False positive acetaminophen concentrations in icteric serum
| Autor: | T.F. Veneman, M.J. Henstra, T.H. Oude Munnink, L. de Jong, D.G. Knapen |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2015 |
| Předmět: |
medicine.medical_specialty
acetaminophen overdose Bilirubin medicine.medical_treatment Clinical Biochemistry Jaundice Case Report High-performance liquid chromatography Gastroenterology digestive system lcsh:Chemistry 03 medical and health sciences chemistry.chemical_compound 0302 clinical medicine Internal medicine medicine 030212 general & internal medicine Antidote Hepatic encephalopathy Acetaminophen lcsh:R5-920 Radiological and Ultrasound Technology Chemistry organic chemicals digestive oral and skin physiology Liver failure medicine.disease digestive system diseases stomatognathic diseases Paracetamol lcsh:QD1-999 Anesthesia Enzymatic-colorimetric assays medicine.symptom HPLC lcsh:Medicine (General) Interference 030217 neurology & neurosurgery medicine.drug Cysteine |
| Zdroj: | Practical Laboratory Medicine Practical Laboratory Medicine, Vol 4, Iss, Pp 38-40 (2016) |
| ISSN: | 2352-5517 |
| Popis: | Introduction: Serum concentrations of acetaminophen are measured to predict the risk of hepatotoxicity in cases of acetaminophen overdose and to identify acetaminophen use in patients with acute liver injury without a known cause. The acetaminophen concentration determines if treatment with N-acetyl cysteine, the antidote for acetaminophen poisoning, is warranted. Description: A 49-year-old woman was admitted to our hospital with a hepatic encephalopathy and a total serum bilirubin concentration of 442 µmol/l. The acetaminophen concentration of 11.5 mg/l was measured with an enzymatic-colorimetric assay, thus treatment with N-acetyl cysteine was started. Interestingly, the acetaminophen concentration remained unchanged (11.5–12.3 mg/l) during a period of 4 consecutive days. In contrast, the acetaminophen concentration measured by HPLC, a chromatographic technique, remained undetectable Discussion: In the presented case, elevated bilirubin was the most likely candidate to interfere with acetaminophen assay causing false positive results. Bilirubin has intense absorbance in the ultraviolet and visible regions of the electromagnetic spectrum and for that reason it causes interference in an enzymatic-colorimetric assay. Conclusion: False positive acetaminophen laboratory test results may be found in icteric serum, when enzymatic-colorimetric assays are used for determination of an acetaminophen concentration. Questionable acetaminophen results in icteric serum should be confirmed by a non-enzymatic method, by means of ultrafiltration of the serum, or by dilution studies. Keywords: Acetaminophen, Enzymatic-colorimetric assays, HPLC, Bilirubin, Interference, Paracetamol, Liver failure, Jaundice |
| Databáze: | OpenAIRE |
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