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False-positive enzymatic alcohol results in perimortem specimens
Bishop-Freeman, S. C., Bertholf, R. L., Powers, R. H., Mayhew, L. C., & Winecker, R. E. (2020). False-positive enzymatic alcohol results in perimortem specimens. Laboratory Medicine, 51(4), 394-401. https://doi.org/10.1093/labmed/lmz082
Herein, we present 2 cases referred to the North Carolina Office of the Chief Medical Examiner (NC OCME) in which ethanol results reported by different hospital laboratories, using alcohol dehydrogenase (ADH)-based assays, were positive, whereas results of headspace gas chromatography testing performed in the NC OCME laboratory were negative. Literature reports suggest that false-positive ethanol measurements from ADH-based assays can occur when a combination of elevated lactate and lactate dehydrogenase (LD) are present in the specimen. The results were reported in perimortem specimens collected from 2 children with unrelated medical conditions. The cases and associated clinical parameters are considered based on the lactate/LD explanation for the false-positive results, to facilitate the recognition of circumstances that can produce erroneous serum ethanol results.
