False negativity to carbohydrate-deficient transferrin and drugs: a clinical case

Biochem Med (Zagreb). 2014 Feb 15;24(1):175-9. doi: 10.11613/BM.2014.020. eCollection 2014.

Abstract

Introduction: In this work we report on the possible effect of the medical therapy on CDT concentration in a chronic alcohol abuser, with known medical history (July 2007 - April 2012) and alcohol abuse confirmed by relatives.

Case history: At the end of 2007, patient displayed the following laboratory results: AST 137 U/L, ALT 120 U/L, GGT 434 U/L, MCV 101 fL and CDT 3.3%. On December 2007, after double coronary artery bypass surgery, he began a pharmacological treatment with amlodipine, perindopril, atorvastatin, isosorbide mononitrate, carvedilol, ticlopidine and pantoprazole. In the next months, until may 2011, the patient resumed alcohol abuse, as confirmed by relatives; however, CDT values were repeatedly found negative (0.8% and 1.1%) despite elevated transaminases and GGT, concurrent elevated ethyl glucuronide concentration (> 50 mg/L) and blood alcohol concentration (> 1 g/L). Alcohol consumption still continued despite increasing disulfiram doses ordered by an Alcohol Rehab Center. On May 2011, the patient was transferred to a private medical center where he currently lives.

Conclusions: This study suggests the possibility that a medical therapy including different drugs may hamper the identification of chronic alcohol abusers by CDT.

Keywords: alcoholism; carbohydrate-deficient transferrin; combination; drug therapy; false negative reactions.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Alcoholism / complications
  • Alcoholism / diagnosis*
  • Biomarkers / analysis*
  • Coronary Artery Bypass
  • Coronary Artery Disease / complications
  • Coronary Artery Disease / drug therapy*
  • Diagnostic Errors*
  • False Negative Reactions
  • Humans
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors / pharmacology
  • Male
  • Transferrin / analogs & derivatives*
  • Transferrin / analysis
  • Transferrin / drug effects

Substances

  • Biomarkers
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors
  • Transferrin
  • carbohydrate-deficient transferrin