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Summary
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.
- acute renal failure
- poisoning
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Footnotes
Contributors All authors have contributed substantially to this case report, including writing up draft and critically reviewing the clinical content and interpretation of the data. DP: contributed to measuring creatinine by enzymatic method, interpretation of data and performing literature searches and writing up the case and facilitating the revisions. LH: contributed to measuring creatinine by enzymatic method, interpretation of data and performing literature searches and writing up the case. DS: clinical management of the case in close liaison with the lab, asked the patient for permission to report the case anonymously and helped with writing up the case report. MA-J: contributed to early recognition of the false AKI alert, interpretation of the data and getting the patient’s written consent and writing up the case.
Competing interests None declared.
Patient consent Obtained.
Provenance and peer review Not commissioned; externally peer reviewed.