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Int J Legal Med (2008) 122:235239 DOI 10.1007/s00414-007-0218-y
CASE REPORT
Measurement of direct ethanol metabolites in a case of a former driving under the influence (DUI) of alcohol offender, now claiming abstinence
Friedrich M. Wurst & Michel Yegles & Christer Alling &
Steina Aradottir & Jutta Dierkes &
Gerhard A. Wiesbeck & Claudia C. Halter &
Fritz Pragst & Volker Auwaerter
Received: 20 January 2006 / Accepted: 16 November 2007 / Published online: 6 February 2008 # Springer-Verlag 2007
Abstract A 37-year-old female subject had been convicted of driving under the influence of alcohol, and 19 months later, claimed abstinence after supervised disulfiram treatment. Our aim was to elucidate the value of direct ethanol metabolites as measures of abstinence. Ethyl glucuronide (EtG) and fatty acid ethyl esters (FAEE) in hair, phosphatidylethanol in whole blood and EtG and ethyl sulphate in urine were measured. The results were compared with
F. M. Wurst : G. A. Wiesbeck Psychiatric University Hospital, University of Basel, Basel, Switzerland
M. Yegles Laboratoire National de Sant, Toxicologie, Universit du Luxembourg,Luxembourg, Luxembourg
C. Alling : S. Aradottir Department of Medical Neurochemistry, Lund, Sweden
J. DierkesInstitute of Clinical Chemistry, Otto von Guericke University, Magdeburg, Germany
C. C. Halter : V. Auwaerter (*)
Institute of Legal Medicine, University Hospital Freiburg, Albertstr. 9,79104 Freiburg, Germanye-mail: [email protected]
F. PragstInstitute of Legal Medicine, Humboldt University, Berlin, Germany
F. M. WurstChristian-Doppler-Clinic, Paracelsus Medical University, Salzburg, Austria
self-report of alcohol consumption and traditional blood biomarkers for chronically elevated alcohol consumption as carbohydrate deficient transferrin (CDT), gamma glutamyl transpeptidase, mean corpuscular erythrocyte volume, aspartate aminotransferase and alanine aminotransferase. EtG was found in distal parts of hair only, whereas the proximal parts were negative. Furthermore, FAEE concentrations were found in the typical distribution over the hair length and showed values typical for either moderate social drinking or abstinence. CDT was above cut-off in 9 out of 16 analyses with a decreasing tendency and the lowest values in the last 2 months before the end of sampling. The data suggest that in addition to traditional markers, a combination of direct ethanol metabolites can be useful in the expert assessment of judging driving ability. A careful individual interpretation of the results for the different markers, however, is an absolute necessity.
Keywords Alcoholism ....