Mathew Vivek, Ramakrishnan Anantharaman, Srinivasan Ranjini, Sushma K, Bantwal Ganapathi, Ayyar Vageesh
Department of Endocrinology, St. John's Medical College, Bangalore, Karnataka, India.
Indian J Endocrinol Metab. 2013 Oct;17(Suppl 1):S289-91. doi: 10.4103/2230-8210.119616.
We report a 2-month-old child with galactosemia and falsely high glucose readings with a glucometer using mutant variant of quinoprotein glucose dehydrogenase (MutQ-GDH) chemistry. Potentially fatal hypoglycemia could have been induced in the child if insulin infusion had been initiated as per glycemic management protocol. Even though, the product information with the glucometer carries warning regarding interference by high galactose levels, the awareness regarding this interaction is generally poor in many practice settings. Although, false readings have been reported with glucose dehydrogenase pyrroloquinoline quinone (GDH-PQQ) glucometers, to our knowledge this is the first case report of a falsely high glucose reading due to high galactose in a proven case of galactosemia with a glucometer using the MutQ-GDH chemistry (a modified GDH-PQQ chemistry). Our experience has prompted us to write this case report and we suggest avoiding these glucometers in neonates and infants when a metabolic disease is suspected.
我们报告了一名2个月大患有半乳糖血症的儿童，使用含突变型醌蛋白葡萄糖脱氢酶（MutQ-GDH）化学法的血糖仪时出现血糖读数假性升高。如果按照血糖管理方案开始输注胰岛素，该儿童可能会诱发潜在致命的低血糖。尽管血糖仪的产品信息中有关于高半乳糖水平干扰的警告，但在许多实际应用场景中，对这种相互作用的认识普遍不足。虽然已有使用葡萄糖脱氢酶吡咯喹啉醌（GDH-PQQ）血糖仪出现错误读数的报道，但据我们所知，这是首例在确诊的半乳糖血症病例中，使用MutQ-GDH化学法（一种改良的GDH-PQQ化学法）的血糖仪因高半乳糖导致血糖读数假性升高的病例报告。我们的经验促使我们撰写本病例报告，并且我们建议在怀疑患有代谢性疾病的新生儿和婴儿中避免使用这些血糖仪。
