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Related Experiment Videos

Marked digoxin-like immunoreactive factor interference with an enzyme immunoassay.

J A Karboski1, P J Godley, P A Frohna

  • 1College of Pharmacy University of Texas, Austin 78712.

Drug Intelligence & Clinical Pharmacy
|September 1, 1988
PubMed
Summary
This summary is machine-generated.

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Digoxin-like immunoreactive factors (DLIF) can significantly interfere with enzyme immunoassays, leading to falsely elevated serum digoxin concentrations (SDC) in patients with renal insufficiency. Fluorescence polarization immunoassays offer a more reliable alternative in such cases.

Area of Science:

  • Clinical Chemistry
  • Analytical Chemistry
  • Pharmacology

Background:

  • Renal insufficiency can alter drug metabolism and excretion, potentially affecting serum drug concentrations.
  • Digoxin is a cardiac glycoside commonly prescribed for heart failure and arrhythmias.
  • Accurate monitoring of serum digoxin concentration (SDC) is crucial for therapeutic efficacy and toxicity prevention.

Observation:

  • A case report details a 79-year-old female patient with renal insufficiency presenting with elevated SDC by enzyme immunoassay (EIA).
  • Simultaneously analyzed samples using fluorescence polarization immunoassay (FPIA) showed SDCs within the therapeutic range.
  • This discrepancy highlighted a potential interference issue with the EIA method.

Findings:

  • The enzyme immunoassay method demonstrated significant cross-reactivity with digoxin-like immunoreactive factors (DLIF).

Related Experiment Videos

  • This interference resulted in markedly overestimated SDC, potentially leading to incorrect clinical decisions.
  • FPIA proved to be a more accurate method for SDC determination in this patient, unaffected by DLIF.

    • Implications:

    • Clinicians should be aware of potential DLIF interference in EIA digoxin assays, especially in patients with renal impairment.
    • Alternative immunoassay methods, such as FPIA, may be necessary for accurate SDC monitoring in cases of suspected interference.
    • This case underscores the importance of method selection and validation in therapeutic drug monitoring.