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Endogenous digitalis-like factors.

S W Graves

    Critical Reviews in Clinical Laboratory Sciences
    |January 1, 1986
    PubMed
    Summary
    This summary is machine-generated.

    Digoxin-like compounds in the body can interfere with diagnostic tests, leading to inaccurate digoxin level measurements in patients. These substances are found in various conditions, including kidney failure and pregnancy.

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    Area of Science:

    • Biochemistry
    • Clinical Chemistry
    • Pharmacology

    Background:

    • Endogenous compounds in blood and urine exhibit cross-reactivity with digoxin antibodies.
    • This immunoreactivity poses diagnostic challenges for digoxin monitoring via immunoassay.
    • Such substances are detected in digoxin-free patients with renal failure, during pregnancy, and in newborns.

    Purpose of the Study:

    • To investigate the nature and implications of digoxin-like immunoreactive substances.
    • To understand their role in diagnostic inaccuracies and potential physiological functions.

    Main Methods:

    • Characterization of the endogenous compound (small, neutral, nonpeptidic).
    • Analysis of protein binding in serum and conjugation in urine.
    • Association studies with volume homeostasis and hypertension.

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    Main Results:

    • Serum levels of these compounds can mimic therapeutic digoxin levels.
    • Alterations in protein binding contribute to false-positive immunoassay results.
    • The urinary form is likely conjugated.

    Conclusions:

    • Digoxin-like immunoreactive substances can cause significant diagnostic interference.
    • These substances may be involved in regulating volume homeostasis.
    • They are associated with essential and pregnancy-induced hypertension.
    • Measurement of these substances may have independent clinical value.