FALSE ELEVATION OF SERUM CREATININE FOLLOWING SKIN ABSORPTION OF NITROMETHANE COMPLICATES THE CLINICAL-DIAGNOSIS OF RHABDOMYOLYSIS

A patient had extensive blunt trauma from a a high-speed crash in whic h nitromethane fuel erupted from the fuel tank and soaked into his pro tective multilayer jumpsuit. The clinical diagnosis was complicated be cause the absorption of nitromethane fuel through the skin and by inha lation falsely increased the serum creatinine value when a modified Ja ffe reaction was used in the laboratory. This spurious value was ''unm asked'' by use of an enzymatic method to measure the serum creatinine level. A high serum creatinine value disproportionate to the level of BUN and recent skin exposure to nitromethane were the clinical indicat ions that suggested the differentiation of massive rhabdomyolysis from spurious hypercreatinemia. This spurious value was a confounding fact or in the diagnosis of crush syndrome and rhabdomyolysis.