Description

Measurement of ethyl glucuronide and ethyl sulfate in the urine can be used to monitor a patient for recent alcohol use. However, a number of factors must be taken into account when interpretting results from these tests.


 

Ethyl glucuronide is produced when ethanol is conjugated with glucuronide by UDP-glucuronosyltransferase (UGT) in the liver. This affects only a tiny fraction of an ingested dose of alcohol.

 

Ethyl sulfate is produced when ethanol is conjugated with sulfate by sulfotransferase.

 

Factor

Effect

urine dilution by excessive fluid intake

negative tests for the glucuronide and sulfate; reporting the result as a ratio to urine creatinine reduces false negatives

urine contamination with bacteria producing glucuronidase

degradation of ethyl glucuronide with false negative result; ethyl sulfate unaffected

urinary tract infection or urine overgrowth with yeast or bacteria

false positive for ethyl glucuronide; ethyl sulfate unaffected; this can be avoided by refrigerating the urine or adding a preservative

therapy with chloral hydrate

metabolite chloral hydrate glucuronide may be misidentified as ethyl glucuronide giving a false positive immunoassay

ingesting baker’s yeast

false positive tests for ethyl glucuronide and ethyl sulfate

drinking non-alcoholic beer

false positive tests for ethyl glucuronide and ethyl sulfate

drinking non-alcoholic wine

false positive test for ethyl sulfate

repeated use of alcohol hand sanitizer

false positive tests for ethyl glucuronide and ethyl sulfate

 


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