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Endogenous digoxin-like immunoreactive factors: impact on digoxin measurements and potential physiological
Clinical Chemistry
|September 1, 1985
Summary
Endogenous digoxin-like immunoreactive factors (DLIF) are found in various patient groups, potentially causing inaccurate digoxin measurements. These factors exist in different protein-bound states, with altered distribution in renal failure, pregnancy, and newborns.
Area of Science:
- Clinical Chemistry
- Pharmacology
- Endocrinology
Background:
- Endogenous digoxin-like immunoreactive factors (DLIF) are reported in conditions like renal failure, liver failure, pregnancy, and newborns.
- These factors cross-react with digoxin antibodies in immunoassays, leading to potential measurement errors.
Purpose of the Study:
- To summarize findings on DLIF, including their presence, states in serum, and implications.
- To investigate the distribution and detection of DLIF in different physiological and pathological states.
Main Methods:
- Review of laboratory findings from own and other research groups.
- Analysis of DLIF states in serum: tightly protein-bound, weakly protein-bound, and unbound.
- Comparison of DLIF distribution in normal subjects versus patients in renal failure, pregnant women, and newborns.
Main Results:
- DLIF are present in various biological fluids and patient groups.
- In normal subjects, DLIF are predominantly tightly protein-bound (>90%) and not easily detected.
- In renal failure, pregnancy, and newborns, there is a redistribution towards weakly bound and unbound DLIF, increasing detected values.
Conclusions:
- Increased apparent digoxin levels in certain groups are due to altered DLIF distribution, not necessarily increased total DLIF.
- Carrier proteins likely play a significant role in DLIF transport.
- Understanding DLIF is crucial for accurate drug measurement and clinical interpretation.
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