Citation

Franken LG, Andrews LM, Slooff VD, de Wildt SN, Koch BC. Ther. Drug. Monit. 2015; 38(1): 1-3.

Affiliation

1Dept. of Hospital Pharmacy, Erasmus Medical Centre, Rotterdam, the Netherlands. 2 Intensive Care and Dept. of Paediatric Surgery, Erasmus Medical Centre-Sophia Children's Hospital, Rotterdam, the Netherlands.

Copyright

(Copyright © 2015, Lippincott Williams and Wilkins)

DOI

10.1097/FTD.0000000000000244

PMID

26327308

Abstract

The authors discuss the case of a 14 year old girl who was transferred to the ICU of our hospital with an ethanol intoxication (3.3 g/L), loss of consciousness (E5M3V1) and severe amnesia upon recovery who was suspected of a gamma-hydroxybutyric acid (GHB) intoxication. STAT toxicology screening may be necessary, when sexual assault under GHB intoxication is suspected. Therefore the initial analysis of a urine sample was performed with a new enzymatic assay analysis for GHB. The enzymatic assay reported a GHB concentration of 26mg/L which is above the cut-off value of 10 mg/L. This cut-off value is to differentiate endogenous and exogenous levels since low levels of GHB occur naturally in the body. However, confirmation of these results by gas chromatography (GC), which is common practice to confirm a positive GHB, gave a negative result. This discrepancy is probably contributed to interference of ethanol with the assay. This is a substantial downside of the GHB rapid screen, since the combination of GHB and ethanol is common. It is therefore advised when using the rapid screen to confirm positive GHB results lower than 50 mg/L with GC. This way false-positive results and consequent inappropriate social and legal actions may be avoided.

Language: en