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Test Code ETGR Ethyl Glucuronide Screen with Reflex, Random, Urine


Ordering Guidance


For situations where chain of custody is required, a Chain of Custody Kit (T282) is available. For chain-of-custody testing, order ETGX / Ethyl Glucuronide Confirmation, Chain of Custody, Random, Urine.



Additional Testing Requirements


If urine creatinine is required or adulteration of the sample is suspected, the following test should also be ordered, ADULT / Adulterants Survey, Random, Urine.



Specimen Required


Supplies: Sarstedt Aliquot Tube, 5 mL (T914)

Collection Container/Tube: Plastic urine container

Submission Container/Tube: Plastic, 5 mL tube

Specimen Volume: 5 mL

Collection Instructions:

1. Collect a random urine specimen.

2. No preservative.


Forms

If not ordering electronically, complete, print, and send a Therapeutics Test Request (T831) with the specimen.

Useful For

Screening and confirmation for drug abuse involving alcohol

Profile Information

Test ID Reporting Name Available Separately Always Performed
ETGS Ethyl Glucuronide Screen, U Yes Yes

Reflex Tests

Test ID Reporting Name Available Separately Always Performed
ETGC Ethyl Glucuronide Confirmation, U Yes No

Testing Algorithm

Testing begins with a screening assay. If the screen is positive, then the liquid chromatography tandem mass spectrometry confirmation with quantification will be performed at an additional charge.

Method Name

Immunoassay

Reporting Name

Ethyl Glucuronide Scrn w/Reflex, U

Specimen Type

Urine

Specimen Minimum Volume

2.5 mL

Specimen Stability Information

Specimen Type Temperature Time Special Container
Urine Refrigerated (preferred) 28 days
  Frozen  28 days
  Ambient  72 hours

Reject Due To

  All specimens will be evaluated at Mayo Clinic Laboratories for test suitability.

Clinical Information

Ethyl glucuronide is a direct metabolite of ethanol that is formed by enzymatic conjugation of ethanol with glucuronic acid. Alcohol in urine is normally detected for only a few hours, whereas ethyl glucuronide can be detected in the urine for 1 to 3 days.

 

This procedure uses immunoassay reagents that are designed to produce a negative result when no drugs are present in a natural (ie, unadulterated) specimen of urine; the assay is designed to have a high true-negative rate. Like all immunoassays, it can have false-positives due to cross-reactivity with natural chemicals and drugs other than those they were designed to detect. The immunoassay can also have false negatives due to the antibody's ability to cross react with different drugs in the class being screened. When the screen result is positive, liquid chromatography tandem mass spectrometry will be performed to confirm the result.

Reference Values

Negative

Screening cutoff concentration: 500 ng/mL

Interpretation

If the screen result is negative, ethyl glucuronide concentrations were not detected.

 

If the screen result is positive, then confirmation by liquid chromatography tandem mass spectrometry will be performed.

 

A positive interpretation will be given if either the ethyl glucuronide (EtG) result is greater than or equal to 250 ng/mL and/or the ethyl sulfate (EtS) is greater than or equal to 100 ng/mL.

 

A "high" positive (ie, >1000 ng/mL) may indicate:

-Heavy drinking on the same day or previously (ie, previous day or 2).

-Light drinking the same day

 

A "low" positive (ie, 500-1000 ng/mL) may indicate:

-Previous heavy drinking (ie, previous 1 3 days).

-Recent light drinking (ie, past 24 hours).

-Recent intense "extraneous" exposure (ie, within 24 hours or less).

 

A "very low" positive (ie, 100-500 ng/mL) may indicate:

-Previous heavy drinking (ie, 1-3 days)

-Previous light drinking (ie, 12-36 hours).

-Recent "extraneous" exposure.(2)

Day(s) Performed

Monday through Saturday

Report Available

Same day/1 to 2 days

Specimen Retention Time

14 days

Performing Laboratory

Mayo Clinic Laboratories in Rochester

Test Classification

This test was developed and its performance characteristics determined by Mayo Clinic in a manner consistent with CLIA requirements. It has not been cleared or approved by the US Food and Drug Administration.

CPT Code Information

80307

LOINC Code Information

Test ID Test Order Name Order LOINC Value
ETGR Ethyl Glucuronide Scrn w/Reflex, U 58375-7

 

Result ID Test Result Name Result LOINC Value
63420 Ethyl Glucuronide Screen, U 58375-7