A case of glyphosate poisoning with falsely elevated creatinine levels measured by dry chemistry methods

Abstract

Background

The ingestion of glyphosate herbicides can cause severe acute kidney injury. We present a case of glyphosate poisoning in which creatinine levels were falsely elevated when measured using a dry chemistry analyzer.

Case Presentation

An 83-year-old man ingested glyphosate herbicide during a suicide attempt and presented with gastrointestinal symptoms. A dry chemistry analyzer showed high creatinine levels (10.62 mg/dL); thus, the patient was transported to our hospital for renal replacement therapy. However, enzymatic testing showed a lower creatinine level (1.36 mg/dL). Further investigation comparing creatinine measurements revealed a high creatinine level only through the dry chemistry method, despite the relatively low glyphosate concentration (55 mg/L).

Conclusion

The dry chemistry method falsely shows an elevated creatinine value, which may affect clinical decisions regarding the management of patients with glyphosate poisoning. Careful interpretation of creatinine measurements using the dry chemistry method is important in glyphosate poisoning cases.