Resolving discrepant digoxin results: A case study involving multiple interferences

Journal of Clinical Ligand Assay

Volumn 19, Issue 2, 1996, Pages 131-137

  Jortani, Saeed A ^a   Miller, James J ^a   Valdes Jr , Roland ^a  

^a University of Louisville School of Medicine   (United States)

Author keywords

Background fluorescence; Crossreactivity; Digoxin like immunoreactive factors; High performance liquid chromatography

Indexed keywords

DIGOXIN;

AGED; ARTICLE; CASE REPORT; DRUG ANALYSIS; DRUG BLOOD LEVEL; HIGH PERFORMANCE LIQUID CHROMATOGRAPHY; HUMAN; HUMAN TISSUE; IMMUNOASSAY; INCUBATION TIME; MALE; RADIOIMMUNOASSAY; ULTRAFILTRATION;

EID: 0029999564     PISSN: 10811672     EISSN: None     Source Type: Journal    
DOI: None     Document Type: Article

References (23)

1. Howanitz PJ, Steindel, SJ: Digoxin therapeutic monitoring practice, A College of American Pathologists Q-Probes study of 666 institutions and 18679 toxic levels. Arch Pathol Lab Med 1993;117:684-690.
2. Physicians' Desk Reference: Lanoxin Tablets. Montvale: Medical Economics Company Inc., 1992, pp 783-786.
3. Hoffman BF, Bigger T Jr: Digitalis and allied cardiac glycosides. In: Gilman AG, Rall TW, Nies AS, Taylor P, (eds): Goodman and Gilman's Pharmacological Basis of Therapeutics, 8th ed. New York: Macmillan, 1990, pp 814-839.
4. Craver JL, Valdes R, Jr: Anomalous serum digoxin concentrations in uremia. Ann Intern Med 1983;98:483-484.
5. Gault H, Vasdev S, Valasses P, et al: Interpretation of serum digoxin values in renal failure. Clin Pharmacol Ther 1986;39:530-536.
6. Valdes R Jr, Graves SW, Brown BA, et al: Endogenous substances in newborn infants causing false positive digoxin measurements. J Pediatr 1983;102:947-950.
7. Doolittle MH, Lincoln K, Graves SW: Unexplained increases in serum digoxin: a case report. Clin Chem 1994;40:487-492.
8. Lukas DS, De Martino AG: Binding of digitoxin and some related cardenolides to human plasma proteins. J Clin Invest 1969;48:1041-1053.
9. Christenson RH, Studenberg SD, Beck-Davis S, et al: Digoxin-like immunoreactivity eliminated from serum by centrifugational ultrafiltration before fluorescence polarization immunoreactivity of digoxin. Clin Chem 1987;33:606-608.
10. Graves SW, Sharma K, Chandler AB: Methods for eliminating interferences in digoxin immunoassays caused by digoxin-like factors. Clin Chem 1986;32:1506-1509.
11. Valdes R, Jr., Graves SW, Becker SL: Protein binding of endogenous digoxin-immunoreactive factors in human serum and its variation with clinical condition. J Clin Endocrinol Metab 1985;60:1135-1143.
12. Valdes R, Jr., Miller JJ: Increasing specificity of immunoassays. J Clin Immunoassay 1992;15:87-96.
13. Miller JJ, Valdes R, Jr: Approaches to minimizing interference by cross-reacting molecules in immunoassays. Clin Chem 1991;37:144-153.
14. Valdes R Jr: Endogenous digoxin-like immunoreactive factors: Impact on digoxin measurements and potential physiological implications. Clin Chem 1985;31:1525-1532.
15. Lau BWC, Valdes R, Jr: Criteria for identifying endogenous compounds as digoxin-like immunoreactive factors in humans. Clinica Chemica Acta 1988;175:67-78.
16. Miller JJ, Straub RW, Valdes R, Jr: Digoxin immunoassay with cross-reactivity of digoxin metabolite proportional to their biological activity. Clin Chem 1994;40:1898-1903.
17. R System Operation Manual. Abbott Diagnostics, Abbott Park IL, 1993 pp 6-61.
18. Shaikh IM, Lau BWC, Siegfried BA, et al: Isolation of digoxin-like immunoreactive factors from mammalian adrenal cortex. J Biol Chem 1991;266:13672-13678.
19. Dasgupta A, Peng Y: Dialyzability and binding of digoxin-like immunoreactive factors (DLIF) with serum macromolecules in uremic patients on hemodialysis. Life Sci 1991;49:1603-1609.
20. Qazzaz HMAM, Goudy S, Miller JJ, et al: Treatment of human serum with sulfosalicylic acid structurally alters digoxin and endogenous digoxin-like immunoreactive factors. Ther Drug Monit 1995;17:53-59.
21. Vininig RF, Compton P, McGinley R: Steroid radioimmunoassay-effect of shortened incubation time on specificity. Clin Chem 1981;27:910-913.
22. Matheke ML, Valdes R, Jr: Antibody specificity reduces interference by endogenous digoxin-like immunoreactive factors. J Clin Immunoassay 1989;12:115-121.
23. Rainey PM: Effects of digoxin immune Fab (ovine) on digoxin immunoassays. Am J Clin Pathol 1989;92:779-786.