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

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Nitromethane falsely elevates creatinine levels when measured with the Jaffé method. Enzymatic assays, like those used with Vitros® or i-STAT® analyzers, provide accurate creatinine measurements, avoiding misdiagnosis.

Keywords:
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Area of Science:

  • Clinical Chemistry
  • Toxicology
  • Analytical Chemistry

Background:

  • Nitromethane is a component in racing fuels.
  • Standard creatinine analysis using the Jaffé method can yield falsely elevated results in the presence of nitromethane.
  • This false elevation can lead to unnecessary medical interventions.

Observation:

  • Seven cases of nitromethane ingestion were analyzed.
  • Creatinine levels were measured using the Jaffé method, Vitros® analyser, and i-Stat® point-of-care testing.
  • Nitromethane was detected and quantified using gas chromatography methods.

Findings:

  • Jaffé method consistently showed elevated creatinine levels.
  • Vitros® and i-Stat® enzymatic assays provided accurate, normal creatinine readings.
  • Nitromethane concentrations in patients ranged from 42 to 310 μg/mL.

Implications:

  • Enzymatic assays (Vitros®, i-STAT®) are reliable alternatives for creatinine measurement when nitromethane exposure is suspected.
  • Routine toxic alcohol analysis can detect and quantify nitromethane.
  • Accurate creatinine assessment prevents misdiagnosis and inappropriate medical care.