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Test Code LAB15592 Ethyl Glucuronide Screen with Reflex, Random, Urine


Specimen Required


Only orderable as part of profile. For more information see CSMEU / Controlled Substance Monitoring Enhanced Profile with Reflex, 21 Drug Classes, High Resolution Mass Spectrometry and Immunoassay Screen, Random, Urine.

 

Container/Tube: Plastic, 60-mL urine bottle

Specimen Volume: 5 mL

Collection Instructions:

1. Collect a random urine specimen.

2. No preservative.


Useful For

Screening for drug abuse involving alcohol

Reflex Tests

Test ID Reporting Name Available Separately Always Performed
ETGC Ethyl Glucuronide Confirmation, U Yes No

Testing Algorithm

Testing begins with a screening assay. If the screen is positive, then the liquid chromatography-tandem mass spectrometry confirmation with quantification will be performed at an additional charge.

Method Name

Only orderable as part of profile. For more information see CSMEU / Controlled Substance Monitoring Enhanced Profile with Reflex, 21 Drug Classes, High Resolution Mass Spectrometry and Immunoassay Screen, Random, Urine.

 

Immunoassay

Reporting Name

Ethyl Glucuronide Scrn w/Reflex, U

Specimen Type

Urine

Specimen Minimum Volume

2.5 mL

Specimen Stability Information

Specimen Type Temperature Time Special Container
Urine Refrigerated (preferred) 28 days
  Frozen  28 days
  Ambient  72 hours

Reject Due To

  All specimens will be evaluated at Mayo Clinic Laboratories for test suitability.

Clinical Information

This procedure uses immunoassay reagents designed to produce a negative result when no drugs are present in a natural (ie, unadulterated) urine specimen; the assay is designed to have a high true-negative rate. Like all immunoassays, it can have a false-positive rate due to cross-reactivity with natural chemicals and drugs other than those they were designed to detect. The immunoassay also has a false-negative rate to the antibody's ability to cross-react with different drugs in the class being screened.

 

Ethyl glucuronide is a direct metabolite of ethanol formed by enzymatic conjugation of ethanol with glucuronic acid. Alcohol in urine is normally detected for only a few hours, whereas ethyl glucuronide can be detected in the urine for 1 to 3 days.

Reference Values

Only orderable as part of profile. For more information see CSMEU / Controlled Substance Monitoring Enhanced Profile with Reflex, 21 Drug Classes, High Resolution Mass Spectrometry and Immunoassay Screen, Random, Urine.

 

Negative

 

Screening cutoff concentration:

Ethyl Glucuronide: 500 ng/mL

Interpretation

This assay only provides a preliminary analytical test result. A more specific alternative method (ie, liquid chromatography-tandem mass spectrometry) must be used to obtain a confirmed analytical result. A positive result using the ethyl glucuronide screen indicates only the potential presence of ethyl glucuronide and does not necessarily correlate with the extent of physiological and psychological effects.

Cautions

Care should be taken when interpreting results since there are many factors (eg, fluid intake and other biologic factors) that may influence a urine test result. It is possible that substances other than those investigated in the specificity study may interfere with the test and cause false-positive or negative results.

Clinical Reference

1. Schmitt G, Aderjan R, Keller T, Wu M. Ethyl glucuronide: an unusual ethanol metabolite in humans. Synthesis, analytical data, and determination in serum and urine. J Anal Toxicol. 1995;19(2):91-94

2. Dahl H, Stephanson N, Beck O, Helander A. Comparison of urinary excretion characteristics of ethanol and ethyl glucuronide. J Anal Toxicol. 2002;26(4):201-204. doi:10.1093/jat/26.4.201

3. Wurst FM, Skipper GE, Weinmann W. Ethyl glucuronide--the direct ethanol metabolite on the threshold from science to routine use. Addiction. 2003;98 (Suppl 2):51-61. doi:10.1046/j.1359-6357.2003.00588.x

4. Zimmer H, Schmitt G, Aderjan R. Preliminary immunochemical test for the determination of ethyl glucuronide in serum and urine: comparison of screening method results with gas chromatography-mass spectrometry. J Anal Toxicol. 2002;26(1):11-16. doi:10.1093/jat/26.1.11

5. Weinmann W, Schaefer P, Thierauf A, Schreiber A, Wurst FM. Confirmatory analysis of ethyl glucuronide in urine by liquid chromatography/electrospray ionization/tandem mass spectrometry according to forensic guidelines. J Am Soc Mass Spectrom. 2004;15(2):188-193. doi:10.1016/j.jasms.2003.10.010

6. Langman LJ, Bechtel LK, Holstege CP. Clinical toxicology. In: Rifai N, Chiu RWK, Young I, Burnham CAD, Wittwer CT, eds. Tietz Textbook of Laboratory Medicine. 7th ed. Elsevier; 2023:454

Method Description

This assay is a homogeneous enzyme-linked immunosorbent assay technique. The assay will be performed semiquantitatively. The assay is based on competition between free drug in the urine sample, and a drug labeled with the enzyme glucose-6-phosphate dehydrogenase for a fixed amount of specific antibody binding sites. Active enzyme converts nicotinamide adenine dinucleotide (NAD+) to NADH, which results in an absorbance change that can be measured spectrophotometrically at 340 nm.(Package insert: DRI Ethyl Glucuronide Assay. Microgenics Corporation; 09/2015)

Day(s) Performed

Monday through Saturday

Report Available

Same/1 to 2 days

Specimen Retention Time

14 days

Performing Laboratory

Mayo Clinic Laboratories in Rochester

Test Classification

This test was developed and its performance characteristics determined by Mayo Clinic in a manner consistent with CLIA requirements. It has not been cleared or approved by the US Food and Drug Administration.

CPT Code Information

80307

LOINC Code Information

Test ID Test Order Name Order LOINC Value
ETGSR Ethyl Glucuronide Scrn w/Reflex, U 58375-7

 

Result ID Test Result Name Result LOINC Value
616033 Ethyl Glucuronide Screen, U 58375-7

NY State Approved

Yes