title: Validation of a rapid, automated method for the measurement of ethylene glycol in human plasma.
abstract: Background Ethylene glycol is a highly toxic compound found in various household products. Cases of poisoning are rare but may be fatal unless diagnosed and treated promptly. Early recognition of poisoning is critical for the management and recovery of patients. Indirect testing is not specific for the presence of ethylene glycol. Therefore, urgent and accurate measurement should be sought if ingestion is suspected in order to determine the need for treatment with an antidote. Here, we present the validation of an automated assay for measurement of ethylene glycol on an Abbott Architect using a commercially available kit (Catachem). Methods Analytical parameters of imprecision, linearity, stability and bias were determined using spiked human plasma samples processed on both the Catachem assay and on an in-house gas chromatography-mass spectrometry method. Interference was assessed using samples collected into a variety of sample collection tubes and spiked with a number of alcohols. Results Excellent agreement was observed between the two methodologies with the enzymatic assay demonstrating linearity and precision across the relevant clinical range (50-3000 mg/L). In addition, the Catachem assay displayed no interference from a number of different sample tubes and alcohols. However, propylene glycol interference was observed at concentrations associated with excessive use (>1 g/L) and 2,3-butanediol interference observed at concentrations associated with butanone ingestion. Inspection of the enzymatic reaction profile was found to differentiate between alcohols. Conclusions This automated assay is suitable for the diagnosis of ethylene glycol poisoning and is now in routine use, enabling the laboratory to provide a rapid 24 h service with support by gas chromatography-mass spectrometry as necessary.
authors.affiliation: Department of Clinical Chemistry, Immunology & Toxicology, Heart of England NHS Foundation Trust, Birmingham, UK.
authors.forename: Anna F
authors.initials: AF
authors.lastname: Robson
authors.affiliation: Department of Clinical Chemistry, Immunology & Toxicology, Heart of England NHS Foundation Trust, Birmingham, UK.
authors.forename: Alexander J
authors.initials: AJ
authors.lastname: Lawson
authors.affiliation: Department of Clinical Chemistry, Immunology & Toxicology, Heart of England NHS Foundation Trust, Birmingham, UK.
authors.forename: Laura
authors.initials: L
authors.lastname: Lewis
authors.affiliation: Department of Clinical Chemistry, Immunology & Toxicology, Heart of England NHS Foundation Trust, Birmingham, UK.
authors.forename: Alan
authors.initials: A
authors.lastname: Jones
authors.affiliation: Department of Clinical Chemistry, Immunology & Toxicology, Heart of England NHS Foundation Trust, Birmingham, UK.
authors.forename: Stephen
authors.initials: S
authors.lastname: George
mesh_terms: D057205:Automation, Laboratory; D002138:Calibration; D057075:Enzyme Assays / Q000592:standards*; D019855:Ethylene Glycol / Q000506:poisoning*; D008401:Gas Chromatography-Mass Spectrometry / Q000592:standards*; D006801:Humans; D057230:Limit of Detection; D020258:Neurotoxicity Syndromes / Q000097:blood* / Q000175:diagnosis* / Q000209:etiology; D011933:Reagent Kits, Diagnostic; D015203:Reproducibility of Results
chemical_list: D011933:Reagent Kits, Diagnostic; D019855:Ethylene Glycol
keywords: Abbott; Ethylene glycol; automated; enzymatic; gas chromatography-mass spectrometry; poisoning