UNASSIGNED:硝基甲烷是一种主要的硝基烷烃,用作溶剂和可能因摄入而有毒的燃料,吸入,或联系。它的存在可以在暴露者的血清中检测到,但水平是不容易得到指导病人的护理。当临床实验室使用Jaffe测定法测量肌酐时,硝基甲烷已被证明会错误地升高血清肌酐;酶测定不受影响。离体实验表明,血清硝基甲烷与Jaffe测定肌酐升高之间存在线性关系。此病例报告显示,暴露于硝基甲烷后,通过Jaffe测定法测得的肌酐升高,而通过酶测定法测得的肌酐正常。
未经评估:一个21个月大的女孩摄入了未测量数量的爱好燃料,含有甲醇的燃料,硝基甲烷(20%),和用于微型内燃机的润滑油,比如遥控汽车。她最初是在社区医院接受评估的,经验治疗甲醇毒性与fomepizole和叶酸,并转移到大学医院接受进一步管理。摄入后19小时,甲醇低于检测,但是2.63mg/dl的血清肌酐引起了肾损伤的关注。毒理学咨询认识到肌酐是使用Jaffe测定法测量的,并建议使用酶测定法重复肌酐,在正常范围内。患者仍在住院接受进一步评估,这允许她的Jaffe测定肌酐在3天内的趋势。Jaffe测定肌酐显示出逐渐下降;重复酶法测定肌酐保持在正常范围内。
UNASSIGNED:该儿科患者的Jaffe测定肌酐的下降与硝基甲烷的一级清除率一致,以前在成人暴露中已经描述过。这个案例证明了Jaffe分析得出的血清肌酐如何在儿科人群中有用,量化、和趋势硝基甲烷暴露与基本同时使用酶测定法来确定实际肌酐。
UNASSIGNED: Nitromethane is a primary nitroalkane used as a solvent and a fuel that may be toxic by ingestion, inhalation, or contact. Its presence can be detected in serum of exposed persons, but levels are not readily available to guide patient care. Nitromethane has been shown to falsely elevate serum creatinine when clinical laboratories use Jaffe assays to measure creatinine; enzymatic assays are not affected. Ex vivo experiments have demonstrated a linear relationship between serum nitromethane and the elevation in Jaffe assay creatinine. This case report demonstrates an elevation of creatinine measured by Jaffe assay with normal creatinine measurement by enzymatic assay after exposure to nitromethane.
UNASSIGNED: A 21-month-old girl ingested an unmeasured quantity of a hobby fuel, a fuel containing methanol, nitromethane (20%), and lubricants used in miniature internal combustion engines, such as remote-controlled cars. She was initially evaluated at a community hospital, treated empirically for methanol toxicity with fomepizole and folic acid, and transferred to a university hospital for further management. By 19 hours after ingestion, methanol was below detection, but a serum creatinine of 2.63 mg/dl raised concern for kidney injury. Toxicology consultation recognized that the creatinine had been measured using a Jaffe assay and recommended a repeat creatinine using an enzymatic assay, which was within normal limits. The patient remained an inpatient for further evaluation, which permitted trending of her Jaffe assay creatinine over a 3-day period. The Jaffe assay creatinine demonstrated a gradual decline; repeat enzymatic assay creatinine remained within normal limits.
UNASSIGNED: The decline in this pediatric patient\'s Jaffe assay creatinine is consistent with first-order clearance of nitromethane, which has been previously described in adult exposures. This case demonstrates how Jaffe assay-derived serum creatinine may be useful in the pediatric population to establish, quantify, and trend nitromethane exposure with essential concurrent use of an enzymatic assay to determine actual creatinine.