distance racing, model cars, and model airplanes, produces a falsely elevated serum creatinine with standard creatinine analysis via the Jaffé method. Erroneous creatinine elevation often triggers extensive testing, leads to inaccurate diagnoses, and delayed or inappropriate medical interventions. Multiple reports in the literature identify "enzymatic assays" as an alternative method to detect the true value of creatinine, but this ambiguity does not help providers translate what type of enzymatic assay testing can be done in real time to determine if there is indeed false elevation.

METHODS

We report seven cases of ingested nitromethane where creatinine was determined via Beckman Coulter

RESULTS

When creatinine was determined using i-Stat

CONCLUSIONS

These cases demonstrate reliable assessment of creatinine through other enzymatic methods using a Vitros


DOI: 10.1080/15563650.2017.1360497
PubMed: 28814126

Links to Exploration step

pubmed:28814126

Le document en format XML

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<name sortKey="Murphy, Christine M" sort="Murphy, Christine M" uniqKey="Murphy C" first="Christine M" last="Murphy">Christine M. Murphy</name>
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<nlm:affiliation>a Department of Emergency Medicine , Carolinas Medical Center , Charlotte , NC , USA.</nlm:affiliation>
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<name sortKey="Devlin, John J" sort="Devlin, John J" uniqKey="Devlin J" first="John J" last="Devlin">John J. Devlin</name>
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<nlm:affiliation>b Georgia Poison Center , Atlanta , GA , USA.</nlm:affiliation>
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<name sortKey="Beuhler, Michael C" sort="Beuhler, Michael C" uniqKey="Beuhler M" first="Michael C" last="Beuhler">Michael C. Beuhler</name>
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<nlm:affiliation>c Carolinas Poison Center , Charlotte , NC , USA.</nlm:affiliation>
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<name sortKey="Cheifetz, Paul" sort="Cheifetz, Paul" uniqKey="Cheifetz P" first="Paul" last="Cheifetz">Paul Cheifetz</name>
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<nlm:affiliation>d Metrolina Nephrology Associates , PA, Charlotte , NC , USA.</nlm:affiliation>
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<name sortKey="Maynard, Susan" sort="Maynard, Susan" uniqKey="Maynard S" first="Susan" last="Maynard">Susan Maynard</name>
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<nlm:affiliation>e Carolinas Pathology Group , Charlotte , NC , USA.</nlm:affiliation>
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<name sortKey="Schwartz, Michael D" sort="Schwartz, Michael D" uniqKey="Schwartz M" first="Michael D" last="Schwartz">Michael D. Schwartz</name>
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<nlm:affiliation>b Georgia Poison Center , Atlanta , GA , USA.</nlm:affiliation>
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<name sortKey="Maynard, Susan" sort="Maynard, Susan" uniqKey="Maynard S" first="Susan" last="Maynard">Susan Maynard</name>
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<name sortKey="Schwartz, Michael D" sort="Schwartz, Michael D" uniqKey="Schwartz M" first="Michael D" last="Schwartz">Michael D. Schwartz</name>
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<title level="j">Clinical toxicology (Philadelphia, Pa.)</title>
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<term>Adolescent (MeSH)</term>
<term>Adult (MeSH)</term>
<term>Autoanalysis (methods)</term>
<term>Creatinine (blood)</term>
<term>Enzyme Assays (methods)</term>
<term>False Positive Reactions (MeSH)</term>
<term>Female (MeSH)</term>
<term>Gas Chromatography-Mass Spectrometry (methods)</term>
<term>Humans (MeSH)</term>
<term>Male (MeSH)</term>
<term>Methane (analogs & derivatives)</term>
<term>Methane (blood)</term>
<term>Methane (poisoning)</term>
<term>Nitroparaffins (blood)</term>
<term>Nitroparaffins (poisoning)</term>
<term>Point-of-Care Systems (MeSH)</term>
<term>Young Adult (MeSH)</term>
</keywords>
<keywords scheme="MESH" type="chemical" qualifier="analogs & derivatives" xml:lang="en">
<term>Methane</term>
</keywords>
<keywords scheme="MESH" type="chemical" qualifier="blood" xml:lang="en">
<term>Creatinine</term>
<term>Methane</term>
<term>Nitroparaffins</term>
</keywords>
<keywords scheme="MESH" qualifier="methods" xml:lang="en">
<term>Autoanalysis</term>
<term>Enzyme Assays</term>
<term>Gas Chromatography-Mass Spectrometry</term>
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<keywords scheme="MESH" type="chemical" qualifier="poisoning" xml:lang="en">
<term>Methane</term>
<term>Nitroparaffins</term>
</keywords>
<keywords scheme="MESH" xml:lang="en">
<term>Adolescent</term>
<term>Adult</term>
<term>False Positive Reactions</term>
<term>Female</term>
<term>Humans</term>
<term>Male</term>
<term>Point-of-Care Systems</term>
<term>Young Adult</term>
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<div type="abstract" xml:lang="en">
<p>
<b>AIM</b>
</p>
<p>Nitromethane, found in fuels used for short distance racing, model cars, and model airplanes, produces a falsely elevated serum creatinine with standard creatinine analysis via the Jaffé method. Erroneous creatinine elevation often triggers extensive testing, leads to inaccurate diagnoses, and delayed or inappropriate medical interventions. Multiple reports in the literature identify "enzymatic assays" as an alternative method to detect the true value of creatinine, but this ambiguity does not help providers translate what type of enzymatic assay testing can be done in real time to determine if there is indeed false elevation.</p>
</div>
<div type="abstract" xml:lang="en">
<p>
<b>METHODS</b>
</p>
<p>We report seven cases of ingested nitromethane where creatinine was determined via Beckman Coulter</p>
</div>
<div type="abstract" xml:lang="en">
<p>
<b>RESULTS</b>
</p>
<p>When creatinine was determined using i-Stat</p>
</div>
<div type="abstract" xml:lang="en">
<p>
<b>CONCLUSIONS</b>
</p>
<p>These cases demonstrate reliable assessment of creatinine through other enzymatic methods using a Vitros</p>
</div>
</front>
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<PMID Version="1">28814126</PMID>
<DateCompleted>
<Year>2019</Year>
<Month>07</Month>
<Day>03</Day>
</DateCompleted>
<DateRevised>
<Year>2019</Year>
<Month>07</Month>
<Day>03</Day>
</DateRevised>
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<Journal>
<ISSN IssnType="Electronic">1556-9519</ISSN>
<JournalIssue CitedMedium="Internet">
<Volume>56</Volume>
<Issue>4</Issue>
<PubDate>
<Year>2018</Year>
<Month>04</Month>
</PubDate>
</JournalIssue>
<Title>Clinical toxicology (Philadelphia, Pa.)</Title>
<ISOAbbreviation>Clin Toxicol (Phila)</ISOAbbreviation>
</Journal>
<ArticleTitle>Detection of ingested nitromethane and reliable creatinine assessment using multiple common analytical methods.</ArticleTitle>
<Pagination>
<MedlinePgn>237-244</MedlinePgn>
</Pagination>
<ELocationID EIdType="doi" ValidYN="Y">10.1080/15563650.2017.1360497</ELocationID>
<Abstract>
<AbstractText Label="AIM">Nitromethane, found in fuels used for short distance racing, model cars, and model airplanes, produces a falsely elevated serum creatinine with standard creatinine analysis via the Jaffé method. Erroneous creatinine elevation often triggers extensive testing, leads to inaccurate diagnoses, and delayed or inappropriate medical interventions. Multiple reports in the literature identify "enzymatic assays" as an alternative method to detect the true value of creatinine, but this ambiguity does not help providers translate what type of enzymatic assay testing can be done in real time to determine if there is indeed false elevation.</AbstractText>
<AbstractText Label="METHODS">We report seven cases of ingested nitromethane where creatinine was determined via Beckman Coulter
<sup>®</sup>
analyser using the Jaffé method, Vitros
<sup>®</sup>
analyser, or i-Stat
<sup>®</sup>
point-of-care testing. Nitromethane was detected and semi-quantified using a common clinical toxic alcohol analysis method, and quantified by headspace-gas chromatography-mass spectrometry.</AbstractText>
<AbstractText Label="RESULTS">When creatinine was determined using i-Stat
<sup>®</sup>
point-of-care testing or a Vitros
<sup>®</sup>
analyser, levels were within the normal range. Comparatively, all initial creatinine levels obtained via the Jaffé method were elevated. Nitromethane concentrations ranged from 42 to 310 μg/mL.</AbstractText>
<AbstractText Label="CONCLUSIONS">These cases demonstrate reliable assessment of creatinine through other enzymatic methods using a Vitros
<sup>®</sup>
analyser or i-STAT
<sup>®</sup>
. Additionally, nitromethane is detectable and quantifiable using routine alcohols gas chromatography analysis and by headspace-gas chromatography-mass spectrometry.</AbstractText>
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<QualifierName UI="Q000097" MajorTopicYN="Y">blood</QualifierName>
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<KeywordList Owner="NOTNLM">
<Keyword MajorTopicYN="Y">Creatinine</Keyword>
<Keyword MajorTopicYN="Y">Jaffé method</Keyword>
<Keyword MajorTopicYN="Y">methanol</Keyword>
<Keyword MajorTopicYN="Y">nitromethane</Keyword>
<Keyword MajorTopicYN="Y">racing fuel</Keyword>
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