False-Positive Enzymatic Alcohol Results in Perimortem Specimens

False-Positive Enzymatic Alcohol Results in Perimortem Specimens

Abstract Herein, we present 2 cases referred to the North Carolina Office of the Chief Medical Examiner (NC OCME) in which ethanol results reported by different hospital laboratories, using alcohol dehydrogenase (ADH)–based assays, were positive, whereas results of headspace gas chromatography testi...

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Bibliographic Details
Published in:Laboratory medicine Vol. 51; no. 4; pp. 394 - 401
Main Authors: Bishop-Freeman, Sandra C, Bertholf, Roger L, Powers, Robert H, Mayhew, Lisa C, Winecker, Ruth E
Format: Journal Article
Language:English
Published: US Oxford University Press 08-07-2020
Subjects:
Alcohol Dehydrogenase - metabolism
Alcohols
Blood Chemical Analysis - methods
Blood Chemical Analysis - standards
Child
Chromatography
Chromatography, Gas - methods
Chromatography, Gas - standards
Dehydrogenases
Ethanol
Ethanol - blood
False Positive Reactions
Humans
Infant
L-Lactate Dehydrogenase - metabolism
Laboratories
Lactic Acid - blood
Male
Medical laboratories
lactic acid
forensic toxicology
serum ethanol
alcohol dehydrogenase (ADH)–based assays
perimortem specimens
lactate dehydrogenase (LD)
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Summary:Abstract Herein, we present 2 cases referred to the North Carolina Office of the Chief Medical Examiner (NC OCME) in which ethanol results reported by different hospital laboratories, using alcohol dehydrogenase (ADH)–based assays, were positive, whereas results of headspace gas chromatography testing performed in the NC OCME laboratory were negative. Literature reports suggest that false-positive ethanol measurements from ADH-based assays can occur when a combination of elevated lactate and lactate dehydrogenase (LD) are present in the specimen. The results were reported in perimortem specimens collected from 2 children with unrelated medical conditions. The cases and associated clinical parameters are considered based on the lactate/LD explanation for the false-positive results, to facilitate the recognition of circumstances that can produce erroneous serum ethanol results.
ISSN:0007-5027
1943-7730
DOI:10.1093/labmed/lmz082