Laboratory Test Information Guide

Details for Ethyl Glucuronide

Test Name: Ethyl Glucuronide
Alternate Name(s): ETG
Laboratory: Core
Specimen Type: Urine (Random)
Collection Information: Random Urine, 5 mL minimum volume is required.
Test Schedule: Referred out Monday-Thursday
Testing is performed Fridays at CAMH
Turnaround time from when specimen
is received in testing laboratory:
Up to 12 days
Mon./Tues. collections received in lab by 1000 will have a TAT of 7 days
Reference Range: Creatinine: 2.0 - 20.0 mmol/L

pH - Urine: 4.6 - 8.0

Ethanol - Urine: ≤2.4 mmol/L

Ethyl Glucuronide:
Negative <100 g/8.8 mmol Cre
Indeterminate 100 - 200 g/8.8 mmol Cre
Positive ≥200 g/8.8 mmol Cre
Effective Date: 2019-05-15
Revised Date: 2021-12-21
Critical Value:  
Interpretive Comments: Ethyl glucuronide (ETG) is a minor metabolite of ethanol. It may be detected in urine for up to 3 days following exposure to alcohol.
Special Processing: If necessary to aliquot urine, transfer to sterile air-tight container to avoid bacterial contamination. Store and send cold or frozen.
Comments: ETG testing is available only for patients under consideration for liver transplant or follow-up. Routine testing for liver transplant is approved for send-out to CAMH.

Priority testing is available for initial ETG testing to allow a patient to be listed on the Transplant List. Testing by CAMH (via ICL) is preferred (notify ICL/CAMH that sample is a priority sample for Transplant Listing).

*Requires Biochemist Approval
Parallel testing to CAMH and Dynacare is available on a case by case bias with Biochemist Approval:
-a quick result is required to list patient for transplant
-There is a significant TAT advantage (>6-7 days) by sending to Dynacare over CAMH
- there is low probability of alcohol use by the patient
- The patient has not been in hospital for a prolonged period of time (Patients in hospital for a prolonged period of time are assumed to have a negative ETG result, and expedited testing through Dynacare is not required)
Method of Analysis: LC-MS/MS (CAMH) preferred methodology (has a more sensitive cutoff for positivity of ≥200 g/8.8 mmol Cre

Alternate Method (Dynacare London): Immunoassay (has a less sensitive cutoff for positivity of 1000 ng/mL)
Critical Information Required:  
Storage & Shipment: Keep urine cold and send to VH referred-out bench immediately. Store and send frozen to ICL.

Samples sent to Dynacare should be refrigerated and sent with Dynacare courier ASAP.
System Codes: 
ETGU/GENX- samples to Dynacare
Referred To: In-Common Laboratories
(sent to CAMH)

Questions? Comments? Contact Laura Gopaul