Leonard Charlene P, Akhtar Javed
Division of Pediatric Critical Care Medicine, Wolfson Children's Hospital, Jacksonville, FL, USA.
Pediatr Crit Care Med. 2007 Jul;8(4):392-3. doi: 10.1097/01.PCC.0000269393.00760.71.
To report a case of co-ingestion of methanol and nitromethane in a child in order to heighten the awareness of false elevation of serum creatinine from nitromethane ingestion.
Case report.
Pediatric intensive care unit.
A 4-yr-old previously healthy girl ingested an unknown quantity of "Blue Thunder" model-engine fuel, which consisted of methanol and nitromethane. The patient was treated with fomepizole for methanol ingestion using elevated creatinine level as a reason for treatment.
The patient was asymptomatic but her creatinine level increased ten-fold (from 0.4 mg/dL to 4 mg/dL) within 6 hrs. Blood urea nitrogen, anion gap, and osmolar gap remained within normal limits. When the serum creatinine level was measured with enzymatic method instead of Jaffe's method, a normal creatinine level was obtained. The falsely elevated creatinine level was due to nitromethane.
The falsely elevated serum creatinine levels due to nitromethane ingestion can lead to unnecessary therapeutic interventions. We intend to heighten awareness of this potential misstep by reporting this case.
报告一例儿童同时摄入甲醇和硝基甲烷的病例，以提高对因摄入硝基甲烷导致血清肌酐假性升高的认识。
病例报告。
儿科重症监护病房。
一名4岁既往健康的女孩摄入了未知量的“蓝色雷霆”模型发动机燃料，该燃料由甲醇和硝基甲烷组成。患者因肌酐水平升高，以甲醇中毒为由接受了甲吡唑治疗。
患者无症状，但6小时内其肌酐水平升高了10倍（从0.4mg/dL升至4mg/dL）。血尿素氮、阴离子间隙和渗透压间隙仍在正常范围内。当采用酶法而非贾菲法测量血清肌酐水平时，得到了正常的肌酐水平。肌酐水平假性升高是由于硝基甲烷所致。
因摄入硝基甲烷导致的血清肌酐水平假性升高可导致不必要的治疗干预。我们希望通过报告该病例来提高对这一潜在失误的认识。
