Wallach's Interpretation of Diagnostic Tests: Pathways to Arriving at a Clinical Diagnosis (670 page)

   Oral contraceptives

   Pregnancy

   Limitations

   In clinical practice, one of the two dye-binding assays—bromocresol green (BCG) and bromocresol purple (BCP)—is used for measuring albumin levels, and systematic differences between these methods have long been recognized.

   BCG methods are subject to nonspecific interference from binding to nonalbumin proteins, whereas BCP is more specific. BCP has been shown to underestimate serum albumin in pediatric patients on hemodialysis and patients in chronic renal failure. Chronic dialysis units often have little influence over the method.

   Antialbumin antibodies are commonly found with hepatic dysfunction and are typically of IgA type.

   Ischemia-modified albumin, in which the metal-binding capacity of albumin has decreased due to exposure to ischemic events, is a biologic marker of myocardial ischemia.

ALCOHOLS (VOLATILES, SOLVENTS)
*

   Definition

   Alcohols are organic compounds that contain the −OH group, including methanol (CH
₃
OH), ethanol (ethyl alcohol; C
₂
H
₅
OH), isopropanol (rubbing alcohol), and methanol (wood alcohol). Although acetone (CH
₃
COCH
₃
) is a ketone, not an alcohol, it is included in this group, because it is often detected in the same testing methodology.

   
Normal range:

   Ethanol: <10 mg/dL.

   50 mg/dL: decreased inhibition, slight incoordination

   100 mg/dL: slow reaction time; altered sensory ability