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Kavain Interference with Amphetamine Immunoassay.

H Madhavaram1, T Patel1, C Kyle1

  • 1LabPlus, Auckland City Hospital, Auckland, New Zealand.

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|December 16, 2020
PubMed
Summary
This summary is machine-generated.

Kavain, found in the kava drink, can cause false positive amphetamine test results in urine immunoassays. Gas chromatography-mass spectrometry confirmed the presence of kavain, not amphetamines, in patient samples.

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Area of Science:

  • Forensic Toxicology
  • Analytical Chemistry

Background:

  • Kava (Piper methysticum) consumption is prevalent in Oceania and Australasia.
  • Kavain is a kava-lactone found in kava, known for ceremonial and recreational use.
  • Unexpected false positive urine immunoassay results for amphetamine-type substances were observed in three patients.

Purpose of the Study:

  • To investigate the cause of false positive amphetamine immunoassay results.
  • To identify the substance responsible for cross-reactivity with amphetamine assays.
  • To determine if kavain, a kava component, interferes with drug testing.

Main Methods:

  • Urine samples were analyzed using Beckman Coulter AU480 immunoassay and gas chromatography-mass spectrometry (GC-MS).
  • Kava powders and authentic kavain standard were tested for cross-reactivity.
  • Kavain standard was analyzed by GC-MS to compare mass fragmentation and retention time.

Main Results:

  • Patient urine samples tested positive for amphetamines by immunoassay but were negative for amphetamine-type substances by GC-MS, containing only kavain.
  • Kava powders and kavain standard demonstrated cross-reactivity with the amphetamine immunoassay, yielding false positive results.
  • GC-MS confirmed the absence of amphetamine-type compounds in kava powders and kavain standard.

Conclusions:

  • Kavain is identified as the cause of false positive amphetamine immunoassay results.
  • This is the first reported instance of kavain causing false positive amphetamine measurements.
  • Clinical laboratories should be aware of potential interference from kava consumption in drug testing.