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Digoxin assay anomalies due to digoxin-specific Fab immunotherapy
1Division of Medical Genetics, Eunice Kennedy Shriver Center for Mental Retardation, Waltham, MA 02254.
DICP : the Annals of Pharmacotherapy
|July 1, 1991
Summary
Digoxin-specific antibody fragments interfere with digoxin testing. A new ultrafiltration method accurately measures serum digoxin levels, aiding treatment of digitalis toxicity and evaluating patients with abnormal protein levels.
Area of Science:
- Pharmacology
- Clinical Chemistry
- Immunology
Background:
- Severe digitalis intoxication is treated with digoxin-specific Fab antibody fragments.
- Standard immunoassays (fluorescence and radioimmunoassays) are used to measure serum digoxin concentrations.
- Accurate monitoring of digoxin levels is crucial for effective treatment and patient safety.
Observation:
- Digoxin-specific Fab antibody fragments significantly interfere with common digoxin immunoassays.
- This interference can lead to inaccurate serum digoxin concentration measurements.
- Existing methods lack the precision needed for patients undergoing antidigoxin immunotherapy.
Findings:
- A rapid ultrafiltration method was developed to overcome Fab-induced assay interference.
- This technique provides accurate and precise determination of free and protein-bound digoxin.
- The method successfully separates digoxin from interfering antibody fragments.
Implications:
- The ultrafiltration method enables precise serum digoxin concentration measurement in patients receiving antidigoxin immunotherapy.
- It serves as a valuable tool for managing digoxin toxicity.
- This technique may also improve the evaluation of digoxin levels in patients with altered plasma protein concentrations.