title: False negativity to carbohydrate-deficient transferrin and drugs: a clinical case.
abstract: BACKGROUND
  In this work we report on the possible effect of the medical therapy on CDT concentration in a chronic alcohol abuser, with known medical history (July 2007 - April 2012) and alcohol abuse confirmed by relatives.
  
  
  METHODS
  At the end of 2007, patient displayed the following laboratory results: AST 137 U/L, ALT 120 U/L, GGT 434 U/L, MCV 101 fL and CDT 3.3%. On December 2007, after double coronary artery bypass surgery, he began a pharmacological treatment with amlodipine, perindopril, atorvastatin, isosorbide mononitrate, carvedilol, ticlopidine and pantoprazole. In the next months, until may 2011, the patient resumed alcohol abuse, as confirmed by relatives; however, CDT values were repeatedly found negative (0.8% and 1.1%) despite elevated transaminases and GGT, concurrent elevated ethyl glucuronide concentration (> 50 mg/L) and blood alcohol concentration (> 1 g/L). Alcohol consumption still continued despite increasing disulfiram doses ordered by an Alcohol Rehab Center. On May 2011, the patient was transferred to a private medical center where he currently lives.
  
  
  CONCLUSIONS
  This study suggests the possibility that a medical therapy including different drugs may hamper the identification of chronic alcohol abusers by CDT.
authors.affiliation: Department of Health Sciences, University "Amedeo Avogadro" of East Piedmont, and Clinical Chemistry Unit, Maggiore della Carità Hospital, Novara, Italy.
authors.forename: Matteo
authors.initials: M
authors.lastname: Vidali
authors.affiliation: Toxicology Laboratory, Deaprtment of Clinical Pathology, SS. Antonio e Biagio e C. Arrigo Hospital, Alessandria, Italy.
authors.forename: Vincenza
authors.initials: V
authors.lastname: Bianchi
authors.affiliation: Department of Health Sciences, University "Amedeo Avogadro" of East Piedmont, and Clinical Chemistry Unit, Maggiore della Carità Hospital, Novara, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Bagnati
authors.affiliation: Department of Health Sciences, University "Amedeo Avogadro" of East Piedmont, and Clinical Chemistry Unit, Maggiore della Carità Hospital, Novara, Italy.
authors.forename: Nadia
authors.initials: N
authors.lastname: Atzeni
authors.affiliation: Department of Health Sciences, University "Amedeo Avogadro" of East Piedmont, and Clinical Chemistry Unit, Maggiore della Carità Hospital, Novara, Italy.
authors.forename: Andrea Marco
authors.initials: AM
authors.lastname: Bianchi
authors.affiliation: Department of Health Sciences, University "Amedeo Avogadro" of East Piedmont, and Clinical Chemistry Unit, Maggiore della Carità Hospital, Novara, Italy.
authors.forename: Giorgio
authors.initials: G
authors.lastname: Bellomo
mesh_terms: D000368:Aged; D000437:Alcoholism / Q000150:complications / Q000175:diagnosis*; D015415:Biomarkers / Q000032:analysis*; D001026:Coronary Artery Bypass; D003324:Coronary Artery Disease / Q000150:complications / Q000188:drug therapy*; D003951:Diagnostic Errors; D005188:False Negative Reactions; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000494:pharmacology; D008297:Male; D014168:Transferrin / Q000031:analogs & derivatives* / Q000032:analysis / Q000187:drug effects
chemical_list: D015415:Biomarkers; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D014168:Transferrin; C056759:carbohydrate-deficient transferrin
keywords: alcoholism; carbohydrate-deficient transferrin; combination; drug therapy; false negative reactions