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HelpTest Code ETGC Ethyl Glucuronide Confirmation, 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 drug panels and specific requests are available: call 800-533-1710.
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: Aliquot tube, 5 mL
Specimen Volume: 1 mL
Collection Instructions:
1. Collect a random urine specimen.
2. No preservative.
Additional Information:
1. No specimen substitutions.
2. STAT requests are not accepted for this test.
3. Submitting less than 1 mL will compromise our ability to perform all necessary testing.
Forms
If not ordering electronically, complete, print, and send a Therapeutics Test Request (T831) with the specimen.
Secondary ID
63421Useful For
Monitoring abstinence in clinical and justice system settings
Method Name
Liquid Chromatography Tandem Mass Spectrometry (LC-MS/MS)
Reporting Name
Ethyl Glucuronide Confirmation, USpecimen Type
UrineSpecimen Minimum Volume
0.5 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 (EtG) and ethyl sulfate (EtS) are minor metabolites of ethanol that are detectable in body fluids following alcohol consumption and, less commonly, following extraneous exposure. EtG and EtS can be detected up to 5 days in urine using a cutoff of 500 ng/mL.(1)
Reference Values
Negative
Interpretation
A positive interpretation will be given if either the ethyl glucuronide (EtG) result is greater than or equal to 250 ng/mL 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)
Cautions
Incidental exposure to alcohol in many daily use products (ie, hand sanitizers, mouthwash) may result in detectable levels of ethyl glucuronide (EtG) or ethyl sulfate (EtS).
In addition, upper respiratory infections as well as beta-glucuronidase hydrolysis may lower levels of EtG but do not seem to affect EtS.(2)
EtG/EtS results should be interpreted in the context of all available clinical and behavioral information.
Clinical Reference
1. Reisfield GM, Goldberger BA, Crews BO, et al. Ethyl glucuronide, ethyl sulfate, and ethanol in urine after sustained exposure to an ethanol-based hand sanitizer. J Anal Toxicol. 2011;35(2):85-91. doi:10.1093/anatox/35.2.85
2. Substance Abuse and Mental Health Services Administration (SAMSHA) Advisory: The role of biomarkers in the treatment of alcohol use disorders, 2012 Revision. HHS; 2012;11(2):1-7. doi:10.1037/e558582006-001
3. Langman LJ, Bechtel LK, Holstege CP. Clinical toxicology. In: Rifai N, Chiu RWK, Young I, Burnham CAD, Wittwer CT, eds. Tietz Textbook of Laboratory Medicine. 7th ed. Elsevier; 2023:chap 43
Method Description
The urine sample is diluted with internal standard in 0.1% formic acid for detection by tandem mass spectrometry.(Unpublished Mayo method)
Day(s) Performed
Monday, Wednesday, Friday
Report Available
3 to 5 daysSpecimen Retention Time
14 daysPerforming 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
80321; G0480 (if appropriate)
LOINC Code Information
| Test ID | Test Order Name | Order LOINC Value |
|---|---|---|
| ETGC | Ethyl Glucuronide Confirmation, U | 93705-2 |
| Result ID | Test Result Name | Result LOINC Value |
|---|---|---|
| 63421 | Ethyl Glucuronide | 58378-1 |
| 36848 | Ethyl Sulfate | 58425-0 |
| 36849 | Ethyl Gluc/Sulfate Interpretation | 69050-3 |