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A case of divergent digitoxin values under treatment of a patient with acute digitoxin overdose with digitalis antibody fragments

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Summary

A 36 year old male was admitted to the intensive care unit with acute digitalis intoxication after ingestion of 350 digitoxin tablets (=35 mg digitoxin).

He was treated with Fab fragments of a digitalis antiserum raised in sheep, the concentrations of digitoxin in serum, urine and dialysates being measured with two automated digitoxin immunoassays based on fluorescence labelling techniques. Whereas one assay reflected the total digitoxin concentrations, including that bound to the antidote, the other measured only the bioactive “free” form of the drug.

This article examines the use and limitations of both assay systems in assessing and monitoring cases of digitalis poisoning.

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References

  1. Berger S, Teufel M, Arnold D, Lasch P, Hannack D, Niessen KH (1988) Verlauf einer chronischen lebensbedrohlichen Digitalis-Intoxikation im Säuglingsalter unter immunpharmakologischer Behandlung mit Antidigoxin Fab vom Schaf. Monatsschr Kinderheilkd 73:280–282

    Google Scholar 

  2. Clarke W, Ramoska EA (1988) Acute digoxin overdose: use of digoxin-specific antibody fragments. Amer J Emerg Med 6:465–470

    Google Scholar 

  3. Erdmann E, Mair W, Knedel M, Schaumann W (1989) Digitalis intoxication and treatment with digoxin antibody fragments in renal failure. Klin Wochenschr 67:16–19

    Google Scholar 

  4. Hursting MJ, Raisys VA, Opheim KE, Bell JL, Trobaugh GB, Smith TW (1987) Determination of free digoxin concentrations in serum for monitoring Fab treatment of digoxin overdose. Clin Chem 33:1652–1655

    Google Scholar 

  5. Lemon M, Andrews DJ, Binks AM, Georgiou GA (1987) Concentrations of free serum digoxin after treatment with antibody fragments. Brit Med J 295:1520–1521

    Google Scholar 

  6. Lignian H, Vincent JL, Hallemans R (1984) Treatment of severe digitoxin intoxication by digoxin specific Fab antibody fragments. Acta Cardiol Brux 39:301–305

    Google Scholar 

  7. Shumaik GM, Wu AW, Ping AC (1988) Oleander poisoning: treatment with digoxin-specific Fab antibody fragments. Ann Emerg Med 17:732–735

    Google Scholar 

  8. Smolarz A, Roesch E, Lenz E, Neubert H, Abshagen P (1985) Digoxin specific antibody (Fab) fragments in 34 cases of severe digitalis poisoning. J Toxicol Clin Toxicol 23:327–340

    Google Scholar 

  9. Stolshek BS, Osterhout SK, Dunham G (1988) The role of digoxin specific antibodies in the treatment of digitalis poisoning. Med Toxicol Adverse Drug Exp 3:167–171

    Google Scholar 

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Wood, W.G., Färber, P. & Kurowski, V. A case of divergent digitoxin values under treatment of a patient with acute digitoxin overdose with digitalis antibody fragments. Klin Wochenschr 68, 324–327 (1990). https://doi.org/10.1007/BF01649024

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  • DOI: https://doi.org/10.1007/BF01649024

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