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Related Experiment Videos

Interference from digoxin-like immunoreactive substance(s) in commercial digoxin kit assay methods.

R G Morris1, D B Frewin, N C Saccoia

  • 1Department of Clinical Pharmacology, Queen Elizabeth Hospital, Woodville South, South Australia.

European Journal of Clinical Pharmacology
|January 1, 1990
PubMed
Summary

Digoxin-like immunoreactive substances (DLIS) interfere with many commercial digoxin tests. This interference, particularly in cord blood, can impact patient management and requires careful consideration of assay methods.

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Area of Science:

  • Clinical Chemistry
  • Pharmacology
  • Immunochemistry

Background:

  • Digoxin assays are crucial for therapeutic drug monitoring.
  • Digoxin-like immunoreactive substances (DLIS) are endogenous compounds that can interfere with digoxin measurements.
  • The clinical significance of DLIS interference in various commercial digoxin assays remains a concern.

Purpose of the Study:

  • To evaluate the extent of DLIS interference in 10 commercially available digoxin assay methods.
  • To compare the performance of radioimmunoassays (RIA) and non-radioactive immunoassays in the presence of DLIS.
  • To identify digoxin assay methods with minimal DLIS interference.

Main Methods:

  • Tested 10 commercial digoxin assay methods (5 RIA, 5 non-radioactive immunoassays).

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  • Analyzed 55 maternal venous blood specimens (third trimester and delivery) and 32 cord blood samples.
  • Assessed interference from endogenous DLIS in non-digoxin-medicated subjects.

    • Main Results:

    • Significant DLIS interference was observed across tested digoxin assays, with cord blood showing values up to 1.1 µg/L.
    • The "Coat-a Count" RIA and EMIT column method (Cobas MIRA) demonstrated the least DLIS interference.
    • The Delfia Method consistently exhibited the highest cross-reactivity with DLIS.

    Conclusions:

    • DLIS interference remains a persistent issue in several commercial digoxin assay methods.
    • The variability in DLIS interference across different assays necessitates careful selection of methods.
    • Inaccurate digoxin measurements due to DLIS interference may compromise patient management decisions.