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Does fluorescent urine indicate antifreeze ingestion by children?
M J Casavant1, M N Shah, R Battels
1Division of Clinical Pharmacology/Toxicology, Departments of Pediatrics and Emergency Medicine, Ohio State University College of Medicine and Public Health, Columbus, Ohio, USA. casavant@chi.osu.edu
Insights
Fluorescent urine does not reliably indicate antifreeze ingestion in children. Most children
Area of Science:
- Pediatric Toxicology
- Clinical Chemistry
Background:
- Fluorescent urine has been historically associated with ethylene glycol antifreeze ingestion.
- A recent case questioned this association, prompting further investigation.
Purpose of the Study:
- To determine if fluorescent urine is a reliable indicator of ethylene glycol antifreeze ingestion in children.
Main Methods:
- Urine specimens from 30 hospitalized children (unrelated to poisoning) and 16 healthy children were collected.
- Specimens were examined for fluorescence using a Wood's lamp.
Main Results:
- The majority of urine specimens from children exhibited fluorescence.
- Observer interpretation of fluorescence varied.
- Urine container type may affect fluorescence detection.
Conclusions:
- Fluorescent urine is not a specific indicator of ethylene glycol antifreeze ingestion in pediatric patients.
- Clinical suspicion for antifreeze poisoning should not solely rely on urine fluorescence.
Objective:
Fluorescent urine has been reported to indicate antifreeze ingestion. Recently, we evaluated a child who was suspected of ethylene glycol ingestion. Although she had fluorescent urine, subsequent studies showed that she had not ingested antifreeze. We tested whether fluorescent urine indicates antifreeze ingestion by children.
Methods:
A convenience sample of urine specimens from 30 hospitalized children was obtained. All of the patients had been hospitalized for reasons unrelated to poisoning. The specimens were viewed with a Wood's lamp, and the samples were identified as fluorescent or not fluorescent. A second convenience sample of urine specimens from a group of 16 healthy children was obtained, and these specimens were identified as fluorescent or not fluorescent in a similar manner.
Results:
The majority of urine specimens obtained from children are fluorescent. There is variation in the interpretation of urine fluorescence among observers. The type of container used may influence the finding of fluorescence.
Conclusions:
Fluorescent urine is not an indicator of ethylene glycol antifreeze ingestion by children.