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

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.

Comparative analysis between CDT in serum and Ethyl glucuronide in hair to define the best reliable tool for the diagnosis of alcohol abuse

“…Some factors that may influence CDT values have been found in literature, leading to a decrease in these values. It has recently been suggested that some drug therapies could reduce the CDT values (Vidali et al, 2014). It would also appear that high body mass index (BMI), high triglyceridemia and low levels of high-density lipoprotein cholesterol (HDL-C) are associated with a reduced sensitivity of CDT response to alcohol intake (Whitfield et al, 2008;Fagan et al, 2014).…”