R. Palmer
Feb 1, 2009
Citations
2
Influential Citations
69
Citations
Quality indicators
Journal
Seminars in diagnostic pathology
Abstract
Ethyl glucuronide (EtG) is a direct phase-II metabolite of ethanol formed through the UDP-glucuronosyl transferase catalyzed conjugation of ethanol with glucuronic acid. It has been detected in many antemortem and postmortem biological matrices using a variety of analytical methods. Due to its long urinary elimination time, detectability in hair, specificity for ethanol exposure, and low detection limits of assays, the use of EtG has been proposed as a marker of recent ethanol intake in a variety of clinical and legal settings, including medical monitoring for relapse, emergency department patient evaluation, postmortem assessments, and transportation accident investigation. However, challenges associated with factors such as establishing appropriate cut-off levels capable of distinguishing between drinking and nonbeverage sources of ethanol exposure, nonuniform laboratory reporting limits, sample stability, and microbial activity substantially complicate accurate interpretation of results. The following review briefly explores the history, utility, and limitations of EtG in contemporary medical and forensic practice.