دورية أكاديمية
Accidental digitoxin intoxication: an interplay between laboratory and clinical medicine
| العنوان: | Accidental digitoxin intoxication: an interplay between laboratory and clinical medicine |
|---|---|
| المؤلفون: | Castello, Luigi M, Medicina e Chirurgia d’Accettazione e d’Urgenza, Azienda Ospedaliero-Universitaria Maggiore della Carità, Scuola di Specializzazione in Medicina d’Emergenza-Urgenza, Dipartimento di Medicina Traslazionale, Università del Piemonte Orientale, Novara, Italy, Negro, Sophie, Santi, Francesca, Zanotti, Isabella, Vidali, Matteo, Laboratorio Ricerche Chimico-Cliniche, Azienda Ospedaliero-Universitaria Maggiore della Carità, Dipartimento di Scienze della Salute, Università del Piemonte Orientale, Novara, Italy, vidali@med.unipmn.it, Bagnati, Marco, Bellomo, Giorgio, Avanzi, Gian Carlo |
| المصدر: | Biochemia Medica (editorial_office@biochemia-medica.com); Vol.22 No.3 |
| بيانات النشر: | Medicinska naklada; marketing@medicinskanaklada.hr |
| سنة النشر: | 2012 |
| المجموعة: | Hrčak - Portal of scientific journals of Croatia / Portal znanstvenih časopisa Republike Hrvatske |
| مصطلحات موضوعية: | digitalis glycosides/poisoning, digitoxin, digoxin antibodies Fab fragments, digitoxin/toxicity, digitoxin/analysis |
| الوصف: | Introduction: Two Italian adults arrived at the Emergency Department referring diarrhea, nausea and vomiting for 4 days; weakness, fatigue and visual hallucinations were also complained of. Patients reported the ingestion of some leaves of a plant, which they supposed to be "donkey ears", a week before. Physical examination showed hypotension and bradycardia and ECG examination disclosed sinus rhythm and repolarization abnormalities (scooping of the ST-T complex) in both patients and a 2:1 AV block in the man. Materials and methods: Digoxin concentration was evaluated twice for each patient (at the admission and after 4 hours) by the automated immunoassay system ADVIA Centaur®. Digitoxin concentration was evaluated by liquid chromatography-mass spectrometry (LC-MS/MS). Results: Despite clinical picture was suggestive of digitalis intoxication, digoxin levels were undetectable. Due to the more severe clinical picture, the male patient was treated with anti-digoxin antibodies (Digifab®) achieving a good clinical improvement and remission of the AV block within two hours. Initial diagnosis was confirmed by LC-MS/MS showing high digitoxin concentrations, but digoxin was undetectable. Patients remained stable and 48 hours later were discharged from the hospital. Conclusion: Whereas digoxin determination frequently relies on monoclonal antibodies which do not cross-react to digitoxin, polyclonal antibodies constituting Digifab® recognize a large spectrum of cardiac glycosides, including digitoxin. This report emphasizes the primary role of the clinical approach to patients in the emergency setting and how an active communication and a continuous sharing of professional experiences between Laboratory and Clinicians ensure an early and correct diagnosis. |
| نوع الوثيقة: | text |
| وصف الملف: | |
| اللغة: | English |
| العلاقة: | http://hrcak.srce.hr/89409Test; http://hrcak.srce.hr/file/132407Test |
| الإتاحة: | http://hrcak.srce.hr/89409Test http://hrcak.srce.hr/file/132407Test |
| حقوق: | Full-text papers can be used for personal or educational purposes only. Authors' and publisher's copyrights must be acknowledged. |
| رقم الانضمام: | edsbas.21A5487F |
| قاعدة البيانات: | BASE |
| الوصف غير متاح. |