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Elevated lactate in ethylene glycol poisoning: True or false?
Qing H Meng1, Khosrow Adeli, Gordon A Zello
1Department of Pathology and Laboratory Medicine, University of Saskatchewan, Saskatoon, Canada. qing.meng@usask.ca
Clinica Chimica Acta; International Journal of Clinical Chemistry
|January 26, 2010
Summary
False elevations in blood lactate can occur in ethylene glycol poisoning due to glycolic acid interference on blood gas analyzers. Always confirm high lactate levels with a chemistry analyzer for accurate diagnosis.
Area of Science:
- Clinical Chemistry
- Toxicology
- Analytical Chemistry
Background:
- Ethylene glycol poisoning is associated with elevated lactate levels, but interference in measurement is a concern.
- Reports indicate a false increase in lactate, particularly with blood gas analyzers.
Observation:
- Two cases of ethylene glycol poisoning presented with significantly high blood lactate concentrations on an ABL blood gas analyzer.
- Lactate measurements were compared across multiple instruments, with varying results depending on glycolic acid levels.
Findings:
- High glycolic acid concentrations caused significant positive interference in lactate measurements on the ABL analyzer.
- Other chemistry instruments showed minimal to no interference from glycolic acid, providing more accurate lactate values.
Implications:
- Blood gas analyzers may inaccurately report lactate levels in ethylene glycol poisoning.
- Confirming elevated lactate with a separate chemistry analyzer is crucial for accurate diagnosis and management of ethylene glycol poisoning.
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