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HelpTest Code ETGL Ethylene Glycol, Serum
Reporting Name
Ethylene Glycol, SUseful For
Confirming and monitoring ethylene glycol toxicity
Method Name
Gas Chromatography-Flame Ionization Detection (GC-FID)
Performing Laboratory
Mayo Clinic Laboratories in Rochester
Specimen Type
Serum RedSpecimen Required
Supplies: Sarstedt Aliquot Tube 5 mL (T914)
Collection Container/Tube: Red top (serum gel/SST tubes are not acceptable)
Submission Container/Tube: Plastic vial
Specimen Volume: 2 mL
Collection Instructions: Centrifuge and aliquot serum into plastic vial within 2 hours of collection.
Specimen Minimum Volume
0.3 mL
Specimen Stability Information
| Specimen Type | Temperature | Time | Special Container |
|---|---|---|---|
| Serum Red | Refrigerated (preferred) | 14 days | |
| Ambient | 14 days | ||
| Frozen | 14 days |
Reject Due To
| Gross hemolysis | Reject |
| Gross lipemia | Reject |
| Gross icterus | Reject |
Reference Values
Toxic concentration: ≥20 mg/dL
Day(s) Performed
Monday through Sunday
CPT Code Information
80320
G0480 (if appropriate)
LOINC Code Information
| Test ID | Test Order Name | Order LOINC Value |
|---|---|---|
| ETGL | Ethylene Glycol, S | 5646-5 |
| Result ID | Test Result Name | Result LOINC Value |
|---|---|---|
| 8749 | Ethylene Glycol, S | 5646-5 |
Clinical Information
Ethylene glycol is present in antifreeze products, deicing products, detergents, paints, and cosmetics. Ethylene glycol has initial central nervous system (CNS) effects resembling those of ethanol and may be ingested accidentally or for the purpose of inebriation or suicide. Ethylene glycol itself is relatively nontoxic, however, metabolism of ethylene glycol by alcohol dehydrogenase results in the formation of a number of acid metabolites, including oxalic acid and glycolic acid. These acid metabolites are responsible for much of the toxicity of ethylene glycol.
Clinically, poisoning has historically been divided into three stages, although timing may vary, and stages may overlap. The first stage typically begins 30 minutes to 12 hours after ingestion due to the intoxicating effects of the ethylene glycol and may range from mild CNS depression to coma. The second stage begins 12 to 24 hours after ingestion and is characterized severe metabolic acidosis, due to the accumulation of acid metabolites. The third stage occurs 24 to 72 hours after ingestion and is characterized by renal failure due to calcium oxalate crystal deposition in the proximal tubules.
Ethylene glycol toxicity can be treated with 4-methylpyrazole (4-MP; fomepizole) or ethanol by competitively inhibiting alcohol dehydrogenase and thereby preventing conversion of ethylene glycol to its toxic metabolites.
Interpretation
Toxic concentrations are those greater than or equal to 20 mg/dL
Cautions
Propionic acid produced in the rare inborn error of metabolism methylmalonic acidemia may be confused with ethylene glycol in the gas chromatographic assay.
Specimens collected in serum gel tubes are not acceptable, as the drug/analyte can absorb on the gel and lead to falsely decreased concentrations.
Method Description
Ethylene glycol is quantitated in serum by precipitating serum protein with methanol. The supernatant is analyzed by gas chromatography with flame ionization detection.(Unpublished Mayo method)