Dear All
A male patient discharged on 11/11am from our surgical ward presented to the A&E department at 3pm on 11/11 having accidentally consumed 2-3 mouthfuls of model plane fuel stored in a lemonade bottle. The fuel in question was Byron RACE containing 64% Methanol, 25% Nitro-methane and 16% lubricants. The laboratory results reported on the patient are as follows.
Unit
Male Med
Male Med
A&E
Male Surg
Date
13/11/08
11/11/08
11/11/08
10/11/08
Sodium
139
144
143
143
mmol/L
Potassium
3.9
4.1
4.4
4.1
mmol/L
Chloride
99
102
104
101
mmol/L
Urea
4.1
5.0
5.5
4.7
mmol/L
Picrate Creat
320
497
500
71
m mol/L
Enzymatic Creat
83
81
81
m mol/L
HCO3
27.1
30.1
28.4
31.3
mmol/L
Glucose
5.4
mmol/L
Serum Osmo
305
mosm/Kg
PH
7.36
PO2
5.89
kPa
Pco2
6.7
kPa
Total Bicarb
29.5
mmol/L
The only thing of note from the results is the dramatic increase in creatinine from the result reported on 10/11. The result were recheck and also confirmed on a subsequent samples. As the creatinine did not parallel the urea I requested a rerun using the enzymatic creatinine assay which as you can see gave a result in keeping with the change in the urea compared to the previous result.
I have gone through the list of interferences. The patients is not taking ascorbic acid nor cephalosporin. The patient urine was dipped for ketones which was negative.
I would appreciate any further suggestions as to the potential cause of the discrepancy in the creatinine results.
thanks in anticipation
Derek McKillop
Dr Derek McKillop
Principal Clinical Scientist
Dept Clinical Biochemistry
Craigavon Area Hospital
Southern Health and Social Care Trust
Internal Extension: 3709
Direct Line: 028 38613709
Fax: 028 38334582
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