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Ethylene Glycol (including Propylene Glycol)

Ethylene Glycol Level (Quantitative), Ethylene Glycol and Propylene Glycol Levels

Test Codes

Antrim #13435, EPIC: LAB5898, SOFT: EGPG

Department

Toxicology

Specimen Collection Criteria

Collect: One plain Red-top tube (Minimum Whole Blood: 2.0 mL)

Do not use Serum Separator Tubes.
Record exact time of specimen collection on the tube or in the computer system.

Physician Office/Draw Specimen Preparation

Let specimen clot 30-60 minutes. Refrigerate (2-8°C or 36-46°F) the collection tube within two hours of collection. (Minimum: 2.0 mL blood)

Preparation for Courier Transport

Transport: Collection tube, refrigerated (2-8°C or 36-46°F). (Minimum: 2.0 mL blood)

Rejection Criteria

• Serum Separator (SST) tubes. 
• Severely lipemic or hemolyzed specimens.

In-Lab Processing

Let specimen clot 30-60 minutes. Centrifuge specimen to separate serum from cells. Deliver an aliquot of serum or the collection tube immediately to the appropriate testing station.

Storage

Specimen Stability for Testing:

Room Temperature (20-26°C or 68-78.8°F): 24 hours
Refrigerated (2-8°C or 36-46°F): 7 days
Frozen (-20°C/-4°F or below): 3 months

Specimen Storage in Department Prior to Disposal:

Frozen (-20°C/-4°F or below): 2 months

Laboratory

Royal Oak Toxicology Laboratory

Performed

Sunday – Saturday, 24 hours a day. 
STAT results available within 1 hour of receipt in the Laboratory.  
Routine results available within 24 hours.

Reference Range

Ethylene Glycol
None detected.
Critical: Greater than 50 mg/dL.

Propylene Glycol
None detected.
Critical: Greater than 40 mg/dL.

Test Methodology

Gas Liquid Chromatography with Flame Ionization Detection (GC/FID).

This test was developed and its performance characteristics determined by Beaumont Health. It has not been cleared or approved by the FDA. The Laboratory is regulated under CLIA as qualified to perform high-complexity testing. This test is used for clinical purposes and should not be regarded as investigational or for research.

Interpretation

Ethylene glycol can cause significant metabolic acidosis and renal damage. Ethylene glycol levels above 50 mg/dL may require hemodialysis and, if the time after ingestion is not known, lower levels may require dialysis.

Antidotal treatment for Ethylene glycol intoxication is Ethanol administration. Follow-up treatment should include monitoring Ethylene glycol and Ethanol to follow the rate of decline of the former and to insure adequate levels of the latter are maintained (100 mg/dL).

Propylene glycol is considerably less toxic than Ethylene glycol. It is also a primary ingredient of some anti-freezes (Sierra, Evergreen) and is a solubilizing agent in a number of intravenous medications. Treatment should be a consideration for concentrations in excess of 40 mg/dL.

Clinical Utility

This assay is used to confirm and monitor ethylene glycol toxicity. Ethylene glycol is the active ingredient in automobile antifreeze. It is occasionally consumed as a substitute for ethanol. The inebriating effects of ethylene glycol are similar to those of ethanol. The toxic manifestations of ethylene glycol ingestion may include central nervous system depression, nausea, vomiting, muscle paralysis, ataxia, renal failure, congestive heart failure, pulmonary edema, convulsions, and coma.

CPT Codes

Ethylene: 82693, Propoylene: 84600
LOINC:  Propolene Glycol 12552-6, 5646-5

Contacts

Last Updated

1/26/2023