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Intoxication with nitromethane-containing fuels: don't be "fueled" by the creatinine
M E Mullins1, C A Hammett-Stabler
1Oregon Poison Center, Oregon Health Sciences University, Portland 97201-3098, USA. mullinmi@ohsu.edu
Journal of Toxicology. Clinical Toxicology
|August 26, 1998
Summary
Nitromethane in fuels can falsely elevate creatinine test results, appearing 10-20 times higher than normal. This chemical interference does not necessitate dialysis if other lab results are stable.
Area of Science:
- Clinical Toxicology
- Analytical Chemistry
Background:
- Two patients experienced laboratory abnormalities after exposure to nitromethane-containing fuels.
- One patient ingested fuel; the other had dermal exposure from saturated clothing.
Observation:
- Both patients presented with significantly elevated serum creatinine concentrations.
- The elevated creatinine levels were attributed to nitromethane exposure.
Findings:
- Nitromethane interferes with the Jaffé reaction, a common method for measuring creatinine.
- This interference caused apparent creatinine levels to increase 10- to 20-fold in patients.
Implications:
- Clinicians should be aware of nitromethane's interference with creatinine assays.
- False elevations in creatinine due to nitromethane do not require hemodialysis if other clinical indicators are normal.
- Management should focus on treating potential methanol toxicity associated with fuel exposure.