Powell Darren, Hassall Louise, Scholes David, Al-Jubouri Mohammad
Department of Clinical Biochemistry, St. Helens & Knowsley Teaching Hospitals NHS Trust, Prescot, UK.
Department of Acute Medicine, St. Helens & Knowsley Teaching Hospitals NHS Trust, Prescot, UK.
BMJ Case Rep. 2017 Sep 28;2017:bcr-2017-221134. doi: 10.1136/bcr-2017-221134.
We report a case of accidental ingestion of model car fuel (Optifuel) resulting in an apparent elevation of serum creatinine of 274 µmol/L (3.1 mg/dL) as measured by the Jaffe (alkaline picrate) reaction, which resulted in an acute kidney injury (AKI) stage 3 alert being reported. Optifuel contains nitromethane, which has been reported to interfere in the Jaffe reaction causing falsely high creatinine measurements. The laboratory staff were vigilant about this potential interfering substance so repeated the analysis of the creatinine using an enzymatic method that showed a markedly lower result of 47 µmol/L (0.5 mg/dL). This report highlights the ability of nitromethane to potentially mimic AKI and the importance of being aware of the limitations of biochemical tests to avoid misinterpretation of results and instigating inappropriate treatment.
我们报告一例意外摄入模型车燃料（Optifuel）的病例，通过杰氏（碱性苦味酸盐）反应测得血清肌酐明显升高至274µmol/L（3.1mg/dL），这导致报告了急性肾损伤（AKI）3期警报。Optifuel含有硝基甲烷，据报道该物质会干扰杰氏反应，导致肌酐测量值假性升高。实验室工作人员对这种潜在的干扰物质保持警惕，因此使用酶法重复分析肌酐，结果显示明显较低，为47µmol/L（0.5mg/dL）。本报告强调了硝基甲烷可能模拟急性肾损伤的能力，以及认识到生化检测局限性以避免结果误判和引发不适当治疗的重要性。
